HIV Testing and Screening in the Emergency Department

Revised June 2014

Originally approved April 2007

Early diagnosis and treatment for human immunodeficiency virus (HIV) can prolong life, reduce transmission, and is a cost-effective public health intervention.

HIV screening has substantial net benefits to individuals and the public health as recognized by the US Preventive Services Task Force (USPSTF) Level A Grading.¹ 

The USPSTF recommends that clinicians screen for HIV infection in the following populations:

• Adolescents and adults aged 15 to 65 years.
• All pregnant women including those who present in labor who are untested and whose HIV status is unknown.
• Younger adolescents and older adults who are at increased risk for HIV infection.

Emergency department (ED) HIV screening programs deliver the greatest public health impact when:

• Local prevalence of HIV infection is ≥ 0.1%.
• Screening procedures are practical, feasible, and do not interfere with the primary acute care mission of emergency medicine.
• Integration exists between the ED and the resources of the entire health care system.
• Policies and procedures clearly address patient confidentiality, informed consent (state dependent), provider training, opportunities for counseling, and linkage to care.
• Adequate funding or reimbursement is available to meet the operational and personnel costs required for programs sustainability.
• All local and state requirements are met.

HIV testing in the evaluation for acute care conditions in the ED should be available in a timely and efficient fashion similar to testing and results for other conditions.