Article Document Academic Article Information Content Entity Continuant Continuant Journal Article Entity Entity Generically Dependent Continuant 2025-05-06T12:43:52 RDF description of A comparison of routine, opt-out HIV screening with the expected yield from physician-directed HIV testing in the ED - http://repository.healthpartners.com/individual/document-rn807 HIV-AIDS Cross-Sectional Studies 2022-02-21T22:48:57.408-06:00 document-rn807 A comparison of routine, opt-out HIV screening with the expected yield from physician-directed HIV testing in the ED 10813 10.1016/j.ajem.2014.12.057 Screening Comparative Studies <p>OBJECTIVES: The Centers for Disease Control and Prevention recommends routine opt-out HIV screening in health care settings. Our goal was to evaluate the feasibility and yield of this strategy in the emergency department (ED) and to compare it to the expected yield of physician-directed testing. METHODS: This is a cross-sectional study in an urban ED during random shifts over 1 year. Patients were ineligible for screening if they were younger than 18 years or older than 64, a prisoner, a victim of sexual assault, in an ED resuscitation room, or had altered mental status. Research associates administered rapid HIV tests and conducted standardized interviews. The patients' ED physician, blinded to the HIV result, was asked if they would have ordered a rapid HIV test if it had been available. RESULTS: Of 7756 ED patients, 3957 (51%) were eligible for HIV screening, and 2811 (71%) of those did not opt out. Routine testing yielded 9 new HIV cases (0.32% of those tested; 95% confidence interval, 0.16%-0.63%). Physician-directed testing would have missed most of these infections: 2 of the 785 patients identified by physicians for testing would have been newly diagnosed with HIV (0.25%; 95% confidence interval, 0.04%-1.0%). Of the 9 new HIV cases, 5 established HIV care, and their median CD4 count was 201 cells/muL (range, 71-429 cells/muL). CONCLUSIONS: Routine opt-out HIV screening was feasible and accepted by a majority of ED patients. The yield of this strategy only modestly exceeded what may have been observed with physician-directed testing.<p> Physician's Practice Patterns Emergency Medicine American Journal of Emergency Medicine 4 public 33 16206