HIV Testing Strategies in Emergency Departments

Emergency departments (EDs) have emerged as critical venues for identifying undiagnosed HIV infection and linking patients to care. Strategies range from routine opt-out screening within existing blood draws to dedicated point-of-care testing services staffed by counsellors. In high-prevalence settings, non-targeted universal screening policies seek to normalise HIV testing and reduce missed opportunities among patients presenting with acute illness or injury. Integration with electronic health records (EHRs) can automate test offers and clinical reminders, thereby streamlining workflows and minimising dependence on individual provider initiative. Quality improvement models emphasise iterative assessment of barriers such as staffing constraints, consent procedures and stigma, with adaptations to local context driving sustained increases in testing uptake. Across diverse settings, rapid assay technologies facilitate same-visit diagnosis, while structured pathways ensure prompt linkage to antiretroviral therapy and specialist services. Collectively, these approaches demonstrate that embedding HIV testing within emergency care can reach underserved populations, contribute to early detection and support public health objectives for epidemic control.

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HIV Testing Strategies in Emergency Departments publication trend

The graph below shows the total number of articles in hiv testing strategies in emergency departments across all publications each year (not limited to Nature Index journals).

Technical terms

Opt-out testing: An approach where HIV screening is performed routinely unless the patient declines.

Non-targeted universal screening: Offering HIV tests to all ED attendees regardless of risk profile or presenting complaint.

Rapid point-of-care testing: Use of assays that deliver HIV results within minutes at the patient’s bedside.

Linkage to care: Structured referral processes ensuring patients with positive tests access specialist HIV treatment and support services.

References

1. The role of evidence and context for implementing a multimodal intervention to increase HIV testing. Implementation Science (2015).
2. Opt-Out Panel Testing for HIV, Hepatitis B and Hepatitis C in an Urban Emergency Department: A Pilot Study. PLOS ONE (2016).
3. HIV testing in a South African Emergency Department: A missed opportunity. PLOS ONE (2018).
4. A systematic review of emergency department based HIV testing and linkage to care initiatives in low resource settings. PLOS ONE (2017).