HIV Testing in US Emergency Rooms Finds Few New Cases

Carol Pearson | Washington
23 July 2010


The goal of rapid HIV testing in emergency rooms is to save lives and prevent the spread of HIV. The U.S. Centers for Disease Control recommends routine HIV screening of patients admitted to hospital emergency rooms, unless the patient refuses or opts-out of the test. But, a study on the testing did not produce the results doctors expected.

Stewart Thomas knows the importance of HIV testing. He was diagnosed with HIV, the virus that causes AIDS, 24 years ago.

"If you have the opportunity to get tested for HIV, and there are so many different places that you can test for free, why wouldn't someone want to find out more information about their health," he asks.

That's exactly why the Centers for Disease Control began recommending rapid HIV screening in emergency departments and other health care settings four years ago.

Researchers at the Denver Health Medical Center set out to evaluate the effectiveness of this kind of testing.

Their study is published in the Journal of the American Medical Association. Dr. Jason Haukoos says the hope was to identify HIV-infected patients early in the disease. But that's not what happened.

"In our study the majority of patients identified with newly diagnosed HIV infection were found late in their disease course," he said.

Another thing is that most patients - 76 percent - opted out of testing. And of those who were tested, only a small number were positive, even though the researchers tested 30 times more people than would normally be tested for HIV.

"It turns out that it didn't work probably quite as well as everyone hoped," Dr. Haukoos said.

While the results may be disappointing, proponents of testing say identifying even a small number of people is worth the effort because early treatment saves lives and can prevent the spread of HIV.

Stewart Thomas says with proper treatment, HIV can be managed.

"I like working. I have a great set of friends," he said. "I'm living my life with HIV."

The study was conducted at only one hospital.

Dr. Haukoos says alternative HIV testing programs are needed to help those who don't know they have the virus.