Routinely recommended HIV testing at an urban urgent-care clinic--Atlanta, Georgia, 2000

In 1993, CDC recommended that hospitals and associated clinics in areas with high human immunodeficiency virus (HIV) prevalence offer HIV testing routinely to all patients aged 15-54 years (1). Although voluntary routine screening among hospitalized (2) and emergency department patients (3) can identify many undiagnosed HIV-infected persons, few screening programs have been implemented in these settings. A 1997 study at Grady Memorial Hospital, Atlanta, Georgia, found that nearly two thirds of inpatients newly diagnosed with acquired immunodeficiency syndrome (AIDS) had received medical care within the Grady health system during the 12 months preceding admission (4 ); these previous encounters were missed opportunities for earlier diagnosis of HIV. In response to the 1997 study, investigators studied routinely recommending HIV testing to patients presenting to the urgent-care clinic, an ambulatory clinic that provides episodic medical care to indigent and low income adults. This report summarizes the results of that study in which, compared with 1999 when testing was based on symptoms or risk behaviors, more patients were tested for HIV, more HIV infections were detected, and more infected persons learned their diagnosis and entered into care. These results reflect the benefits of recommending HIV testing routinely to patients in medical facilities located in areas with high HIV prevalence.