Targeted HIV screening in the emergency department

Area of Science:

• Public Health
• Infectious Diseases
• Emergency Medicine

Background:

• Rising global human immunodeficiency virus (HIV) rates necessitate innovative screening strategies.
• Emergency departments (EDs) serve diverse, often underserved populations, presenting an opportunity for HIV testing.
• Current HIV screening methods include opt-out and targeted approaches, with limited data on targeted screening effectiveness in low-prevalence settings.

Purpose of the Study:

• To review the evidence for targeted HIV screening in adult EDs across various HIV prevalence settings.
• To assess the impact, cost-effectiveness, and acceptance of targeted HIV screening in the ED.
• To explore the applicability of targeted screening in low-prevalence areas.

Main Methods:

• Literature review of studies on targeted HIV screening in adult emergency departments.
• Analysis of data from high- and low-HIV prevalence settings.
• Evaluation of screening approaches, including 'opt-out' and 'targeted' methods.

Main Results:

• Targeted HIV screening in the ED is impactful, cost-effective, and well-accepted by patients.
• Implementation challenges include the need for additional funding and staffing, particularly in resource-limited settings.
• Evidence suggests targeted screening may be suitable for both high- and low-prevalence areas.

Conclusions:

• Targeted HIV screening in EDs is a viable strategy for early diagnosis and treatment.
• The approach demonstrates effectiveness and cost-efficiency, though resource allocation is a key consideration.
• Further research and implementation in diverse settings, including low-prevalence areas, are warranted.