Missed Testing Opportunities Among HIV-Positive Adults in a Community Emergency Department

Northern Nevada's most utilized emergency department (ED) could represent a locale of missed opportunity for human immunodeficiency virus (HIV) detection, as the ED serves as a source of primary care for many patients at risk for HIV infection. The authors conducted a retrospective chart review, through the electronic health record, evaluating new diagnoses of HIV between 2012 and 2017 within a single hospital system. An opportunity for prior detection of HIV in the hospital's adult ED, within the past 5 years, was recorded as a missed testing opportunity (MTO). Out of 46 new HIV diagnoses at this hospital for a 5-year period, 19 patients with at least one MTO were identified. Eight of these patients with an MTO were diagnosed with acquired immunodeficiency syndrome (AIDS) concomitant with detection of their HIV status. Encouraging earlier HIV detection in the ED could reduce transmission, mortality, and health care expenditures.