Creating and Implementing Wisconsin's First Emergency Department-Based Universal Opt-Out HIV Testing Program

The Centers for Disease Control and Prevention recommends HIV screening for all patients aged 13 to 64. We sought to improve the health of our patient population by enacting universal HIV screening in our emergency departments.

Universal opt-out HIV screening was implemented in 7 southeastern Wisconsin emergency departments and included linkage to care for those diagnosed with HIV.

In the first year of this initiative, 57 565 patients were screened for possible testing and 24 417 patients did not opt out (42.4%). In total, 12 406 HIV tests were performed in the first year of the program.

Our emergency department opt-out HIV screening initiative identified 23 new cases of HIV, approximately 10% of the average number of incident HIV cases in Wisconsin. We linked 96% of persons newly diagnosed with HIV to HIV medical care.