Targeted HIV screening in the emergency department

This article discusses the two main approaches to screening; ‘Opt-out’ screening offers testing routinely in all clinical settings, and ‘Targeted’ screening offers testing to individuals prese nting with indicator conditions. There are many studies of ‘Opt-out’ ED HIV screening in urban areas of high-HIV prevalence. However, little is known about the effectiveness of ‘targeted’ HIV screening, especially in areas of low prevalence. This review discusses the background to HIV screen ing in the ED and reviews the evidence around ‘targeted’ HIV screening in adult EDs in different HIV prevalence settings, concluding that targeted HIV screening at the ED can be impactful, cost-effective, and well accepted in the ED population, but its long-term implementation requires extra fun ding and increased staffing resource limiting its application in low resource setting. Despite most evidence being from areas of high-HIV prevalence, targeted screening might also be appropriate in low-HIV prevalence areas.
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research