The extent of undiagnosed HIV infection among emergency department patients: Results of a blinded seroprevalence survey and a pilot HIV testing program

This study was performed to determine the rate of previously undiagnosed HI V infection among patients presenting to an urban emergency department (ED) and to assess the feasibility of routinely offering voluntary HIV testing in this setting, HN serostatus was determined anonymously among consecutive acute medicine and trauma ED patients (aged 18-55) who had blood drawn as part of their medical care. Excess serum was aliquoted and coded with an an onymous study code. Before performing HIV testing, the number of persons wi th previously reported HIV infection was determined by linkage with the sta te HIV/AIDS reporting registry. Concurrent with the blinded HIV serosurvey, ED patients were offered voluntary HIV testing in a pilot program. Overall , 76 of 2,155 (3.5%) adult ED patients in the blinded survey were HIV-serop ositive, 15 of whom (0.7% of those tested, 20% of those HIV-seropositive) h ad no infection previously reported to the state HIV/AIDS registry. In the pilot program, six of the 156 (3.8%) individuals who underwent voluntary HI V testing were HIV-seropositive, including three of 53 (5.6%) individuals w ithout prior HIV testing. Of the six HIV-seropositive subjects, one was pre viously diagnosed, while five of the remaining 155 (3.2%) represented previ ously undiagnosed infections, Overall, 3.5% of ED patients from whom blood was obtained for other reasons tested positive for HIV antibody, 20% of who m were previously undiagnosed. Implementation of the voluntary testing prog ram uncovered newly diagnosed infection among 3.2% of those tested. An ED m ay be an important setting for routinely offering HIV testing, especially f or patients who have not been previously tested for HIV, (C) 2000 Elsevier Science Inc.