title: 2009 US emergency department HIV testing practices.
abstract: OBJECTIVE
  We characterize HIV testing practices and programs in US emergency departments (EDs) in 2009.
  
  
  METHODS
  A national Web-based survey of members of the National ED HIV Testing Consortium, participants in the 2007 Centers for Disease Control and Prevention (CDC)-sponsored ED HIV Testing Workshops, all US academic EDs, and a weighted random sample of US community EDs with snowball sampling to recruit additional testing sites was conducted. Data collected included geographic location, estimated seroprevalence, indications for testing, method of consent, weekly number of tests, funding, and costs.
  
  
  RESULTS
  Of 619 sites surveyed, 338 (54.6%) responded. A total of 277 (82.0%) reported conducting any HIV testing, and 75 (22.2%) reported systematic HIV testing programs, operationally defined as having testing or screening organized at the departmental or institutional level. systematic HIV testing programs were concentrated in the Northeast, at high-volume urban EDs, and in regions with higher HIV/AIDS prevalence. Most systematic HIV testing programs had existed for less than or equal to 3 years, and nearly one third reported using an opt-out approach for consent. Among systematic HIV testing programs, the number of patients tested ranged from less than 1 to 2,100 tests per week. Overall, universal screening was the most commonly reported screening method reported overall, and rates of HIV positivity were consistently above the CDC threshold of 0.1%.
  
  
  CONCLUSIONS
  The number of EDs conducting HIV testing has grown substantially since release of the 2006 CDC HIV testing recommendations. Although many EDs have systematic HIV testing programs, the majority do not. Ongoing surveillance will be required to quantify the evolution of ED-based HIV testing and the factors that facilitate or impede expanded translation.
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD 21209, USA. rrothma1@jhmi.edu
authors.forename: Richard E
authors.initials: RE
authors.lastname: Rothman
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Hsieh
authors.forename: Leah
authors.initials: L
authors.lastname: Harvey
authors.forename: Samantha
authors.initials: S
authors.lastname: Connell
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lindsell
authors.forename: Jason
authors.initials: J
authors.lastname: Haukoos
authors.forename: Douglas A E
authors.initials: DA
authors.lastname: White
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Kecojevic
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lyons
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D015658:HIV Infections / Q000175:diagnosis*; D019538:Health Care Surveys; D006801:Humans; D008403:Mass Screening; D014481:United States