Late diagnosis of HIV infection is believed to be responsible for high rates of HIV
transmission. The purpose of this study is to determine whether targeted screening versus
routine screening will identify a greater number of HIV infected participants. This study
will also compare the costs of the resources used for targeted screening versus routine
Novel strategies are needed to reduce HIV transmission, particularly among individuals who
are unaware of their HIV status. Emergency departments (EDs) routinely receive individuals
in a medical setting where an opportunity exists to screen them for HIV. The purposes of
this study are to determine whether the proportion of tested participants identified as HIV
infected by targeted screening exceeds routine screening and to determine whether the
program resources used per infected patient identified are lower for targeted screening than
for routine screening.
Participants will be recruited from the University of Cincinnati Emergency Medicine Clinical
Trials Center. The existing ED-based clinical HIV counseling and testing program in a lower
HIV prevalence area will randomly alternate between two strategies for offering testing to
ED participants: 1) targeted screening based on self-reported HIV risk and 2) routine
screening. Participants will be randomly assigned to the targeted or routine screening group
based on their presence in the ED during randomized days and times.
At study entry an interview, blood collection, and counseling will occur. Participants will
be telephoned following their ED visit to be given their negative results. Participants with
positive results will be asked to return to the ED for notification, counseling, and
connections to subsequent care. Participants who are HIV infected will be transferred to the
University of Cincinnati Infectious Disease Center for care.
- Adult participants presenting for care in the ED
- Participants cognitively unable or unwilling to consent for voluntary HIV counseling