Journal of the American Medical Association: Routine Opt-Out Rapid HIV Screening And Detection Of HIV Infection In Emergency Department Patients -- This study examines whether widespread routine HIV screening in a busy hospital emergency department (ED) is "associated with identification of more patients with newly diagnosed HIV infection than physician-directed diagnostic rapid HIV testing." Denver Health Medical Center researchers examined the number of new HIV cases identified during three 4-month periods, during which ED patients, 16 or older, were told they would receive a rapid HIV test unless they declined to. Those results were compared with three 4-month periods during which rapid HIV testing occurred when physicians requested it.

Of the 28,043 patients eligible, 6,762 (about 24 percent) did not opt out of testing. Of those, 16 patients were found to have an HIV infection, including 10 who had new diagnoses. In the diagnostic phase, 29,925 patients were eligible and 243 patients (0.8 percent) were screened. HIV infections were confirmed in five of those patients and 4 had new diagnoses. The authors conclude: "Nontargeted opt-out rapid HIV screening in the ED, vs diagnostic testing, was associated with identification of a modestly increased number of patients with new HIV diagnoses, most of whom were identified late in the course of disease" (Haukoos et al., 7/21).