Table 1 Characteristics of three emergency department HIV testing programs
Testing Model | Testing Program Planners | Program Already Existed at CDC Grant Award? | Rapid Test Type | Patient Selection Criteria | Test Offer and Consent | Pre-test Counselling | Test Performer | Test Results and Confirmation | Disclosure | Linkage to Care |
|---|---|---|---|---|---|---|---|---|---|---|
Parallel | ED clinicians | Yes | Oral swab | Non-targeted | Signed opt-out at registration | At the discretion of the tester | Tester, almost 24/7 | Rapid test results in 20 minutes Blood drawn in ED for confirmation | Tester discloses negative results; physician discloses positive results | Referral to guaranteed HIV clinic drop-in appointment |
Provider | HIV clinicians and ED clinicians | Yes | Venipuncture specimen | Targeted to all admitted patients and symptoms/risk factors | Verbal opt-in by physician; implied consent if impacts care | At the discretion of the physician | Hospital laboratory 24/7 | Results available in electronic medical record in 1 to 2 hours Confirmation done on same specimen | Physician discloses negative and positive results | Dedicated HIV clinic-based linkage to care team who will meet patient at disclosure |
Provider -Parallel | HIV clinicians and ED clinicians | No | Oral swab | Non-targeted | Verbal opt-in by triage nurse | None | Tester, almost 24/7 | Blood drawn in ED for confirmation | Physicians disclose negative and positive results | Dedicated linkage to care liaison who will meet patient at disclosure |