Evolution in testing technology enables some urban EDs to implement HIV screening at relatively low cost.

Despite strong recommendations from the CDC for EDs and other health care settings to implement routine screening for HIV, only a minority of EDs offer HIV screening programs. However, new testing platforms that enable high-volume, laboratory-based blood tests with a reasonable turnaround time for results, are enabling a number of hospitals in urban areas to implement HIV screening for a relatively low cost. Ben Taub General Hospital in Houston now performs opt-out screening for all ED patients who require a blood draw for any reason. Since this testing program began in 2008, Ben Taub has identified 780 patients as HIV positive, and most of these patients had been to the ED multiple times previously without becoming aware of their disease status. The approach has enabled Ben Taub to lower the cost of HIV screening from $77 per test to about $12 per test. Ben Taub uses service linkage workers to connect patients identified as HIV positive with appropriate resources for care.