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Rapid HIV Testing Program Implementation: Lessons from the Emergency Department
Arbelaez, Christian; Block, Brian; Losina, Elena; Wright, Elizabeth A.; Reichmann, William M.; Mikulinsky, Regina; Solomon, Jessica D.; Dooley, Matthew M.; Walensky, Rochelle P.
BACKGROUND. The US Centers for Disease Control and Prevention (CDC) guidelines and the World Health Organization (WHO) both recommend HIV testing in health-care settings. However, neither organization provides prescriptive details regarding how these recommendations should be adapted into clinical practice in an emergency department. METHODS. We have implemented an HIV-testing program in the ED of a major academic medical center within the scope of the Universal Screening for HIV Infection in the Emergency Room (USHER) Trial—a randomized clinical trial evaluating the feasibility and cost-effectiveness of HIV screening in this setting. RESULTS AND CONCLUSION. Drawing on our collective experiences in establishing programs domestically and internationally, we offer a practical framework of lessons learned so that others poised to embark on such HIV testing programs may benefit from our experiences.