Targeted vs. Nontargeted HIV Screening: The Debate Continues

The CDC recommends nontargeted, opt-out HIV testing in all healthcare settings, but the feasibility and effectiveness of that approach remain controversial. Two recent studies on testing in the emergency department (ED) add to the debate.

In one study, d'Almeida and colleagues evaluated a nontargeted, opt-in screening program implemented at 29 EDs in and around Paris. During the evaluation period, approximately 139,000 visits were made to participating EDs, and 78,411 patients were deemed eligible for screening. Of these, 20,962 were offered a fingerstick rapid test (written consent required), and 13,229 accepted. In the end, 12,754 patients were tested. This group represented 16% of eligible participants and was similar demographically to t…