Can HIV Tests Be as Routine as RPRs?

In most sexually transmitted disease (STD) clinics, a rapid plasma reagin (RPR) test for syphilis is part of the initial evaluation of any patient presenting with a new problem. At the Denver Metro Health STD Clinic, investigators explored whether they could make rapid HIV testing as routine as RPR testing.

From late 2003 to early 2005, the clinic instituted a sequence of changes intended to normalize HIV testing: the introduction of optional rapid HIV testing, the gradual phasing out of standard ELISA, and the shifting of the consent process from clinicians to clerical staff and from opt-in to opt-out testing. During the study period, which began 11 months before any changes occurred and ended 19 months after all changes were implemented, R…