Figure.

Number of HIV tests per month during counselor-based/point-of-care (July 2012–June 2013) and triage- integrated (August 2013–July 2014) testing^a at an academic emergency department in Baltimore, Maryland^b

^aPOC refers to a rapid point-of-care oral HIV test (OraQuick ADVANCE^® Rapid HIV-1/2 Antibody Test, OraSure Technologies, Bethlehem, Pennsylvania). Blood tests refer to blood-based, rapid, fourth-generation HIV Ag/Ab Combo ELISA (Abbott Laboratories, Abbott Park, Illinois).

^bThe data are expressed as total numbers of tests conducted by month. During the period described in the externally staffed approach, 67,844 patients attended the emergency department (ED), of whom 46,818 met age and acuity criteria and were eligible for HIV testing. During the period described in the triage-integrated approach, 69,442 patients attended the ED, of whom 49,697 met age and acuity criteria and were eligible for HIV testing. Thus, although the tests were not standardized to numbers of patients, the patient populations during each phase were of comparable size.

^cIn July 2013, we transitioned from an exclusively supplementary staff-only HIV testing model for ED HIV screening to an integrated staffing model in which triage staff members initiated screening (including test offer, consent, and order) that was integrated into the ED workflow. We allowed for a one-month rollout period (in July) for nurse training and education, and evaluated the screening program from August 2013 through July 2014.

HIV = human immunodeficiency virus

POC = point of care