Seroprevalence study using oral rapid HIV testing in a large urban Emergency Department

Sachin Jain, Erik S. Lowman, Adam Kessler, Jaime Harper, Dino P. Rumoro, Kimberly Y. Smith, Yanina Purim-Shem-Tov, Harold A. Kessler

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: The Centers for Disease Control (CDC) recommends universal human immunodeficiency virus (HIV) testing for patients aged 13-64 years in health care settings where the seroprevalence is > 0.1%. Rapid HIV testing has several advantages; however, recent studies have raised concerns about false positives in populations with low seroprevalence. Study Objectives: To determine the seroprevalence of HIV in our Emergency Department (ED) population, understand patient preferences toward rapid testing in the ED, and evaluate the performance of a rapid oral HIV test. Methods: A serosurvey offered oral rapid HIV 1/2 testing (OraQuick ADVANCE, Bethlehem, PA) to a convenience sample of 1348 ED patients beginning August 2008. Subjects declining participation were asked to complete an opt-out survey. Results: 1000 patients were tested. Twelve had positive results (1.2%), including one who had newly diagnosed HIV infection; 988 patients tested negative. Of these, 335 (33.3%) had never been tested; 640 had prior history of a negative HIV test. No false-positive rapid HIV results were detected; 98.7% received the results of their preliminary HIV test, including 100% of those who tested positive. Most subjects who declined testing cited either a recent negative HIV test (160/348) or low perceived risk (65/348). A minority cited a concern regarding their privacy (11/348) or that the test might delay their treatment (7/348). Conclusions: The seroprevalence estimate of 1.2% was above the rate recommended by the CDC for routine universal opt-out testing in our study population. The acceptance rate of rapid HIV testing and the percentage of patients receiving results approximated other recent reports.

Original languageEnglish (US)
Pages (from-to)e269-e275
JournalJournal of Emergency Medicine
Issue number5
StatePublished - Nov 2012
Externally publishedYes


  • Emergency Department
  • HIV
  • oral
  • prevalence
  • rapid
  • test

ASJC Scopus subject areas

  • Emergency Medicine


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