Implementing Routine Opt-Out Rapid HIV Testing in an Urban Pediatric/Adolescent Emergency Department using Health Educators and Nurses to Affect Risk Behaviors and Overcome Barriers

Responding to the CDC's recommendation that HIV testing should be integrated into routine patient care and barriers to HIV testing be removed, St. Christopher's Hospital for Children is one of the first pediatric hospitals in Pennsylvania to establish a testing program in the Emergency Department. The Rapid HIV Testing Initiative in the Emergency Department provides sexual health education and counseling to at-risk adolescent patients, safety screening assessment, rapid HIV testing, and additional intensive counseling and linkage to care for those who test positive. This is a fast-paced environment and our goal is to complement and enhance the standard and quality of care provided to adolescent patients by privately offering and providing rapid HIV testing within the duration of their visit. To increase the effectiveness and sustainability of this initiative, buy-in was attained from key personnel among the ED's medical staff to refer patients for HIV testing to the designated HIV Testing Specialist. In the absence of the testing specialist, the nursing staff can perform testing on patients. This initiative is three years old. The HIV testing data indicates that on average we've tested over 1,000 eligible patients (13 and older) annually. Many of whom may not have had access to timely testing in the absence of the initiative. Within the first year of this initiative, the program was expanded to include the escort (i.e., friends and family) of patients coming in to the ED. Overall, the initiative has been effective and widely accepted by healthcare providers, patients and parents.