The following is a summary of “Evaluation of an emergency department opt-out provider-driven HIV and syphilis screening and linkage-to-care program,” published in the March 2024 issue of Emergency Medicine by Scott, et al.

For a study, researchers sought to assess the impact of an opt-out provider-initiated HIV and syphilis screening program on screening, diagnosis, and linkage to care outcomes.

A retrospective review was conducted comparing patients screened pre- (2014–2017) and post (2017–2021) program implementation. Primary outcomes included HIV and syphilis screening rates, incidence of positive tests, and the proportion of patients linked to care. Secondary outcomes comprised pre-exposure prophylaxis (PrEP) referral and successful linkage rates for patients with HIV-negative syphilis-positive .

Pre-implementation, 882 HIV tests were conducted, revealing 22 (2.49%) new cases, with 18 (81.82%) patients linked to care. Additionally, 754 syphilis tests were performed, identifying 33 (4.38%) active infections, with 30 (90.91%) receiving treatment. No eligible patients received PrEP referral. Post-implementation, 12,999 HIV tests were administered, yielding 73 (0.56%) new cases, with 55 (75.34%) individuals linked to care. Furthermore, 10,885 syphilis tests were conducted, detecting 216 (1.98%) active infections, with 188 (87.04%) receiving treatment. A total of 25 (9.09%) eligible patients were referred for PrEP, and four (16.0%) attended their appointment.

Following program implementation, there was a substantial increase in screening rates for HIV (1373.81%) and syphilis (1343.63%), as well as in the detection of positive cases of HIV (231.82%) and syphilis (554.55%). The findings demonstrated the successful integration of dual screening programs into the existing emergency department framework, facilitating increased screening and early detection of HIV and syphilis.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723007076