In their recent article, Walensky et al1 demonstrated that by instituting a routine, voluntary human immunodeficiency virus (HIV) testing system at their hospital, more HIV tests were performed on inpatients and more new cases of HIV infection were diagnosed per month. This is a significant step toward reducing the number of people in the United States living with undiagnosed HIV or acquired immunodeficiency syndrome. Currently, the standard practice in most hospital settings is targeted testing based on high-risk behaviors such as men having sex with men, injecting drug use, or having multiple heterosexual partners. By using targeted testing, we may be missing a substantial cohort of patients who are HIV positive yet appear to have low or no risk of infection based on routine risk assessment. By concluding that patients who do not report traditional HIV risk factors are at low risk of infection, we continue to miss testing opportunities on an estimated 300 000 persons living in the United States with undiagnosed HIV infection.
Beckwith CG, Lally MA, Flanigan TP. Routine HIV Testing Among Inpatients. Arch Intern Med. 2002;162(19):2252–2253. doi:
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