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Reducing HIV’s Spread and Stigma with Universal Screening in the ED

Valleywise Health has identified 342 people with undiagnosed HIV since 2011

An estimated 1.2 million Americans are living with HIV, and 1 in 7 are not aware they have it. Diagnosing HIV early can add years to patients’ lives and prevent further spread, but fear of stigma can prevent people from getting tested. Valleywise Health, a county hospital in Phoenix, Arizona began routine testing for all patients in the emergency department, and since 2011, they’ve identified around 350 people who were previously unaware that they had HIV.  

“As a safety-net hospital, many of our patients in the emergency department are at risk for HIV and do not have access to primary care where they can easily get a routine HIV test,” said Kara Geren, MD, an emergency medicine physician at Valleywise. “Offering an HIV test to all patients decreases the stigma of HIV, and helps us address factors that can put patients at risk.”

As patients are triaged in the ED, nurses ask whether they’ve ever been tested for HIV and explain that testing is standard for all patients. If a patient’s test comes back positive, physicians are prompted to set up a consult with a care manager to determine the next steps for the patient’s care.

“We have been able to diagnose patients with HIV before they have symptoms and get them into the care they need to lead a healthy, long life,” Dr. Geren said.

After just two years of universal screening, Valleywise estimated that earlier detection saved $17.9 million in healthcare costs by helping patients get care earlier and prevent further transmission.

Epic community members can learn more about Valleywise’s program on the UserWeb and have Epic staff install it as part of Epic’s Services.