Abstract
Despite serving populations emphasized in the Ending the HIV Epidemic Initiative, emergency departments (EDs) infrequently offer routine HIV screening. The objective of this study was to characterize US EDs by whether they screen for HIV and to explore factors associated with screening. We surveyed a random sample of US ED directors to obtain data on ED-level and patient-level characteristics, as well as information on directors' perceived barriers to implementing preventive health services. Using descriptive statistics and regression modeling, we found that EDs that routinely screen for HIV, compared with those that do not, had higher median visit volumes (21 000 vs 12 600), were more often a teaching hospital (12.7% vs 4.3%), and had more availability of social workers (23.6% vs 9.4% had 24 hour/day coverage); their directors also less often expressed strong worry about costs (5.9% vs 28.2%), all significant at P < .05; in the regression analysis, only worry about costs was significant (relative risk = 0.13; 95% CI, 0.03-0.51). Our findings may reflect a need for additional funding and resources allocated to EDs to promote HIV screening.