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Critical to the mission of an HIV testing program is the capacity to link newly identified patients to care.
The short- and long-term sustainability of the HIV testing program often relies on a dedicated funding source.
The final critical piece of any comprehensive HIV testing program is linkage to long-term HIV care.
Obtaining "buy-in" from the ED staff is most successful when they are knowledgeable about the benefits of a routine HIV testing program.
As such, the HIV testing program should be handled in close collaboration with the infectious disease (ID) division that will often provide the patient's first follow-up visit.
Based on our domestic and international experiences, an HIV testing program in the ED is feasible with appropriate infrastructure and longitudinal support.
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Implementation of routine HIV testing programs should be tailored to the specific international setting conditions.
Numerous international HIV testing programs have been implemented and report a high yield of HIV case identification [28, 36 38].
The goal for HIV testing programs is to optimize the test for the specific setting without compromising test reliability for the patients [1, 26 29].
Over the last decade, several EDs especially those serving high-risk, inner-city populations began developing specific HIV testing programs in this setting.
Most importantly, because of the numerous barriers to follow-up, HIV testing programs in developed and developing countries should emphasize linkage to care protocols that are coordinated among patients, urgent care physicians, and HIV providers.
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