Study finds new program to enhance HIV screening dramatically boosts testing in urgent care clinics and emergency departments

A new study from researchers at Intermountain Health in Salt Lake City finds that a comprehensive program with a strong focus on education in the health system’s urgent care clinics and emergency departments significantly increased HIV testing for patients being evaluated for other sexually transmitted diseases, helping to increase the number of previously undiagnosed patients who learned they were living with HIV and promptly connected to care.

The Intermountain study, which was published in the medical journal, Clinical Infectious Diseases, found that screening rates for HIV increased by 42 percent in urgent care clinics and by 53 percent in Intermountain emergency department for patients being evaluated for gonorrhea and chlamydia after the multifaceted program was launched. 

This proactive approach was designed to ensure fewer missed opportunities for early HIV diagnosis, in line with national recommendations to offer HIV tests to patients undergoing evaluation for other sexually transmitted infections. 

Throughout the initiative, previously undiagnosed individuals learned they were living with HIV and promptly connected to care. Historically, Utah has ranked last among all states in the proportion of adults ever tested for HIV, highlighting the need for expanded screening in the community. 

“By making HIV testing a routine part of STI evaluations in urgent care clinics and emergency department settings, we’re closing a critical gap in preventive care and advancing health equity for our patients in the community,” said Allan Seibert, MD, an Intermountain Health infectious disease physician and principal investigator of the study. “Diagnosing and linking people with HIV to care early is crucial for improving outcomes and preventing further transmission, which aligns with our mission to help people live the healthiest lives possible.”

The Intermountain HIV co-testing initiative – implemented across 26 Intermountain Health urgent care clinics and 22 hospital emergency departments over an 86,000 square mile area – combined several strategies to drive its success, including clinician and patient education to ensure newly diagnosed people with HIV are seen by infectious disease physicians as soon as possible, and electronic health record alerts that prompt HIV testing when appropriate. 

A key feature of the initiative was a dedicated “link-to-care” program that ensured that any patient newly diagnosed with HIV (or requiring additional confirmatory testing) was rapidly referred to an infectious disease care team for counseling and treatment. 

Additionally, a custom alert in the electronic health record (EHR) prompted providers to order an HIV test whenever a patient was being tested for gonorrhea or chlamydia or other sexually transmitted infections and their HIV status was unknown. 

Researchers found that all patients who tested positive for HIV through the program received prompt follow-up and linkage to specialty care, demonstrating the effectiveness of the support system in place.

“We’re proud of how our urgent care and emergency department teams embraced this initiative,” said Park Willis, MD, a family medicine physician and regional medical director of urgent care at Intermountain Health. “By working together across disciplines, we not only improved testing rates but also helped patients get diagnosed earlier than they might have otherwise. It’s incredibly gratifying to know that our efforts led to real people getting the care they need sooner.”

Dr. Seibert emphasized that the study’s outcomes reflect a strong collaborative effort and a model that can be expanded moving forward. 

“This was a true team collaboration between our urgent care, emergency medicine, infectious disease, pharmacy, stewardship, and clinical informatics teams,” said Dr. Seibert. “Our success shows that relatively simple interventions – education, an EHR prompt, and a solid follow-up program – can have significant impact to enhance community health.”

This effort supports national public health goals, such as the Ending the HIV Epidemic initiative, and exemplifies Intermountain Health's mission of helping people live the healthiest lives possible. 

Intermountain plans to continue innovating and expanding access to early HIV diagnosis and treatment, ensuring that all individuals – regardless of where they seek care – can receive essential preventive services and support, noted Dr. Seibert.

“We hope to build on this momentum and extend these best practices to even more care settings and other regions across our health system so that routine HIV screening becomes standard and no patient falls through the cracks,” he said.

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