• Douglas A E White, Alicia N Scribner, and Jennifer V Huang.
• Department of Emergency Medicine, Highland Hospital, Alameda County Medical Center, Oakland, CA 94602, USA. daewhite@gmail.com
• J. Acquir. Immune Defic. Syndr. 2009 Sep 1;52(1):75-8.

BackgroundAlthough whole blood rapid HIV testing has a greater sensitivity and specificity compared with oral fluid (OF) testing, patients prefer HIV testing using OF specimen collection. Whether patient preference for noninvasive collection methods affects acceptance of HIV screening in clinical practice, however, is unknown.ObjectiveTo determine whether patient acceptance of fingerstick whole blood (FWB) and OF rapid HIV screening differs in an emergency department setting.MethodsFrom May 1 to June 30, 2007, triage-based testers offered rapid HIV screening to patients. OF and FWB tests were available on alternate days. Eligible patients were medically stable, > or =15 years of age, and not known to be HIV infected.Results: Two thousand two hundred one patients were referred for HIV screening: 1089 on OF days and 1112 on FWB screening days. Screening rates with OF and FWB were similar (61.9% vs. 59.1%, P = 0.18). Although most reasons why patients declined screening were similar for the groups, the specimen collection method was the primary reason for refusal by 25 patients who declined FWB screening compared with none of the patients who declined OF screening.ConclusionsAmong emergency department patients, the preference for 1 rapid test collection modality over another has a minimal effect on actual screening rates.

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