Emergency departments (EDs) serve as a critical access point for medically underserved populations, including individuals with substance use disorders (SUD), co-occurring psychiatric disorders (COD), and those at elevated risk for HIV. This presentation aims to describe a publicly funded HIV prevention and health services program co-located in two affiliated urban Midwestern EDs, to describe any differences among patients who did and did not receive HIV testing, and to discuss strategies for leveraging Health Promotion Advocates (HPAs) in ED settings.

This clinical program integrates specialized HPAs into the ED team to facilitate routine opt-out HIV testing and provide preventative care for up to six months after ED discharge. Program services were available to patients with diagnosed SUD/COD who were also identified as being at heightened risk of HIV. Those included in this analysis (n = 57) completed both baseline and six-month follow-up assessments, which included demographics, social determinants of health (SDOH) characteristics, and HIV testing status. The mean age of patients was 40.4 years (SD = 10.5), and most identified as non-white (65%), non-Hispanic (88%), and female (51%). The majority reported annual income below $20,000 (72%), unemployment (63%), and transportation barriers (60%). Overall, 61% received HIV testing during the program period. There were no statistically significant differences (p > 0.05) in the completion of an HIV test based on patient demographics or SDOH characteristics. These preliminary findings highlight the critical role that specialized health professionals can play in expanding access to routine HIV testing to vulnerable populations in ED settings.