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.