Background:
Screening for STDs and HIV in urgent care settings provide an opportunity for early identification and treatment of STD/HIV infections.

Objective:
To determine the feasibility and acceptability of STD/HIV screening and direct linkage to HIV medical care in an urban urgent care setting.

Method:
From October 2003 through September 2004, 2,247 urgent care patients were offered rapid HIV and STD testing at the Los Angeles County King-Drew Medical Center. Eligible patients were between 18 and 54 years old and spoke English. Logistic regression was used to estimate predictors of STD/HIV morbidity.

Result:
1,002 (60%) patients were tested with rapid HIV OraQuick®, 794 (47%) patients were tested for Chlamydia (CT)/gonorrhea (GC) with the Aptima Combo 2 Assay urine test. There were 14 (1.4%) HIV positive cases of which 6 were newly identified, 25 (3.1%) CT, 14 (1.8%) GC, and 3(<1%) co-infections. Ten (71%) HIV positive cases were linked to treatment. Of the CT/GC positive cases, 31 (84%) received treatment for their STD infection; 5 (14%) were unable to locate, and 3 (10%) were outside the health department jurisdiction. Patients who tested as a result of provider referrals were 6.8 times more likely to be HIV positive than non-referral patients. Having recently tested and in “too much pain” were the primary reasons patients refused the testing services.

Conclusion:
STD and rapid HIV screening program in the urgent care setting was acceptable and feasible to implement and resulted in the identification treatment or referral of previously unrecognized morbidity.

Implications:
Urban urgent care settings provide an opportunity to identify persons at high-risk for unidentified HIV/STDs and without a regular source of health care.