{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T23:58:42Z","timestamp":1792886322409,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100027162","name":"Society to Improve Diagnosis in Medicine","doi-asserted-by":"publisher","award":["#477"],"award-info":[{"award-number":["#477"]}],"id":[{"id":"10.13039\/100027162","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV testing opportunities are often missed during urgent care (UC) and emergency department (ED) evaluations for sexually transmitted infections. We implemented a multimodal diagnostic stewardship intervention to increase HIV testing in UC and ED gonorrhea (GC)\/chlamydia (CT) testing encounters (\u201cHIV co-testing\u201d).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pre-\/post implementation study across 26 UCs and 22 EDs in our health system (April 2022\u2013March 2024). The intervention included system-wide simultaneous implementation of provider and patient education and a link-to-care program for newly diagnosed people with HIV (PWH) and patients needing additional testing, followed by phased activation of an electronic health record alert prompting HIV co-testing. We estimated the impact of the intervention on HIV GC\/CT co-testing using interrupted time series analysis, measured alert engagement, and described the impact of the link-to-care program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>By the end of the intervention period, HIV GC\/CT co-testing rates were 12.7% points higher in UC (95% CI 6.2\u201319.2), a 41.9% relative increase (P &amp;lt; .001) compared with preintervention trends. In the ED, co-testing rates rose 12.3% points (95% CI 1.08\u201323.6), a 53.4% relative increase (P = .02). A total of 4704 alerts fired, resulting in 730 alert-associated HIV co-tests. During the intervention, 17 PWH were newly diagnosed: 5 (29%) were due to alert-associated co-tests. All PWH and those requiring additional testing received prompt linkage to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HIV GC\/CT co-testing increased in UC and ED during our intervention, leading to new HIV diagnoses and linkage to care. Integrating HIV co-testing into GC\/CT testing encounters improved HIV screening practices in our large health system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf434","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T11:48:27Z","timestamp":1755085707000},"page":"e56-e67","source":"Crossref","is-referenced-by-count":7,"title":["Increasing HIV Testing During Gonorrhea and Chlamydia Evaluations in Urgent Care and Emergency Departments: A Large Health System Initiative"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8142-3405","authenticated-orcid":false,"given":"Allan M","family":"Seibert","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Intermountain Health , Salt Lake City, Utah 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