# Cost-Effectiveness of HIV Testing in U.S. Emergency Departments

> **NIH NIH K08** · STANFORD UNIVERSITY · 2024 · $192,672

## Abstract

PROJECT SUMMARY / ABSTRACT
Roughly 1 in 8 Americans living with HIV are unaware of their infection. As an entry point into the healthcare
system, emergency departments (EDs) are uniquely positioned to help reduce this burden of undiagnosed HIV
in the U.S. A growing amount of all healthcare in the U.S. is delivered in an ED setting. Unfortunately, compared
with other settings, EDs have some of the lowest HIV testing rates. These rates further declined leading up to
the COVID-19 pandemic and despite renewed efforts in the Ending the HIV Epidemic in the U.S. (EHE) initiative.
Decreasing testing rates appear to stem from several barriers, including concerns about cost and the impact of
increased testing on overcrowding and boarding. Unfortunately, few studies have focused on exploring these
barriers, either since EHE’s launch or following the COVID-19 pandemic. The primary purpose of this award is
to provide Dr. Christopher Bennett, Assistant Professor of Emergency Medicine at Stanford University, the
support necessary to facilitate their long-term goals to (1) help EDs lead the charge in ending the HIV epidemic
in the U.S. and (2) transition from a junior investigator to an independent physician–scientist with expertise in
economic analyses, implementation science, and qualitative methods. In Aim 1, Dr. Bennett will train in economic
analyses to investigate the cost-effectiveness of ED-based HIV screening in geographic areas targeted by EHE
compared against current screening rates and then determine the incremental cost-effectiveness of HIV
screening in all U.S. EDs. In Aims 2 and 3, the candidate will innovatively leverage a recent California initiative
in which 28 local EDs received funding to implement or expand routine, opt-out HIV screening. Specifically, in
Aim 2, Dr. Bennett will train in implementation science to create a typology of the screening strategies used by
these EDs; this work will be informed by a stakeholder group of ED leaders with efforts guided by the Reach,
Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. In Aim 3, Dr. Bennett will obtain
additional training in qualitative methods to employ semi-structured interviews of a diverse cohort – frontline ED
providers implementing HIV screening and persons tested for HIV at these EDs – at a subset of these sites to
illuminate firsthand barriers and facilitators encountered during the real-world implementation of HIV screening
programs, guided by the updated Consolidated Framework for Implementation Research (CFIR). This K08 award
is designed to leverage Dr. Bennett’s clinical training and build upon their background in epidemiology and health
services research. This innovative K08 responds to several NIH priorities for HIV and HIV-related research and
will aid decision makers in identifying which strategies work for different communities. Overall, this work will
advance EHE’s mission to make HIV screening routine in all settings that serve a high volume of ra...

## Key facts

- **NIH application ID:** 11009193
- **Project number:** 1K08AI181642-01A1
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Christopher L Bennett
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $192,672
- **Award type:** 1
- **Project period:** 2024-07-19 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11009193

## Citation

> US National Institutes of Health, RePORTER application 11009193, Cost-Effectiveness of HIV Testing in U.S. Emergency Departments (1K08AI181642-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11009193. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*