A 21-year-old man presents to urgent care with a persistent cough and mild fatigue for the past 3 weeks. He reports no significant past medical history. He says he is sexually active with multiple partners and rarely uses condoms. He has never been tested for HIV. His physical examination is unremarkable, and vital signs are within normal limits. What is the best next step in screening this patient for HIV?
- Perform a rapid HIV test during the visit and discuss the potential need for further testing based on the result.
- Refer the patient to a primary care provider for HIV screening and follow-up.
- Order a complete blood count and chest X-ray to rule out other causes of his symptoms before considering HIV testing.
- Reassure the patient that his symptoms are likely viral and recommend over-the-counter medications for the cough.
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Answer: A. HIV screening should be part of routine medical care for all sexually active individuals, particularly those with multiple partners and/or inconsistent condom use. Early detection of HIV is critical for effective management and prevention of transmission. If the rapid test is positive, confirmatory testing should be obtained.
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Tracey Davidoff, MD, FACP, FCUCM, has practiced Urgent Care Medicine for more than 15 years. She is Board Certified in Internal Medicine. Dr. Davidoff is a member of the Board of Directors of the Urgent Care Association and serves as Co-Editor-in-Chief of the College of Urgent Care Medicine’s “Urgent Caring” publication. She is also the Vice President of the Southeast Regional Urgent Care Association and a member of the editorial board of the Journal of Urgent Care Medicine. At EB Medicine, Dr Davidoff is Editor-In-Chief of Evidence-Based Urgent Care, and co-host of the Urgentology podcast.
