In case of a reactive rapid test the client will be brought to the consultation room in the ED to ensure privacy and will be informed that the result is a preliminary reactive result for HIV and that a confirmatory test is required. In the case of a reactive test (initial positive), a venous blood sample will be drawn by the HIV Health Educator for confirmation via HIV Western blot. The HIV Health Educator is licensed to draw blood. A separate written consent for HIV will be obtained prior to obtaining blood for the HIV Western blot. The Western blot will be sent to the MA State laboratory with an expected result in < 5 business days. The results of the initial test and the confirmatory test will not be entered into the patient medical record. The state of Massachusetts Department of Health will not have the names of patients tested. The only reporting to the state of positive HIV results will be done when the patient accesses medical care as per state law e.g. the patient's health care provider will report the results to the state. This reporting is not part of this study.