After identification of potential patients according to one of the above methods, the health educator will approach patients who are not otherwise engaged with an ED staff person and prior to discharge from the ED. Patients will be approached in a fashion that does not interfere with the normal flow of the ED visit. Patients too ill to approach (in the opinion of the HIV health educator or ED staff) will be excluded, as will patients who have previously tested positive for HIV. The HIV Health Educator will do an initial risk assessment and brief pretest counseling prior to obtaining verbal and written consent for HIV testing. Counseling and consent will be in Spanish for patients whose primary language is Spanish. (A consent form will be translated into Spanish.) The Health Educator will then obtain blood via finger stick from the patient. The test will be run (according to the instructions in the package insert) by the Health Educator in a designated area of the ED. Results will be read as reactive or non-reactive. In the event of a non-reactive test the patient will be informed of the result. During the post-test counseling session patients will be given risk reduction information and shown harm reduction skills and techniques and counseled on appropriate behaviors to minimize risk of HIV acquisition. The patient will also be offered an opportunity to be retested in the future and encouraged to visit an I-CTR program for sexually transmitted disease and hepatitis testing and vaccinations as needed. Testing will be entirely voluntary and will be confidential