HIV prevention
Denver HIV Risk Score
The Denver HIV risk score is an evidence-based tool that helps triage who should receive immediate HIV testing in emergency and outpatient settings. This calculator implements a simplified adaptation of the published scoring system (Haukoos et al., Ann Emerg Med. 2012). Always test broadly when in doubt.
Reflects epidemiologic disparities observed in the Denver HIV risk model.
Component points
- Age: 6
- Sex: 6
- Race: 0
- Behavior: 10
Denver HIV risk score
22
Higher score = higher priority for testing.
Score 20–29 suggests elevated risk. Offer HIV testing and discuss PrEP/PEP when appropriate.
Regardless of score, CDC recommends routine opt-out HIV screening for all adults at least once.
How to Use This Calculator
Collect core risk information
Ask about age, sex at birth, race/ethnicity, sexual behaviors, injection drug use, and recent STIs during triage.
Consider undiagnosed partner exposure
Sex with a known HIV-positive partner adds substantial weight; always offer testing in those cases.
Use the score to prioritize testing, not to deny it
Even low scores warrant screening when feasible. The score helps identify who should never be missed in resource-limited environments.
Formula
Denver HIV Risk Score = Age points + Sex points + Race points + Behavioral points + Injection drug use points + Recent STI points + Known HIV-positive partner points + Acute HIV symptoms points.
Thresholds commonly used:
- Score ≥ 30 → high priority for immediate testing.
- Score 20–29 → moderate priority.
- Score < 20 → lower priority (still test per routine screening recommendations).
Points reflect published coefficients rounded for clinical use (Haukoos et al., Ann Emerg Med. 2012).
Full Description
The Denver HIV risk score was developed to maximize detection of undiagnosed HIV in emergency departments and urgent care. It integrates demographic factors and high-yield behaviors that correlate with acute or established HIV infection. The score supports – but does not replace – universal opt-out HIV testing, especially in high-prevalence settings.
Remember to counsel on prevention (condoms, PrEP), post-exposure prophylaxis when indicated, and linkage to care for individuals who test positive. Document HIV testing offers and results per local regulations.
Frequently Asked Questions
Can this score replace universal screening?
No. It helps prioritize testing when resources are limited but does not justify turning anyone away from screening.
How should acute HIV symptoms be assessed?
Look for fever, rash, lymphadenopathy, myalgias, or sore throat within 2–6 weeks of exposure. When present, consider RNA testing.
Does PrEP usage affect the score?
PrEP lowers risk but is not incorporated into the original score. Continue routine HIV testing for those on PrEP every 3 months.
What if the patient declines to answer sensitive questions?
Offer testing regardless. The score is only as accurate as the information provided, so maintain a nonjudgmental environment.