This is a cluster randomized trial among dental clinics (n=4) to evaluate whether rapid HIV testing (RHT) during dental visits improves HIV testing rates compared to referral for laboratory HIV testing. Clinics will be randomized to either RHT or referral for HIV testing for a nine-month period - HIV testing will be offered to n~6700 patients by ~ 15 dental providers (dentists and dental hygienists). Outcomes will be assessed using electronic health record reports (EHR), which will include the completion rates of HIV testing among dental patients (84 days after dental visit) and the frequency at which dental providers offer HIV testing (Upon completion of the 9-month testing period).

The objectives of this study are to:

• Compare the effectiveness of on-site rapid HIV testing versus referral to a CHC lab in increasing HIV test completion within 84 days of a dental clinic visit, using EHR data.
• Assess the sustainability of the HIV testing protocol by evaluating changes in dental clinic HIV testing rates over time.

Inclusion Criteria:

Community health center:

• Must be located in Suffolk County in Massachusetts.
• Must provide dental care services.
• Must possess the infrastructure necessary for laboratory-based HIV testing and counseling or have an affiliation with a laboratory that provides these service.

Provider:

• Dental care provider working at a participating community health center during the study period.

Patient:

• Be 18 years of age or older.
• Receive dental care at a participating community health center during the study period.

Exclusion Criteria:

Patient:

• Self-report to be HIV positive at the time of the RHT/ referral.
• Had an HIV test within 12 months (self-report or documented in EHR).