This systematic review and qualitative analysis, undertaken July 2019, aimed to compare rates of HIV testing acceptance and linkage to care for adolescents and young adults across various delivery models: emergency department (ED), primary care/inpatient setting, community-based program, or STI/family planning clinics. 59 studies from North America, Africa, Asia, Australia, and Europe were identified for data review and analysis. In the North American context, the greatest acceptance of testing occurred in ED settings (77.7%), while in other regions acceptance was highest in primary care/hospital settings (93.3%). Review of ED-based studies found a significant association by testing strategy, with opt-in approaches resulting in a higher acceptance rate compared to opt-out (82% vs. 75%). Overall, highest linkage to care rates were reported for ED-based testing, followed by primary care/hospital settings. However, when only North American studies were examined, primary care/hospital settings had the lowest linkage to care rates (38.8%) compared to ED-based testing (93.5%), STI/family planning clinics (81.4%), and community-based programs (69.9%).