New study debunks misconceptions about barriers to the CDC’s HIV testing recommendations

Patient advocates have voiced opposition to opt-out screening for HIV testing because of legitimate concerns that it would not ensure that patients feel they actually have the choice to accept or decline testing,” said Anish P. Mahajan M.D., M.P.H., lead author of the study and a Robert Wood Johnson Foundation Clinical Scholar at UCLA. “We found that The CDC guidelines’ definition of ‘opt-out’ does require specific protection of patient autonomy, which in many cases is not required by state laws. Beyond simply complying with state laws, providers, consumer groups, and other stakeholders should ensure that these protections are adhered to.”

“According to the CDC recommendations, providers are required to give patients information about the HIV test, ask if the patient has any questions, and inform him/her that they have the right to decline the test.

“Opt-out screening could still result in unintended consequences such as patients avoiding the doctor because they do not want to be asked about HIV testing,” cautions Dr. Mahajan who is currently looking at how opt-out HIV screening compares to the more traditional opt-in HIV screening currently used in South Central Los Angeles. Results of this research are expected later this year.

“State law on HIV testing is also widely assumed to be a barrier to implementing the recommendations. The researchers performed a state-by-state review of all statutes pertaining to HIV testing and systematically assessed the consistency of these laws with the new recommendations. Major findings of this analysis include the following:
* Thirty-five states, including the District of Columbia, have laws that are consistent with or neutral toward the recommendations.
* In the two years since the release of the recommendations, nine states have passed new laws to move from inconsistent to consistent with the guidelines.
* Sixteen states still have laws that are barriers to the CDC recommendations.”