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Resource Guide HIV Testing Recommendations 3 and 4

 3.  Screening after notifying the patient that HIV test will be performed unless the patient declines (opt-out screening) is recommended in all health care settings

Key Points 

    • Screening should be voluntary and undertaken only with the patient's knowledge and understanding that HIV testing is planned.
    • Patients should be informed orally or in writing that HIV testing will be performed unless they decline (opt-out screening). 
    • Oral or written information should include an explanation of HIV infection and the meanings of positive and negative thest results, and the patient should be offered an opportunity to ask questions and to decline testing.

4. Requirements for consent vary according to state law, but the CDC advocates that no seperate written consent for HIV testing be required and many states have adopted this recommendation.

Key Points

    • Consent for HIV screening should be incorporated into the patient's general informed consent for medical care.
    • A separate consent form for HIV testing is not recommended. 
    • The CDC guidelines may conflict with state laws governing HIV counseling and written consent. These guidelines do not supersede such laws.

Clinician Educator Tools
Slide Set 
Women's Perceptions of Opt Out Testing

Mandatory reporting of HIV infection and opt-out prenatal screening for HIV infection: effect on testing rates

Changing the Paradigm for HIV Testing- The End of Exceptionalism. Bayer, R Faitchild, AL. NEJM 2006; 335(7): 647-649 
Patient Education Tools 
SGIM Power Point presentation, “HIV testing, prevention, & the new CDC guidelines: are you ready to opt-in?” 
Clinic Preparation Tools
Legal Information 
Updated Compendium of State Laws 

Provider Scripts for Opt-Out Testing 
Questions and Answers for the General Public: Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Healthcare Settings 

ACOG Provider Script for Opt-Out Testing