US: Opt-out screening can improve acceptance of HIV testing

Compared with active choice testing, opt-out screening can substantially increase HIV testing, and opt-in schemes may reduce testing, a new study has suggested.

"Our study provides evidence that small changes in wording can significantly affect patients' behavior and thus our understanding of their preferences. Specifically, modifying HIV testing defaults led to clinically and statistically significant differences in test acceptance percentages." 

"We found that active choice testing, although previously considered a form of opt-in testing, is a distinct category: compared with a strict opt-in scheme informing patients that they can request a test, simply asking patients if they would like a test increased test acceptance by 13 percentage points," the authors write.

In an accompanying editorial, Jason S. Haukoos. MD, and Sarah E. Rowan, MD, both from the University of Colorado School of Medicine, Aurora, emphasize that, "the study by Montoy and colleagues represents one of the largest trials to evaluate consent for HIV testing among emergency department patients, and the only one to do it in a randomized fashion but with particular focus on the efficacy of the various consent options." Read more via MedScape