Consent procedures may discourage HIV testing.

After New York State introduced a streamlined informed consent procedure for HIV testing in June 2005, the number of people tested grew significantly. (1) Under the new procedure, a modified form, which is simpler and easier to read than the old one, allows individuals undergoing testing to consent to a number of other HIV-related procedures (including testing for public health monitoring) at the same time. The form also includes an informational section, which is designed to replace face-to-face pretest counseling. The effect of the change on testing rates was measured in a logistic regression analysis of data from New York's Behavioral Risk Factor Surveillance System. Results indicate that in the six months after the new procedure went into effect, 7% of 18-64-year-olds living in the state underwent HIV testing--31%, or 328,000, more than would have done so in the absence of the streamlined procedure. According to the analyst, these findings "provide support for the [Centers for Disease Control and Prevention's] claim that informed consent is a barrier to HIV testing."

(1.) Wing C, Effects of written informed consent requirements on HIV testing rates: evidence from a natural experiment, American Journal of Public Health, 2009, 99(6): 1087-1092.

FYI is compiled and written by Dore Hollander, executive editor of Perspective on Sexual and Reproductive Health.