Understanding Patients' Perspectives on Opt-Out , Incentivized and Mandatory HIV Testing

Noland, Carey; Vaughn, Nicole A.; Sun, Sirena; Schlecht, Hans P.

doi:10.12816/0024696

Cited by 6 publications

(6 citation statements)

References 16 publications

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“…Rates remained low even after the changes in USPSTF/CDC policy recommendations, suggesting that the policy did not have a substantive on population-level testing rates. Our study finding that prepolicy and postpolicy testing rates were lower among people having no regular source of sick or preventive care is consistent with other studies that have shown lower HIV testing rates in the hospital emergency department compared with other ambulatory care facilities (Huggett et al, 2020;Olatosi et al, 2020). Our observation of comparatively lower HIV testing rates after the policy changes among people with no regular source of care may be attributable to increases in rates of HIV testing among those with a regular source of care or alternatively may also be the result of reduced testing efforts by nonroutine testing providers (e.g., emergency departments, community outreach, nonhealth organizations).…”

Section: Discussionsupporting

confidence: 92%

Associations Between Clinic-Based HIV Testing Guidelines and Population-Level HIV Testing Rates in the United States

Siddiqi¹,

Gwynn²,

Olatosi³

et al. 2023

J Assoc Nurses AIDS Care

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Section: Discussionsupporting

confidence: 92%

Associations Between Clinic-Based HIV Testing Guidelines and Population-Level HIV Testing Rates in the United States

Siddiqi¹,

Gwynn²,

Olatosi³

et al. 2023

J Assoc Nurses AIDS Care

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“…Universal opt-out HCV screening reflects the need for standardized protocols across facilities ensuring the same level of routine screening for all. When applied to other communicable diseases, opt-out screening procedures have resulted in earlier detection, reduced stigma, and increased number of screened individuals ( Young et al , 2009 ; Noland et al , 2015 ), while allowing for infected individuals to decline. Due to considerable variability, universal opt-out HCV screening upon entry will improve the accuracy of HCV estimates, essential evidence for best resource allocation for prison health care and release programs.…”

Section: Opportunities For Expanded Hcv Screening In Us Correctional mentioning

confidence: 99%

Universal opt-out screening for hepatitis C virus (HCV) within correctional facilities is an effective intervention to improve public health

Morris

Brown

Allen

2017

IJPH

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PurposeWorldwide efforts to identify individuals infected with the hepatitis C virus (HCV) focus almost exclusively on community healthcare systems, thereby failing to reach high-risk populations and those with poor access to primary care. In the USA, community-based HCV testing policies and guidelines overlook correctional facilities, where HCV rates are believed to be as high as 40 percent. This is a missed opportunity: more than ten million Americans move through correctional facilities each year. Herein, the purpose of this paper is to examine HCV testing practices in the US correctional system, California and describe how universal opt-out HCV testing could expand early HCV detection, improve public health in correctional facilities and communities, and prove cost-effective over time.Design/methodology/approachA commentary on the value of standardizing screening programs across facilities by mandating all facilities (universal) to implement opt-out testing policies for all prisoners upon entry to the correctional facilities.FindingsCurrent variability in facility-level testing programs results in inconsistent testing levels across correctional facilities, and therefore makes estimating the actual number of HCV-infected adults in the USA difficult. The authors argue that universal opt-out testing policies ensure earlier diagnosis of HCV among a population most affected by the disease and is more cost-effective than selective testing policies.Originality/valueThe commentary explores the current limitations of selective testing policies in correctional systems and provides recommendations and implications for public health and correctional organizations.

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“…Educational information on BBVs was an important resource for opt-out programmes [13, 40, 47, 48, 57, 60, 63, 68]. Misconceptions around BBVs are common amongst prisoners (C).…”

Section: Resultsmentioning

confidence: 99%

Understanding how, why, for whom, and under what circumstances opt-out blood-borne virus testing programmes work to increase test engagement and uptake within prison: a rapid-realist review

Francis-Graham

Ekeke

Nelson

et al. 2019

BMC Health Serv Res

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Background Prisons represent a unique opportunity to diagnose blood-borne viruses. Opt-out testing is receiving increasing interest, as a result of mounting evidence to suggest that the manner in which a test offer is delivered, affects test uptake. Although the effectiveness of opt-out testing within the prison setting has been established, robust explanations are required for the variation in outcomes reported. Methods Rapid-realist review methodology was used to synthesise the literature on prison-based opt-out testing. The review was carried out in three phases. Phase one: An expert panel provided literature relevant to the implementation of opt-out testing within the English prison estate. Unstructured searches were also conducted to identify other social programmes where “opt-out” had been used to increase uptake. Phase two: a systematic search of six peer-review and five grey literature databases was carried out to identify empirical data on opt-out testing within the prison setting. Phase three: Additional non-exhaustive searches were carried out to identify literature that reinforced emergent concepts. The development of programme theory took place with each iteration and was validated in consultation with stakeholders. Results Programme theory was constructed for two outcomes: the proportion of intake offered a test and the proportion offered that accepted testing. The proportion of intake offered testing was influenced by the timing of the test offer, which was often delayed due to barriers to prisoner access. The decision to accept testing was influenced by concerns about confidentiality, fear of a positive diagnosis, a prisoner’s personal interpretation of risk, discomfort with invasive procedures, trust in healthcare, and the fidelity of the opt-out offer. Conclusions This review identified important implementation considerations that moderate the effectiveness of opt-out testing programmes. It also highlighted a lack of appreciation for the theoretical underpinnings of opt-out programmes and tension around how to implement testing in a manner that adheres to both default theory and informed consent. It is anticipated that results will be used to inform the design and implementation of subsequent versions of these programmes, as well as catalyse further in-depth analysis into their operation within the unique context of prison. Review registration CRD42017068342 . Electronic supplementary material The online version of this article (10.1186/s12913-019-3970-z) contains supplementary material, which is available to authorized users.

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Understanding Patients' Perspectives on Opt-Out , Incentivized and Mandatory HIV Testing

Cited by 6 publications

References 16 publications

Associations Between Clinic-Based HIV Testing Guidelines and Population-Level HIV Testing Rates in the United States

Associations Between Clinic-Based HIV Testing Guidelines and Population-Level HIV Testing Rates in the United States

Universal opt-out screening for hepatitis C virus (HCV) within correctional facilities is an effective intervention to improve public health

Understanding how, why, for whom, and under what circumstances opt-out blood-borne virus testing programmes work to increase test engagement and uptake within prison: a rapid-realist review

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