Mandatory reporting of HIV infection does not reduce testing rates

March 17, 2003

Mandatory reporting of HIV infection to public health authorities does not deter people from undergoing testing, Canadian researchers have concluded.

Gayatri Jayaraman and colleagues compared the number of HIV tests conducted on males and females in Alberta between Jan. 1, 1993, and Dec. 31, 2000. Reporting of HIV infection became mandatory in Alberta May 1, 1998, and opt-out prenatal testing was introduced Sept. 1, 1998.

Among females, the average annual increase in the number of HIV tests before 1998 was 9.2%, and in the month immediately following the adoption of opt-out prenatal HIV testing the increase was 28%. Among males, the researchers found the average annual increase in the numbers of HIV tests was 4% for the period before mandatory testing, and 4.3% following its implementation.

The authors conclude that Alberta's opt-out prenatal policy resulted in a dramatic increase in the number of females tested, and that mandatory testing in general did not appear to have a negative impact on rates of HIV testing. A more likely deterrent to testing, the authors say, is fear of receiving a positive test. In a related commentary, Sharon Walmsley suggests that because testing rates among pregnant women improve with the opt-out approach, it should be adopted in all jurisdictions and policies should be modified to consider screening paternal partners as well.
p. 679 Mandatory reporting of HIV infection and opt-out prenatal screening for HIV infection: effect on testing rates
-- G.C. Jayaraman et al

p. 707 Opt in or opt out: What is optimal for prenatal screening for HIV infection? -- S. Walmsley

Canadian Medical Association Journal

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