HIV testing policy and serious mental illness.
OBJECTIVE
Using opinion data from experts, we examined the context of the argument for mandatory testing of psychiatric patients.


METHODS
Vignettes were distributed to experts on HIV and mental illness. Respondents were asked to provide appropriateness ratings for different hypothetical clinical decisions regarding HIV management.


RESULTS
Respondents were reluctant to impose testing without informed consent in most circumstances. The presence of risk factors or danger to another increased appropriateness ratings modestly.


CONCLUSIONS
Despite experts' tendency to emphasize individual rights, public reluctance to mandate testing is unlikely to extend to people with serious mental illness. No argument for mandatory testing can be persuasive if improved voluntary testing can achieve adequate detection rates. Voluntary testing protocols should be studied to determine which successfully identify infected individuals.
Walkup
James
J
Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ 08903, USA. walkup@rci.rutgers.edu
Satriano
James
J
Barry
Danielle
D
Sadler
Pablo
P
Cournos
Francine
F
D015492:AIDS Serodiagnosis / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D003155:Community Mental Health Centers / Q000458:organization & administration; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007258:Informed Consent; D018580:Mandatory Testing / Q000592:standards*; D028642:Persons with Psychiatric Disorders; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States