title: Does the Centers for Disease Control and Prevention's Recommendation of Opt-Out HIV Screening Impact the Effect of Stigma on HIV Test Acceptance?
abstract: HIV/AIDS-related stigma is a key factor impeding patient utilization of HIV testing services. To destigmatize HIV testing, the Centers for Disease Control and Prevention recommended an 'opt-out' screening strategy aimed at all patients in all clinical settings, regardless of HIV risk. This study assessed whether opt-out screening as compared to opt-in screening was associated with increased uptake of HIV testing among patients with HIV/AIDS-related stigma concerns. This study included 374 patients attending two Los Angeles ambulatory care clinics. Stigma items were grouped into three constructs: Blame/isolation, abandonment, and contagion. Individuals endorsing the blame/isolation subscale (AOR = 0.52; 95 % CI 0.29-0.92; p\0.05) and abandonment subscale (AOR = 0.27; 95 % CI 0.13-0.59; p\0.01) were significantly less likely to accept an HIV test. Additionally, the opt-out model did not counter the negative effects of stigma on HIV test acceptance. These findings indicate that stigma remains a barrier to HIV testing, regardless of the opt-out screening approach.
authors.forename: Anish P
authors.initials: AP
authors.lastname: Mahajan
authors.forename: Janni J
authors.initials: JJ
authors.lastname: Kinsler
authors.forename: William E
authors.initials: WE
authors.lastname: Cunningham
authors.forename: Saloniki
authors.initials: S
authors.lastname: James
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Makam
authors.forename: Rishi
authors.initials: R
authors.lastname: Manchanda
authors.forename: Martin F
authors.initials: MF
authors.lastname: Shapiro
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Sayles
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D002487:Centers for Disease Control and Prevention, U.S.; D003955:Diagnostic Tests, Routine / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control*; D006291:Health Policy; D006801:Humans; D015141:Los Angeles; D008297:Male; D008403:Mass Screening / Q000592:standards* / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D064876:Safety-net Providers; D016312:Treatment Refusal; D014481:United States