title: Understanding Patients' Perspectives on Opt-Out, Incentivized, and Mandatory HIV Testing.
abstract: BACKGROUND
  Currently, widespread HIV testing is the best preventive action against further spread of the HIV epidemic. However, over 40% of the U.S. population has never been tested for HIV and 25% of those with HIV have never been tested. To increase testing rates, in 2006 the CDC advised healthcare settings to conduct testing on an opt-out basis.
  
  
  METHODS
  Qualitative, semi-structured interviews with ten seropositive patients and ten seronegative were conducted to address the lack of studies investigating patients' acceptance of and attitude towards this and more novel testing models, e.g. incentivized or anonymous mandatory testing. Participants were asked about their HIV testing history and attitudes towards opt-out, incentivized, and mandatory anonymous HIV testing.
  
  
  RESULTS
  Major themes were identified using grounded theory data analysis. All participants were receptive to opt-out testing, and saw the removal of separate written consent as beneficial as long as patients were given the opportunity to consent in some form.
  
  
  CONCLUSIONS
  Ultimately, both mandatory and opt-out testing were equally indicated by participants as being the most effective testing model at increasing testing rates. A firm understanding of patients' perspectives allows for development of effective HIV testing initiatives that are patient-sensitive and can substantially reduce HIV infection rates.
authors.affiliation: Associate Professor of Communication Studies, Northeastern University 204 Lake Hall, Boston, MA 02115, c.noland@neu.edu , 617-373-7261.
authors.forename: Carey M
authors.initials: CM
authors.lastname: Noland
authors.affiliation: Assistant Professor, Dept. of Health Management & Policy, Drexel University School of Public Health, 3215 Market Street, Philadelphia, PA 19104, nicole.vaughn@drexel.edu.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Vaughn
authors.affiliation: Graduate Researcher, Dept. of Health Management & Policy, Drexel University School of Public Health, 3215 Market Street, Philadelphia, PA 19104.
authors.forename: Sirena
authors.initials: S
authors.lastname: Sun
authors.affiliation: Assistant Professor of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Mail Stop 461, 245 N. 15th Street, Philadelphia, PA 19102-1192.
authors.forename: Hans P
authors.initials: HP
authors.lastname: Schlecht
keywords: HIV testing; incentivized HIV testing; mandatory HIV testing; opt-out HIV testing; patient education