Effects of Written Informed Consent Requirements on HIV Testing Rates: Evidence From a Natural Experiment
American Journal of Public Health 2009 June; 99(6): 1087-1092
OBJECTIVES: I evaluated the effects of written informed consent requirements on HIV testing rates in New York State to determine whether such consent creates barriers that discourage HIV testing. METHODS: New York streamlined its HIV testing consent procedures on June 1, 2005. If written informed consent creates barriers to HIV testing, then New York's streamlining exercise should have reduced such barriers and increased HIV testing rates. I used logistic regression to estimate the effects of New York's policy change. RESULTS: New York's streamlined consent procedures led to a 31.4% (95% confidence interval [CI] = 20.9%, 41.9%) increase in the state's HIV testing rate. In absolute terms, 7% of the state's population had been tested for HIV in the preceding 6 months under the streamlined procedures, whereas only 5.3% would have been tested under the original procedures. These estimates imply that the streamlined consent procedures accounted for approximately 328 000 additional HIV tests in the 6 months after the policy change. CONCLUSIONS: Written informed consent requirements are a substantial barrier to HIV testing in the United States.There may be a trade-off between efforts to increase HIV testing rates and efforts to improve patient awareness.
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Das-Douglas, Moupali; Zetola, Nicola M.; Klausner, Jeffrey D.; Colfax, Grant N.; Goldman, Janlori; Kinnear, Sydney; Chung, Jeannie; Rothman, David J. (2008-09)
An act to amend the Human Rights Act of 1977 to prohibit employment discrimination based on genetic information; to prohibit an employer, employment agency, or labor organization from requesting or requiring a genetic test of, or administering a genetic test to, an employee or applicant for employment or membership; to prohibit an employer, employment agency, or labor organization from seeking to obtain, obtaining, or using genetic information of an employee or applicant for employment; to provide an exemption that allows the use of genetic testing or information with the written and informed consent of the employee or applicant for employment to determine the existence of a bona fide occupational qualification, investigate a workers' compensation or disability compensation claim, or determine an employee's susceptibility or exposure to potentially toxic substances in the workplace; to prohibit health benefit plans and health insurers from using genetic information as a condition of eligibility or in setting District of Columbia. Laws, statutes, etc. (2005-01-03)