The HIV-testing policies of US hospitals

Abstract

To determine the human immunodeficiency virus-testing policies adopted by US hospitals, we surveyed a stratified random sample of all nonfederal general acute care hospitals, drawn from the American Hospital Association's 1987 database. Interviews were completed with the chief administrator in 561 hospitals (response rate, 78.4%). Two thirds of hospitals have admitted at least one patient with the acquired immunodeficiency syndrome, and over 83% have formal written policies about human immunodeficiency virus testing. Most contain provisions protecting patients' rights; eg, 78% require pretest informed consent, 66% require a special human immunodeficiency virus-testing consent form, and 75% require that patients who test seropositive be so informed. Many policies also contain provisions that protect providers; eg, 56% require that test results appear in patients' records, 38% require review of treatment plans when a patient tests seropositive, and 3% require transferring such patients. Hospital characteristics are not strongly associated with the adoption of testing policies.

KIE: This report summarizes the findings of a recent survey of HIV-testing policies in acute care hospitals throughout the United States. The chief administrators of 561 hospitals responded to queries regarding their institutions' experience with AIDS patients, adoption of HIV-testing policies, the decision to adopt a policy, and specific elements of the policies. Two thirds of the hospitals surveyed had admitted at least one patient with AIDS, and over 83% had formal written policies about HIV-testing. Personnel fears of contagion were the most frequently cited influence on the decision to adopt an HIV-testing policy. A number of policies did not include provisions protecting patients' rights involving informed consent to testing, pre-test counseling, and disclosure of results. Lewis and Montgomery conclude that despite the difficulties of formulating HIV-testing policies that protect the rights of patients and of hospital personnel, efforts must continue toward this goal.