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Review
. 2022 Jan;9(1):e63-e66.
doi: 10.1016/S2352-3018(21)00276-9. Epub 2021 Dec 8.

Implied consent for HIV testing in the UK: time for a new approach?

David R Chadwick  1 , Emma Page  2 , Dominic Wilkinson  3 , Julian Savulescu  3
Affiliations
Review

Implied consent for HIV testing in the UK: time for a new approach?

David R Chadwick et al. Lancet HIV. 2022 Jan.

Abstract

Despite HIV infection being a treatable chronic illness and the many advances in testing for HIV, late diagnosis is still common, with associated avoidable morbidity and mortality. Requirements for explicit consent for HIV testing in the UK differ from those for other blood tests and are major barriers to testing. We argue that the disparity is illogical and outdated. We propose a model for normalising HIV testing that allows for routine testing in various health-care settings via implied consent, where other blood tests are performed. Inclusion of testing for hepatitis B and hepatitis C might also be incorporated into this model. The ethical argument for this approach is principally beneficence towards people with undiagnosed infection and the people they might infect. Patient autonomy would be maintained using systems allowing for individuals to opt out of implied consent.

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Conflict of interest statement

Declaration of interests DRC is currently an executive trustee of the British HIV Association (BHIVA), and Chair of the BHIVA Audit and Standards Subcommittee. He reports research grants from Innovate UK and Gilead Sciences, and lecture fees from Gilead Sciences. He is also a member of the Independent Data Monitoring Committee for the Flare trial (funded by LifeArc). EP reports a research grant from Gilead Sciences. For JS, this work was funded in part by the Wellcome Trust (grant number WT203132/Z/16/Z). For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. JS, through his involvement with the Murdoch Children's Research Institute, received funding from the Victorian State Government through the Operational Infrastructure Support Program. DW reports no competing interests.

References

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