Wilson Ly1,2,3, Jennifer Cocohoba4,1, Alexander Chyorny5,6, Jodi Halpern2, Colette Auerswald2, Janet Myers1. 1. School of Medicine, University of California, San Francisco, CA. 2. University of California, Berkeley. 3. Department of Internal Medicine, Infectious Disease Division, Santa Clara Valley Health and Hospital System, CA. 4. School of Pharmacy, University of California, San Francisco, CA. 5. Department of Internal Medicine, Santa Clara Valley Health and Hospital System. San Jose, CA. 6. School of Medicine, Stanford University, CA.
Abstract
BACKGROUND: Providing HIV and hepatitis C virus (HCV) testing on an "opt-out" basis is often considered the "gold standard" because it contributes to higher testing rates when compared with "opt-in" strategies. Although rates are crucial, an individual's testing preferences are also important, especially in correctional settings where legal and social factors influence a person's capacity to freely decide whether or not to test. Our study explored factors influencing HIV and HCV testing decisions and individuals' preferences and concerns regarding opt-in vs. opt-out testing at the time of jail entry. METHODS: We conducted semistructured interviews to explore individuals' previous testing experiences, reasons to test, understanding of their health care rights, HIV and HCV knowledge, and preferences for an opt-out vs. an opt-in testing script. RESULTS: We interviewed 30 individuals detained in the Santa Clara County Jail at intake. Participants reported that their testing decisions were influenced by their level of HIV and HCV knowledge, self-perceived risk of infection and stigma associated with infection and testing, the degree to which they felt coerced, and understanding of testing rights in a correctional setting. Most preferred the opt-in script because they valued the choice of whether or not to be tested. Participants who did prefer the opt-out script did so because they felt that the script was less likely to make people feel "singled out" for testing. CONCLUSIONS: Our findings demonstrate that people care about how testing is offered and suggest a need for further research to see how much this influences their decision about whether to test.
BACKGROUND: Providing HIV and hepatitis C virus (HCV) testing on an "opt-out" basis is often considered the "gold standard" because it contributes to higher testing rates when compared with "opt-in" strategies. Although rates are crucial, an individual's testing preferences are also important, especially in correctional settings where legal and social factors influence a person's capacity to freely decide whether or not to test. Our study explored factors influencing HIV and HCV testing decisions and individuals' preferences and concerns regarding opt-in vs. opt-out testing at the time of jail entry. METHODS: We conducted semistructured interviews to explore individuals' previous testing experiences, reasons to test, understanding of their health care rights, HIV and HCV knowledge, and preferences for an opt-out vs. an opt-in testing script. RESULTS: We interviewed 30 individuals detained in the Santa Clara County Jail at intake. Participants reported that their testing decisions were influenced by their level of HIV and HCV knowledge, self-perceived risk of infection and stigma associated with infection and testing, the degree to which they felt coerced, and understanding of testing rights in a correctional setting. Most preferred the opt-in script because they valued the choice of whether or not to be tested. Participants who did prefer the opt-out script did so because they felt that the script was less likely to make people feel "singled out" for testing. CONCLUSIONS: Our findings demonstrate that people care about how testing is offered and suggest a need for further research to see how much this influences their decision about whether to test.
Authors: Alysse G Wurcel; Jessica Reyes; Julia Zubiago; Peter J Koutoujian; Deirdre Burke; Tamsin A Knox; Thomas Concannon; Stephenie C Lemon; John B Wong; Karen M Freund; Curt G Beckwith; Amy M LeClair Journal: PLoS One Date: 2021-05-26 Impact factor: 3.240
Authors: Anna Maria Geretti; Harrison Austin; Giovanni Villa; Dan Hungerford; Colette Smith; Paula Davies; Jillian Williams; Apostolos Beloukas; Wojciech Sawicki; Mark Hopkins Journal: Sci Rep Date: 2018-10-17 Impact factor: 4.379