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

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 We argue that the disparity is illogical and outdated.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.