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Table 1 Themes of the opt-out approach to HIV testing

From: Perspectives on the ethical concerns and justifications of the 2006 Centers for Disease Control and Prevention HIV testing recommendations

Benefits

Risks or Harms

Opt-out HIV testing...

Theme: Improves the testing process

Sub-theme: Streamlines the testing process

Sub-theme: Overcomes barriers

Sub-subtheme: Overcomes barriers to the individual being tested

Sub-subtheme: Overcomes barriers to the provider conducting testing

Theme: Has beneficial consequences

Sub-theme: Beneficial consequences to public health

Sub-theme: Beneficial consequences to individuals

Sub-theme: Beneficial consequences to society

Theme: Leads to increased testing, which has beneficial downstream effects

Theme: There are risks and harms inherent in the method or process of opt-out HIV testing

Theme: There are associated problems when using opt-out HIV testing

Sub-theme: Opt-out testing does not provide adequate consent

Sub-theme: Opt-out testing does not provide adequate pre-test information

Sub-theme: Opt-out testing will lead to increased testing, which can lead to an increased number of false positives or testing people who do not want to be tested

Theme: There are conditions or situations when opt-out HIV testing presents harms or risks

How does opt-out HIV testing

fulfill responsibilities to patients?

Opt-out HIV testing...

Theme: Leads to increased HIV testing, which has downstream effects

Theme: Promotes HIV screening in clinicians

Theme: Changes a paradigm of HIV testing

Theme: Leads to increased testing, which has downstream effects

Theme: Promotes patient health

Theme: Overcomes patient barriers to testing

How does opt-out HIV testing

violate responsibilities to patients?

Opt-out HIV testing...

Theme: Opt-out testing does not allow for adequate information delivery

Theme: Opt-out testing changes the beneficiary of testing from the patient to public health or society

Theme: Opt-out testing negatively affects patient trust

How does opt-out HIV testing

respect patients' rights?

Opt-out HIV testing...

Theme: Provides an adequate process for patients to refuse testing

Theme: Leads to increased testing, which has positive downstream affects on individuals

Theme: Serves individuals and pubic health needs

How does opt-out HIV testing

violate patients' rights?

Opt-out HIV testing...

Theme: Will likely be poorly implemented, which will violate patients' rights

Theme: Does not provide for an adequate process for HIV testing

Theme: Compromises individual patient needs

Theme: Limits patients' options to make their own decisions