Table 4 Themes for patients bearing the costs of increased HIV screening in health care settings

Benefits

Risks or Harms

Theme: Enables pPatients to learn their HIV status and get treatment as needed

Theme: Creates a barrier to testing

Sub-theme: Discriminates against those least able to pay who need testing most

Theme: Encourages patients to “take ownership” of their behavior and health needs

Sub-theme: Leads to an avoidance of testing because of costs

Theme: Serves as a motivator to decrease risky behavior

Sub-theme: Encourages self-rationing of testing

Theme: Makes HIV screening similar to screening for other treatable conditions

Theme: Leads to question value of HIV testing because of its costs

Theme: Forces people to pay for something they might not want or need

Theme: Uses testing as a source of revenue instead of patient benefit

How does making patients bear the costs of increased HIV screening in health care settings fulfill responsibilities to patients?

How does making patients bear the costs of increased HIV screening in health care settings violate responsibilities to patients?

Theme: Identifies patients needing treatment

Theme: Creates a barrier to good health care

Sub-theme: Discriminates against vulnerable populations

Theme: Enables public health benefit of testing

Sub-theme: Decreases demand for testing despite responsibility for having patients tested

How does making patients bear the costs of increased HIV screening in health care settings respect patients” rights?

How does making patients bear the costs of increased HIV screening in health care settings violate patients’ rights?

Theme: Informs people about their HIV status

Theme: Discriminates by economic and class status

Theme: Enables autonomy of choice in medical care

Theme: Obviates community-level benefit of screening in society

Theme: Inhibits access to medical services

Theme: Inhibits willingness to undergo screening