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June 13, 2007

Consent Policies and Rates of HIV Testing—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(22):2478-2479. doi:10.1001/jama.297.22.2479-a

In Reply: Dr Girardi and colleagues note that in their medical setting an administrative policy change was associated with increased HIV testing but no change in the number of HIV cases identified. This is in contrast with our finding that an administrative policy change was associated with both an increase in HIV testing and in the number of HIV cases identified. Whether an administrative policy change affects HIV case finding depends on the risk characteristics of the population that undergoes increased testing and whether or not those administrative changes make it easier for high-risk persons to get tested. In our setting, an urban hospital, making testing easier was associated with a significant and meaningful effect. To know whether similar results would be observed elsewhere requires persons in those settings to identify potential administrative barriers, implement relevant policy changes, and monitor the impact of those changes.

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