Mandatory testing for HIV.
Explore the source record for details and available documents.
HIV Infections↗
SEARCH · Search PubMed
Results for “Mandatory Testing”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Monthly question. Are systematic pathological tests mandatory?].
Explore the source record for details and available documents.
Ethics, Medical↗
The HIV pandemic in Sweden: what do people really think about mandatory HIV testing?
This study examines (1) how the general population of Sweden defines the concept of mandatory HIV testing; (2) what measures people consider should be taken against HIV infected individuals if mandatory testing is introduced; and (3) how the opinion of mandatory testing is affected if people consider the matter from a personal rather than neutral point of view. The two first questions were investigated in personal interviews with 1651 randomly selected individuals aged 16-74 years (Study 1). The third question was investigated in an experimental study among Swedish college/university students (Study 2). A total of 58% of the respondents in Study 1 favoured mandatory HIV testing. Confronted with a situation where mandatory testing is introduced and someone refuses to take a test 40% favoured forced testing and 24% favoured fines. If someone is identified as being HIV infected three out of four recommended action only in case this person exposes others to risk. In Study 2 mandatory testing was not, as could be expected, considered to be more repellent if the issue was viewed from a personal point of view than from a neutral one.
AIDS Serodiagnosis↗
The feasibility of mandatory HIV testing for health professionals and other special populations.
Infection with the human immunodeficiency virus (HIV) has become an increasingly important public health problem. Due to the profound increase in the incidence of the disease, testing has become an important tool in prevention efforts as well as treatment. In view of the dire prognosis associated with the diagnosis of HIV infection, there is a great deal of interest in mandatory HIV testing of special groups. Mandatory testing has been implemented for several groups such as the United States military. However, there are a number of issues to be considered before implementing a mandatory testing program. These include the predictive value and accuracy of the tests themselves, confidentiality and the social ramifications of breaches in confidentiality, the likelihood of forcing high risk persons underground to avoid testing, and the constitutionality of a mandatory testing policy. Since the discovery of the apparent transmission of HIV infection from a dentist to his patients, there has been increasing interest in a policy mandating the testing of health professionals. However, in view of the low risk of transmission to patients, it would be ill-advised to require HIV testing of health care workers. In general, the benefits of a mandatory testing policy do not outweigh the human and financial costs it would engender.
AIDS Serodiagnosis↗
Mandatory HIV testing for healthcare workers: is it ethical?
The AIDS epidemic has caused hysteria among the public and concern to many healthcare workers in the past 12 years. Currently, legislation exists for mandatory AIDS testing in some populations. The questions remain: Should healthcare workers be routinely tested? If so, is mandatory testing ethical? The author explores the incidence and prevalence of AIDS among healthcare workers, discusses why mandatory testing for healthcare workers is an issue, and examines the legal and ethical principles involved in mandatory testing.
AIDS Serodiagnosis↗
Mandatory HIV testing and occupational therapists.
OBJECTIVES: As the prevalence of human immunodeficiency virus (HIV) increases, so does the prevalence of HIV-positive health care workers. This study explored what effect this will have on occupational therapy service provision. Attitudes and policies of 118 occupational therapy administrators were examined in relation to mandatory testing for HIV, attitudes on treating HIV-positive patients, working with HIV-positive staff members and students, and use of Centers for Disease Control's guidelines on universal precautions. METHODS: A stratified sample of 200 occupational therapy administrators, drawn proportionally from all occupational therapy fieldwork centers, was sent questionnaires. The respondents (N = 118) were asked questions reflecting policy and attitude regarding HIV-positive staff members, students, and patients and mandatory testing. Descriptive statistics and chi-square analyses were computed to examine variances related to policy, ethics, and attitudes. RESULTS: Few occupational therapy departments have policies regarding HIV-positive health care workers or students. Those policies in place involve disability discrimination acts and using universal precautions. More than one third of the respondents support mandatory testing of all health care workers and notifying patients if their occupational therapist is HIV-positive. A large minority of respondents would either refuse to hire or train an HIV-positive therapist or student, or would restrict patient care responsibilities. CONCLUSIONS: Although most occupational therapy administrators adhere to CDC guidelines and anti-discrimination policies, some concern and fear was expressed regarding HIV transmission through occupational therapy practice. This may result in administrative decisions regarding work and training responsibilities that are unnecessarily restrictive, such as limiting all patient care responsibilities.
AIDS Serodiagnosis↗
Prison rights: mandatory drugs tests and performance indicators for prisons.
Mandatory drugs testing of prisoners applies throughout England and Wales. Data from the 1995 pilot study in eight prisons show that the proportion testing positive for opiates or benzodiazepines rose from 4.1% to 7.4% between the first and second phase of random testing and that there was a 20% increase over 1993-4 in the provisional total of assaults for 1995. Interpretation of these data is difficult, but this is no excuse for prevarication over the danger that this policy may induce inmates to switch from cannabis (which has a negligible public health risk) to injectable class A drugs (a serious public health risk) in prison. The performance indicators for misuse of drugs that are based on the random mandatory drugs testing programme lack relevant covariate information about the individuals tested and are not reliable or timely for individual prisons.
Adult↗
Mandatory AIDS testing: factors influencing public opinion.
A survey of 341 persons, 82% of whom were university students whose median age was 27.0 yr., was conducted to investigate the relationship between their attitudes regarding mandatory AIDS testing for various groups, attitudes toward the disease, sexual orientation and behavior, and attitudes toward homosexuals. Homosexual and bisexual respondents were less supportive of mandatory testing for anyone than were heterosexual respondents. Greater homophobia and attitudes in favor of legal sanctions against persons with AIDS were correlated for heterosexual respondents, with attitudes supporting mandatory testing for everyone and homosexuals in particular. However, concern about contracting AIDS was unrelated to heterosexual attitudes favoring mandatory testing. Social and political considerations in an era of growing and potentially militant public health concern are discussed.
AIDS Serodiagnosis↗
Mandatory HIV testing: a position paper.
This article takes the position that mandatory testing of health workers for HIV is unethical because it is a misuse of resources. This is an ethical dilemma in distributive justice. Six facts are detailed to support this position.
AIDS Serodiagnosis↗
Revisiting the debate of voluntary versus mandatory HIV/AIDS testing in U.S. prisons.
Many studies examine HIV/AIDS and often there is a lack of consensus among researchers and policy-makers regarding the importance of mandatory or voluntary testing within a prison setting. This article revisits and extends this discussion by presenting arguments and issues related to testing inmates. A comparison of selected factors indicated that mandatory testing is an important adjunct to minimizing the impact of the spread of the virus both within prison and in the non-offender population. An important policy implication for adopting mandatory testing is that such a policy allows health care providers to intervene early and control the spread of the disease. Potential implications for future research and policy are discussed.
AIDS Serodiagnosis↗
Random mandatory drugs testing of prisoners: a biassed means of gathering information.
BACKGROUND: Our objective was to develop and test a methodology for inferring the percentage of prisoners currently using opiates from the percentage of prisoners testing positive for opiates in random mandatory drugs testing (rMDT). METHODS: The study used results from Willing Anonymous Salivary HIV (WASH) studies (1994-6) in six adult Scottish prisons, and surveys (1994-5 and 1997) in 14 prisons in England and Wales. For Scottish prisons, the percentage of prisoners currently using opiates was determined by assuming, with varying empirical support, that: current users of opiates in prison were 1.5 times as many as current inside-injectors; and current inside-injectors were 0.75 times as many as ever injectors in prison. We also assumed that current inside-users' frequency of use of opiates (by any route) was equal to the frequency of inside-injecting by current inside-injectors in Aberdeen and Lowmoss Prisons in 1996, namely six times in 4 weeks. We assumed that some scheduling of heroin-use prior to weekends takes place, so that only 50% of current inside-users of opiates would test positive for opiates in rMDT: these assumptions allow us to arrive at WASH-based expectations for the total percentage of prisoners testing positive for opiates in rMDT. For England and Wales, a multiplier of 118/68 was applied which was derived from prisoners' interviews, to convert the results from ever inside-injectors, as determined by WASH studies, to the percentage of current inside users of opiates. We made the same assumptions on frequency of inside-use of opiates as in dealing with the Scottish results. RESULTS: We expected 202.7 opiate positive results in April to September 1997 in rMDTs at six adult prisons in Scotland, 226 were observed. We expected 227.0 at a set of 13 adult prisons and one other in England and Wales; 211 were observed. CONCLUSIONS: Further testing of the methodology for prisons in England and Wales will be possible when 1997 WASH data are released. So far, the methodology has performed well. From it, we infer that 24% of inmates at the six adult prisons in Scotland were current inside-users of opiates, compared to 11% at the 14 adult prisons where survey data were available in England and Wales. The corresponding April to September 1997 percentage of opiate positives in rMDT were: 13% (results from the six Scottish prisons) and 5.4% (results from 14 prisons in England and Wales), a two-fold under-estimate of % current users of opiates in prison (24% and 11%). Planning of drug rehabilitation places for prisoners should thus be based on twice the percentage of prisoners testing opiate positive in rMDT. This correction factor of two should be kept under review.
Adult↗
Mandatory drug testing in the workplace.
Although employees may object to mandatory drug testing due to concerns for an invasion of their privacy, employers are responsible for maintaining the public's safety. Education about substance abuse, testing, and treatment should be a part of every employer's anti-drug program. Costs for testing can range from $20 to $200; however, an employer, such as a hospital, that fails to test for substance abuse could face increased liability for an injury to a patient if a drug impaired employee caused it.
Employment↗
An economic evaluation of mandatory premarital testing for HIV.
This study provides a comprehensive assessment of mandatory premarital testing for HIV. We incorporate new evidence about the assumptions underlying an economic evaluation of premarital testing, use standard methods of program evaluation (cost-effectiveness analysis and cost-benefit analysis), and carefully evaluate how changes in the various assumptions affect the results. The cost-effectiveness results show that, under the most likely conditions, the cost per case of HIV infection prevented by mandatory premarital testing would be between $70,000 and $127,000. In the cost-benefit analysis, the benefit-cost ratio in the most likely scenarios ranges between 3.1 and 28.2.
AIDS Serodiagnosis↗
Testing for AIDS: uses and abuses.
In response to the public outcry for mandatory testing for AIDS, this Article explores the major issues concerning the identification of persons with AIDS in society. The Article first studies testing procedures and the purposes behind them to determine if a call for mandatory testing of the general populace would better achieve society's objectives for identifying individuals with AIDS. Concluding that testing should not be required of the population as a whole, the Article then explores whether testing should be required of certain subpopulations which society perceives as likely to have or to spread the disease. In this context, too, the Article concludes that mandatory testing would be unwarranted, and that funds proposed for mandatory testing would be put to better use in education and universal precautions to prevent the further spread of AIDS.
AIDS Serodiagnosis↗
Cost-effectiveness of mandatory stress testing in chest pain center patients.
STUDY OBJECTIVE: To determine whether emergency patients with acute chest pain and low suspicion of acute myocardial infarction (AMI) can be managed cost-effectively and safely in a dedicated chest pain center (CPC) that incorporates mandatory stress testing. METHODS: We assembled a prospective observational case series of consecutive adult patients transferred from the emergency department to a nine-bed, 23-hour CPC in a 564-bed community hospital from January 13 through May 31, 1994. In our institution, all emergency patients with acute nontraumatic chest pain of unclear origin, suggestive of myocardial ischemia but with a low probability of AMI, are transferred to the CPC for further evaluation. All patients in whom AMI is ruled out undergo individually appropriate cardiac diagnostic testing in accordance with CPC clinical guidelines. Patients with end-stage coronary artery disease transferred to the CPC for a "rule-out" protocol only did not undergo further diagnostic testing. Admitted and discharged patients were followed through chart review and telephone survey, respectively. RESULTS: Of the 502 patients transferred to the CPC, 477 (95%) completed follow-up at 14 days. Four hundred ten (86%) were discharged home. Those discharged after diagnostic evaluation yielded negative findings had 100% survival and zero diagnosis of AMI at 5-month follow-up. Overall mortality and incidence of AMI on long-term follow-up for all patients transferred to the CPC were .4% and .2%, respectively. Sixty-seven patients (13%) were admitted from the CPC, of whom 44 (66%) had a final diagnosis of ischemic heart disease (IHD) or AMI. Twenty-four patients with IHD (55%; 6% of stress-tested group) were identified only on further stress testing. Of these patients, seven underwent percutaneous transluminal coronary angioplasty or coronary artery bypass grafting during hospitalization. All were discharged home without major morbidity. Four hundred twenty-four patients (84%) underwent stress testing. The cost of mandatory stress testing to identify one patient with IHD after AMI was ruled out was $3,125. An average cost-per-case savings of 62% was achieved for each patient transferred to the CPC who would have been hospitalized before the inception of the CPC. CONCLUSION: Mandatory stress testing is a safe, cost-effective, and valuable diagnostic and prognostic tool in CPC patients.
Acute Disease↗
Harm reduction measures and injecting inside prison versus mandatory drugs testing: results of a cross sectional anonymous questionnaire survey. The European Commission Network on HIV Infection and Hepatitis in Prison.
OBJECTIVES: (a) To determine both the frequency of injecting inside prison and use of sterilising tablets to clean needles in the previous four weeks; (b) to assess the efficiency of random mandatory drugs testing at detecting prisoners who inject heroin inside prison; (c) to determine the percentage of prisoners who had been offered vaccination against hepatitis B. DESIGN: Cross sectional willing anonymous salivary HIV surveillance linked to a self completion risk factor questionnaire. SETTING: Lowmoss prison, Glasgow, and Aberdeen prison on 11 and 30 October 1996. SUBJECTS: 293 (94%) of all 312 inmates at Lowmoss and 146 (93%) of all 157 at Aberdeen, resulting in 286 and 143 valid questionnaires. MAIN OUTCOME MEASURES: Frequency of injecting inside prison in the previous four weeks by injector inmates who had been in prison for at least four weeks. RESULTS: 116 (41%) Lowmoss and 53 (37%) Aberdeen prisoners had a history of injecting drug use but only 4% of inmates (17/395; 95% confidence interval 2% to 6%) had ever been offered vaccination against hepatitis B. 42 Lowmoss prisoners (estimated 207 injections and 258 uses of sterilising tablets) and 31 Aberdeen prisoners (229 injections, 221 uses) had injected inside prison in the previous four weeks. The prisons together held 112 injector inmates who had been in prison for more than four weeks, of whom 57 (51%; 42% to 60%) had injected in prison in the past four weeks; their estimated mean number of injections was 6.0 (SD 5.7). Prisoners injecting heroin six times in four weeks will test positive in random mandatory drugs testing on at most 18 days out of 28. CONCLUSIONS: Sterilising tablets and hepatitis B vaccination should be offered to all prisoners. Random mandatory drugs testing seriously underestimates injector inmates' harm reduction needs.
Cross-Sectional Studies↗
Mandatory HIV testing and the character of medicine.
Proponents of mandatory HIV testing for patients and providers may not be giving adequate attention to the problems associated with such tests: violations of confidentiality, false negatives, reduced compliance with universal precautions, and misuse of resources.
AIDS Serodiagnosis↗
Responses of health care professionals to proposed mandatory HIV testing.
OBJECTIVE: to survey active health professionals to assess the response to and impact of a mandatory human immunodeficiency virus (HIV) testing policy on health care providers and the communities in which they practice. DESIGN AND SETTING: Anonymous four-page survey of active health professionals at 13 hospitals in northern and central New Jersey. PARTICIPANTS: 1557 physicians and nurses responded to the survey. Response rate was approximately 41%. INTERVENTION: Hypothetical intervention. MAIN OUTCOME MEASURES: Responses to a series of questions relating to a hypothetical mandatory HIV testing policy for health professionals. RESULTS: Approximately three fourths of all surveyed health professionals stated that a mandatory testing policy would persuade individuals in their profession not to work in high-prevalence areas. Among those who currently work in high-prevalence HIV/acquired immunodeficiency syndrome (AIDS) areas, only 51% said that they would definitely or probably remain in that area should such a policy be instituted. Among those practicing surgery or performing invasive procedures, 7% currently avoid HIV-positive patients, and an additional 34% said that they would do so under the proposed testing policy. Finally, 4% of these professionals currently advice others to stop working in high-prevalence areas, and an additional 22% state that they would definitely do so if the proposed policy were instituted. CONCLUSIONS: If physicians and nurses behaved in accordance with their survey responses, institution of a mandatory HIV testing policy would create a shortage of physicians and nurses in high-prevalence HIV/AIDS areas.
Adult↗