School of Medicine, University of California, San Francisco, CA.
University of California, Berkeley.
J Acquir Immune Defic Syndr. 2018 Jun 1;78(2):214-220. doi: 10.1097/QAI.0000000000001664.
Providing HIV and hepatitis C virus (HCV) testing on an "opt-out" basis is often considered the "gold standard" because it contributes to higher testing rates when compared with "opt-in" strategies. Although rates are crucial, an individual's testing preferences are also important, especially in correctional settings where legal and social factors influence a person's capacity to freely decide whether or not to test. Our study explored factors influencing HIV and HCV testing decisions and individuals' preferences and concerns regarding opt-in vs. opt-out testing at the time of jail entry.
We conducted semistructured interviews to explore individuals' previous testing experiences, reasons to test, understanding of their health care rights, HIV and HCV knowledge, and preferences for an opt-out vs. an opt-in testing script.
We interviewed 30 individuals detained in the Santa Clara County Jail at intake. Participants reported that their testing decisions were influenced by their level of HIV and HCV knowledge, self-perceived risk of infection and stigma associated with infection and testing, the degree to which they felt coerced, and understanding of testing rights in a correctional setting. Most preferred the opt-in script because they valued the choice of whether or not to be tested. Participants who did prefer the opt-out script did so because they felt that the script was less likely to make people feel "singled out" for testing.
Our findings demonstrate that people care about how testing is offered and suggest a need for further research to see how much this influences their decision about whether to test.
基于“选择退出”原则提供艾滋病毒和丙型肝炎病毒（HCV）检测通常被认为是“黄金标准”，因为与“选择加入”策略相比，它可以提高检测率。尽管检测率至关重要，但个人的检测偏好也很重要，尤其是在矫正环境中，法律和社会因素会影响个人是否自由决定是否进行检测的能力。我们的研究探讨了影响艾滋病毒和丙型肝炎病毒检测决策的因素，以及个人在入狱时对选择退出与选择加入检测的偏好和关注。
我们进行了半结构化访谈，以探讨个人以前的检测经验、检测原因、对其医疗保健权利的理解、艾滋病毒和 HCV 知识，以及对选择退出与选择加入检测方案的偏好。
我们在圣克拉拉县监狱入监时采访了 30 名被拘留者。参与者报告说，他们的检测决策受到其艾滋病毒和 HCV 知识水平、自我感知的感染风险以及感染和检测相关的耻辱感、他们感到被迫的程度以及对矫正环境中检测权利的理解的影响。大多数人更喜欢选择加入脚本，因为他们重视是否接受检测的选择。那些确实更喜欢选择退出脚本的人之所以这样做，是因为他们觉得脚本不太可能让人感到“被挑出来”进行检测。
我们的研究结果表明，人们关心检测的提供方式，并表明需要进一步研究，以了解这在多大程度上影响他们是否进行检测的决定。
