An 8 year nationwide prospective registration of non-consented HIV testing in Belgium

Little information is available on the number of HIV tests that are carried out without the patient's consent. The aim of this study was to find out about the number of HIV tests for which the specific consent of the patient was not obtained and to describe the circumstances in which these tests were carried out.

Since 1993 a representative network of sentinel general practitioners (GPs) has recorded data about requests for HIV tests, risk behaviour and the patient's awareness about the test.

In total 11,660 HIV tests were recorded and for 3628 tests the question about patient awareness was completed. Although non-consensual HIV testing (NHT) is against European guidelines on informed consent, 453 tests were performed without informed consent. Of the 292 participating GPs, 17.5 per cent never completed the question about the patient's awareness and 35.6 per cent performed at least one non-consensual HIV test. For 28.9 per cent of NHT, no risk behaviour for HIV infection was identified and for 43.4 per cent the risk behaviour was unknown. NHT was recurrent for patients with suggestive symptoms (22.7 per cent), patients consulting for a check-up (21.1 per cent) and women consulting for antenatal care (12.8 per cent).

Never before have figures been available about NHT forthcoming from a prospective registration including such a large number of tested subjects. Physicians should be reminded once more about the unacceptability of NHT. Instead of performing a non-consensual HIV test, physicians should invest more time in pre-test counselling, especially in those patients with a higher risk or with suggestive symptoms for HIV.