Testing for HIV without specific consent: a short review

The practice of testing for human immunodeficiency virus (HIV) without the specific knowledge and consent of the patient raises ethical and legal issues. This report argues that diagnostic HIV testing of specific patients, without their consent, is unethical and may also be illegal. Testing for HIV prevalence on an anonymous, unlinked basis, however, is an important aspect of public health surveillance, and the ethics of clinical intervention should not be confused with the ethics of epidemiological research. Specific consent is usually desirable in view of privacy concerns, the importance of patient autonomy, and the potential for conflict of interest. However, where otherwise appropriate, the law should be clarified to permit nonconsensual HIV testing to proceed legally, possibly following scrutiny by an institutional ethics committee.