Reduction in HIV testing due to opt-in consent linked to significant loss of life

The reduction HIV testing due to opt-in consent laws may be associated with a significant loss of life, according to new data presented at the 47th Annual Meeting of the Infectious Diseases Society of America, held this week in Philadelphia.

The researchers, led by Michael April, DPhil, MSc, from Harvard Medical School, said these findings indicate that revising state laws in accordance with CDC recommendations could lead to 549,437 life years saved.

April and his colleagues compared the differences in 2006 testing rates between states that had opt-in HIV testing consent laws vs. those states that had opt-out HIV testing consent laws. The data was adjusted for a variety of factors, including annual incidence of HIV, prevalence of undiagnosed patients and efficacy of ART. According to April, the researchers also considered scenarios in which optout consent discouraged segments of the population from testing.

The results showed that in 2006, the probability of diagnosis among patients with HIV was 19.9% in states that had opt-in testing laws and 24.9% in states with opt-out testing laws. The researchers said this difference of 25% attributable to opt-out consent.

According to the researchers, the mean lifespan of patients with HIV was 792.1 months in states with opt-in testing laws and 801.2 months in states with opt-out testing laws. The researchers said the results indicate that nationwide implementation of opt-out testing “would translate to 549,437 life years saved over the lifetime of the current HIV-infected population.”

The researchers said more significant benefits would be seen as HIV testing rates increased. “If the testing rate increase associated with opt-out consent was 12.5%, national opt-out testing would yield 348,210 life years saved; a 37.5% increase would yield 744,540 life years saved,” the researchers wrote.