Additional testing of video consents for complex protocols and with subjects of lower literacy is warranted.
Participants were asked about the information that they received before testing; whether they consented to or declined to be tested; their perceptions of consent and counseling processes pre- and post-test; disclosure of HIV status and the outcomes of disclosure; and referral to care for those who were found to be HIV-positive.
In an area with high ANC coverage [ 29] and where pregnant women in the population present the highest overall rate of testing consent and similar rates of testing consent by HIV status than amongst all women, it is difficult to explain why crude and standardised population-based estimates presented for pregnant women and by parity differ so greatly to ANC-based estimates.
(In 1997, New York State began the controversial practice of mandatory testing of newborns without consent; only New York and Connecticut have such testing in place).
Another study from Poland comparing the education level of HCWs reported that doctors with a comprehensive HIV education showed less prejudice and to a lesser extent did not support mandatory HIV testing of patients without consent when compared to their counterparts with a lesser amount of training [ 26].
Finally, although all companies selling DTC genetic tests require some form of consent from the consumer when ordering a test, the process of informed decision-making cannot be reduced to clicking a box to accept the terms of service or signing a document.
A lower proportion said they were told about their right to decline testing; again this measure of consent was higher in VCT, 89.7% (262) than PITC, 80.1% (173), (p = 0.002).
The protocol for post-test counseling and the return of HIV test results to study participants is an important determinant of consent for testing, and should be carefully evaluated in studies that wish to minimize refusal bias in HIV prevalence surveys.
By decreasing barriers to HIV testing, populations with the highest likelihood of HIV test rejection due to lack of consent documentation and HIV positive test results–particularly men, homeless persons and uninsured patients in our sample had the greatest increase in monthly HIV testing rates.
The themes that emerged from an analysis of narratives and comments by providers and clients about campaigns are presented in two sections: (1) Perceptions of the campaigns and reasons for their success in attracting people for testing; (2) Perceptions about quality of care during campaigns (conditions of testing, counseling, consent, confidentiality and access) from a 'rights' perspective.
