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PubMed2003

Mandatory HIV testing used to bar potential immigrants.

Last year Canada turned away 75 people with HIV/AIDS because the federal government said that they would place excessive demands on publically funded services. Another 207 people with HIV/AIDS were allowed to enter Canada, mainly because of exemptions to the excessive-demand provisions. HIV/AIDS organizations have objected to the government's policy of mandatory HIV-antibody testing of potential immigrants and have expressed concerns about the way in which excessive demand is calculated.

AIDS Serodiagnosis↗
PubMed2002

HIV testing policy and serious mental illness.

OBJECTIVES: Using opinion data from experts, we examined the context of the argument for mandatory testing of psychiatric patients. METHODS: Vignettes were distributed to experts on HIV and mental illness. Respondents were asked to provide appropriateness ratings for different hypothetical clinical decisions regarding HIV management. RESULTS: Respondents were reluctant to impose testing without informed consent in most circumstances. The presence of risk factors or danger to another increased appropriateness ratings modestly. CONCLUSIONS: Despite experts' tendency to emphasize individual rights, public reluctance to mandate testing is unlikely to extend to people with serious mental illness. No argument for mandatory testing can be persuasive if improved voluntary testing can achieve adequate detection rates. Voluntary testing protocols should be studied to determine which successfully identify infected individuals.

AIDS Serodiagnosis↗
PubMed1989

Mandatory premarital testing for human immunodeficiency virus. The Illinois experience.

During the first 6 months of legislatively mandated premarital testing for human immunodeficiency virus in Illinois, 8 of 70,846 applicants for marriage licenses were found to be seropositive, yielding a seroprevalence of 0.011%. The total cost of the testing program for 6 months is estimated at $2.5 million or $312,000 per seropositive individual identified. Half of the reported seropositive individuals reported a history of risk behavior. During the same period, the number of marriage licenses issued in Illinois decreased by 22.5%, while the number of licenses issued to Illinois residents in surrounding states increased significantly. We conclude that mandatory premarital testing is not a cost-effective method for the control of human immunodeficiency virus infection.

Costs and Cost Analysis↗
PubMed1996

Cost implications of random mandatory drugs tests in prisons.

BACKGROUND: Compulsory urine testing of prisoners for drugs, a control initiative, was introduced in eight prisons in England and Wales early in 1995. Despite no evidence of effectiveness, testing was extended to all prisons in England and Wales by March 1996. We consider the cost of testing. METHODS: We combined the costs of refusals, confirmatory tests, punishment of confirmed positives for cannabis or for class A drugs to estimate the average costs of random compulsory drugs testing. These costs were then compared to: i) the healthcare budget for a prison; and ii) the cost of putting in place a credible prisons' drugs reduction programme. We then used Scottish data on incarceration and regional prevalence of injecting drug users to estimate the extent of the injecting drug use problem that prisons face. FINDINGS: Costs per 28 days of the random mandatory drugs testing control initiative in an establishment for 500 inmates where refusal rate is a) 10% or b) nil; and 35% of urine samples test positive, one tenth of them for class A drugs were estimated at between a) 22,800 UK pounds and b) 16,000 UK pounds per 28 days [a) $US35,100 and b) $US24,600]. This cost was equivalent to twice the cost of running a credible drugs reduction and rehabilitation programme, and around half the total healthcare expenditure for a prison of 500 which averaged 41,114 UK pounds per 28 days [$US64,860]. Major cost-generating events were the punishment of refusals--over one third of cost a)--and testing positive for cannabis--over 50% of cost a). In Scotland, around 5% of injecting drug users (IDUs) are incarcerated at any time: 5% of Lothian's drugs care, treatment and prevention costs and 2.5% of its HIV/AIDS prevention budget in 1993-94 amounted to 101,300 UK pounds per annum--or 7770 UK pounds per 28 days ($US11,970)--and about 35% of monthly MDT costs. INTERPRETATION: We suggest that 5% of current resources for drugs prevention and treatment and for IDU-targetted HIV/AIDS prevention should be directed towards the prisons because in the prisons, where 5% of the clients are at any time, injectors have less access to harm reduction measures than on the outside.

Costs and Cost Analysis↗
PubMed2004

Alberta: new bill will allow for mandatory HIV testing in emergency situations.

A private member's bill is expected to be introduced in the spring 2004 session of the Alberta Legislative Assembly that will allow for forced testing of individuals for HIV, hepatitis, and other bloodborne diseases if their bodily fluids come into contact with emergency workers or Good Samaritans. The bill will likely have strong support from within the ranks of the governing Conservatives.

AIDS Serodiagnosis↗
PubMedDate not supplied

State dental boards and mandatory HIV testing.

Public and professional debate over what, if any, action should be taken by state regulatory agencies regarding AIDS and the HIV status of dentists has increased in recent months. To determine if state boards had workable policies in place or were considering such policies, a telephone survey of all state boards was undertaken. All boards participated, although three provided only limited information. As of early 1992, only two boards required evidence of immunity to HVB for relicensure and none require evidence of seronegativity to HIV for relicensure. Twelve percent of the boards anticipate such requirements within two years. None have mandatory HIV testing, but 13 percent anticipate such requirements in the near future. The authors conclude that while few agencies have taken more than tentative steps toward rigorous HIV testing or restrictions, most are aware of much closer public scrutiny. More restrictions seem likely as these agencies attempt to balance public and professional rights and responsibilities.

AIDS Serodiagnosis↗