Dr Bonnie Henry, British Columbia’s Provincial Health Officer, released the following letter in regards to Human Immunodeficiency Virus (HIV) testing in acute care settings, including emergency departments. It was shared with the Seek and Treat for Optimal Prevention of HIV/AIDS Collaborative Implementation Committee, PAN, and other community partners. Click here to download a copy.
August 14, 2023
To the Seek and Treat for Optimal Prevention of HIV/AIDS Collaborative Implementation Committee:
Re: Human Immunodeficiency Virus (HIV) testing in acute care settings, including emergency departments.
British Columbia remains committed to achieving the global goal of ending HIV/AIDS as a public health concern by 2030. As part of this important effort, the use of routine, opt-out HIV testing in acute care settings, including emergency departments, continues to be a critical, evidence-based measure that directly benefits the health of individuals and our communities. Among other things, routine, opt-out HIV testing enables faster diagnosis, therapy initiation, and linkage to HIV-related information, counselling, and support. This approach acknowledges that relying on individual risk factors alone for testing is insufficient to achieve early diagnosis and treatment.
In this context, I am writing to affirm provincial direction that routine, opt-out HIV testing can continue to be employed in acute care settings, including emergency departments, as follows:
1. Consent for routine HIV testing is included within the general informed consent given by a patient to undergo standard testing to diagnose a new or worsening medical condition in acute care settings, including emergency departments. Accordingly, obtaining specific, additional consent for an HIV test included within a standard laboratory testing panel is redundant and not required.
2. Operators of health care settings providing routine, opt-out HIV testing must ensure that appropriate information regarding opt-out HIV testing (e.g., that HIV testing is included as part of standard diagnostic testing in the facility; the rationale for the opt-out testing approach; opportunities to ask additional questions about HIV testing; the patient’s right not to provide consent for HIV testing) is displayed in a visible, clear (e.g., plain language; multilingual), and culturally appropriate manner.
For further guidance on HIV testing and follow-up, please see Chapter 5 of the BC Communicable Disease Control Manual at http://www.bccdc.ca/resource-gallery/Documents/Communicable-Disease-Manual/Chapter%205%20-%20STI/HIV_Guidelines_Testing_FollowUp_Prevention.pdf.
Sincerely,
Dr. Bonnie Henry
OBC, MD, MPH, FRCPC
Provincial Health Officer
cc:
HA Chief Medical Health Officers.
Maryna Korchagina, Assistant Deputy Minister, Population and Public Health Division.
Kristy Anderson, Assistant Deputy Minister, Hospital and Provincial Health Services Division.
Mitch Moneo, Assistant Deputy Minister, Pharmaceutical, Laboratory & Blood Services Division.
Dr. Julio Montaner, Executive Director and Physician-in-Chief, BC Center for Excellence.