BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.h6895 (Published 19 January 2016)
What is already known on this topic
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Patients’ preferences are a hallmark of patient centered care, but little is known about how wording of offers of testing can influence perceived preferences
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Opt-in and opt-out HIV testing have not been compared in a randomized controlled setting
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US guidelines endorse opt-out HIV testing, and Europe has seen a trend toward this testing scheme
What this study adds
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Opt-in and opt-out defaults had statistically and clinically significant effects on the likelihood of patients accepting tests
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Patients reporting risk factors were more likely to accept testing in each testing regimen than were patients reporting no risk factors
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Active choice is a distinct test regimen, with test acceptance patterns that may best approximate patients’ true preferences