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Am J Public Health. 2017 Aug;107(8):1259-1265. doi: 10.2105/AJPH.2017.303819. Epub 2017 Jun 22.

The End of Written Informed Consent for HIV Testing: Not With a Bang but a Whimper.

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Ronald Bayer is with the Center for the History and Ethics of Public Health, Mailman School of Public Health, Columbia University, New York, NY. Morgan Philbin is with the Department of Sociomedical Sciences, Mailman School of Public Health. Robert H. Remien is with the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columba University Medical Center, New York.


In 2014, only two states in the United States still mandated specific written informed consent for HIV testing and, after years of controversy, New York ended this requirement, leaving only Nebraska. New York's shift to opt-out testing meant that a singular feature of what had characterized the exceptionalism surrounding HIV testing was eliminated. We trace the history of debates on written informed consent nationally and in New York State. Over the years of dispute from when HIV testing was initiated in 1985 to 2014, the evidence about the benefits and burdens of written informed consent changed. Just as important was the transformation of the political configuration of HIV advocacy and funding, both nationwide and in New York State. What had for years been the subject of furious debate over what a rational and ethical screening policy required came to an end without the slightest public protest. (Am J Public Health. 2017;107:1259-1265. doi:10.2105/AJPH.2017.303819).

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