A Comparison of Patient Satisfaction with Emergency Department Opt-In and Opt-Out Rapid HIV Screening
Table 3
Patient attitudes towards opt-in and opt-out HIV screening, .
Domain
Question
Screening phase
Agree
Disagree
OR
Adjusted ORa
% (95% CI)
% (95% CI)
(95% CI)
(95% CI)
Satisfaction
I would recommend the ER to others as a good place to get tested for HIV
Opt-in
197/207
95.2 (92.3–98.1)
7/207
3.4 (0.9–5.8)
—
—
Opt-out
183/188
97.3 (95.0–99.6)
0/188
0
—
—
I was satisfied with the HIV testing that I received today
Opt-in
200/207
96.6 (94.2–99.1)
6/207
2.9 (0.6–5.2)
ref
ref
Opt-out
180/188
95.7 (92.9–98.6)
4/188
2.1 (0.1–4.2)
1.4 (0.4–4.9)
2.0 (0.5–8.1)
Coercion
I felt pressured into getting an HIV test
Opt-in
18/207
8.7 (4.9–12.5)
181/207
87.4 (82.9–92.0)
ref
ref
Opt-out
6/188
3.2 (0.7–5.7)
180/188
95.7 (92.9–98.6)
0.3 (0.1–0.9)
0.3 (0.1–0.8)
I felt like I had a choice about getting an HIV test
Opt-in
194/207
93.7 (90.4–97.0)
6/207
2.9 (0.6–5.2)
ref
ref
Opt-out
183/188
97.3 (95.0–99.6)
4/188
2.1 (0.1–4.2)
1.4 (0.4–5.1)
1.2 (0.3–4.4)
Process of care
I had to wait too long for my HIV test result
Opt-in
27/207
13.0 (8.5–17.6)
173/207
83.6 (78.5–88.6)
ref
ref
Opt-out
17/188
9.0 (4.9–13.1)
168/188
89.4 (85.0–93.8)
0.6 (0.3–1.2)
0.7 (0.4–1.4)
HIV testing interfered with the overall care I received in the ER
Opt-in
12/207
5.8 (2.6–9.0)
189/207
91.3 (87.5–95.1)
ref
ref
Opt-out
13/188
6.9 (3.3–10.5)
173/188
92.0 (88.2–95.9)
1.2 (0.5–2.7)
0.9 (0.4–2.3)
Confidentiality
Overall, I felt that the HIV testing done today was private
Opt-in
191/207
92.3 (88.6–95.9)
6/207
2.9 (0.6–5.2)
ref
ref
Opt-out
180/188
95.7 (92.9–98.6)
5/188
2.7 (0.4–5.0)
1.1 (0.3–3.8)
1.9 (0.5–7.0)
I felt that my HIV test was told to me in a private way
Opt-in
196/207
94.7 (91.6–97.7)
5/207
2.4 (0.3–4.5)
ref
ref
Opt-out
179/188
95.2 (92.2–98.3)
4/188
2.1 (0.1–4.2)
1.1 (0.3–4.3)
1.2 (0.3–4.8)
Patient attitudes
HIV testing should be a regular part of health care
Opt-in
200/207
96.6 (94.2–99.1)
3/207
1.4 (0–3.1)b
ref
ref
Opt-out
182/188
96.8 (94.3–99.3)
3/188
1.6 (0–3.4)b
0.9 (0.2–4.6)
2.5 (0.4–16.5)
Routine HIV testing should be performed in the ER
Opt-in
188/207
90.8 (86.9–94.8)
8/207
3.9 (1.2–6.5)
ref
ref
Opt-out
182/188
96.8 (94.3–99.3)
3/188
1.6 (0–3.4)b
2.6 (0.7–9.9)
3.2 (0.7–13.8)
I understand the meaning of my HIV test result
Opt-in
201/207
97.1 (94.8–99.4)
3/207
1.4 (0–3.1)b
ref
ref
Opt-out
179/188
95.2 (92.2–98.3)
1/188
0.5 (0–1.6)b
2.7 (0.3–26.0)
2.6 (0.3–26.1)
Information dissemination
The information I was given about HIV testing was just about right
Opt-in
192/207
92.7 (89.2–96.3)
8/207
3.9 (1.2–6.5)
ref
ref
Opt-out
172/188
91.4 (87.5–95.5)
4/188
2.1 (0.07–4.2)
1.8 (0.5–6.1)
3.0 (0.8–11.3)
I would like to have a more in-depth discussion about my risks of getting HIV and ways to prevent itc
Opt-in
46/199
23.1 (17.3–29.0)
135/199
67.8 (61.4–74.3)
ref
ref
Opt-out
15/160
9.4 (4.9–13.9)
134/160
83.8 (78.0–89.5)
3.0 (1.6–5.7)
3.2 (1.7–6.3)d
aOdds ratio adjusted for age, gender, race/ethnicity, and HIV test result.
b1-sided, 97.5% CI.
cOnly asked of patients with negative test results, Opt-in, Opt-out.
dOdds ratio adjusted for age, gender, and race/ethnicity. Frequencies were calculated as a fraction of the total data set and do not add up to 100% due to subjects choosing the response “prefer not to answer.” Abbreviations: OR: odds ratio; ER: emergency room; CI: confidence interval; ref: reference category.
