Implied Consent for HIV testing in the United Kingdom: time for a new approach?

Despite HIV infection being a treatable chronic illness and with many advances in testing for HIV, late diagnosis is still common with associated avoidable morbidity and mortality. Requirements for explicit consent for HIV testing are different to other blood tests and are major barriers to testing. We argue that the disparity is illogical and outdated. We propose a model for normalising HIV testing which allows routine testing in various healthcare settings via implied consent, where other blood tests are being performed. Inclusion of testing for hepatitis B and C might also be incorporated into this model. The ethical argument for this is principally beneficence towards those with undiagnosed infection and those they may infect. Patient autonomy would be maintained using systems allowing individuals to opt-out of implied consent.