To think consent is required to do a HIV or hepatitis blood test??

[Onionbhajisandwich]

Hi all,

Please tell me if I’m wrong here but do the NHS require consent to test for HIV or Hepatitis?? I would have thought they did.

I attended A and E last month (sent by my GP) as I had suspected pneumonia. I received a text today stating this:

“You recently attended the Emergency Department. We are part of an NHS programme testing for HIV, Hepatitis B and C but your test wasn't processed due to technical issues. Please attend one of the walk-in blood test centres, Mon - Fri 8am- 4.30pm. We requested the repeat test electronically, so please give your NHS number on arrival. We will only contact you if the test is positive and you need care”

I’m a bit surprised that they can screen you without consent - as far as I knew the blood tests that they did we for infection markers and a full blood count, along with one that checks for clotting.

I won’t be attending to get the tests done as it’s within work time but aibu to think this isn’t ok??

That is akin to telling an agoraphobic to give themselves a shake and get out the house. Rude and unhelpful.

Absolutely no one is saying that there shouldn’t be testing for HIV. It should be widespread, available, accessible as possible. Encouraged , de stigmatised. But it should be carried out on the basis of patient knowledge, advisement/ education and informed consent. Mandatory / sleuth testing without informing people does nothing to combat stigma, and can be extremely traumatising for those who end up with an unexpected positive result / diagnosis that they didn’t even know they were being tested for and all the consequences that brings . It’s simply not ethical.

I don't agree. It's a public health matter as much as an induvial one. Unless we're going to go down the route of itemised consent forms for each and every Drs visit, I don't see why HIV/Hepatitis ought to be singled out.

No, actually your attitude is appalling. Fear of HIV isn't a diagnosable mental health issue. If you're capable of finding studies around the stigma, you're more than capable of finding the data to challenge your own misconceptions.
You need to ask yourself why you don't want to.

Nor was it ethical to give thousands of people contaminated blood.
Yet they received it, were given that unexpected news, then lived with the illnesses and the stigma and some died from it and still are.

so as a mark of respect, I think helping stop the spread in whatever way is quickest and easiest is a great option,

Testing for things like Downs syndrome during pregnancy is offered and not always taken up on by the mother to be. By that rationale, she shouldn't deny this test?

Downs syndrome is not a communicable disease.

You are now comparing Down’s syndrome to HIV?

I was slightly shocked when I checked my notes when pregnant to find they do hiv etc test too. Barely in mind id never done drugs, hadnt had any blood transfusion and dh and I had only slept with each other. Both were negative but I was shocked it been tested without me knowing. I said nothing but it shocked me. Yanbu. Did they tell you at the time.

I don't see why HIV/Hepatitis ought to be singled out

because of the very heavy social and psychological consequences of HIV diagnosis that still exist. Most particularly because of the history of the disease and the heavy stigma that still prevails. It’s not just one more trivial health matter, it just isn’t. Furthermore, although HIV is absolutely not the death sentence it once was- people have normal life expectancy and healthy lives, it’s still an incurable , life- long condition that requires significant medical management , adherence to medication (side effects), monitoring , etc . It’s not a small thing receiving an HIV diagnosis, even in 2025. Testing needs to be on the basis of informed consent, as is a legal and ethical requirement for other serious diagnoses.

Phobias exist for all manner of things including meeting people with HIV.

Again I will emphasise I would not go running out the room screaming. But yes, when suddenly somebody told me they had aids, I took a step back, quite simply because of that illogical fear.

Thousands of people in the UK are so terrified of a spider in the bathroom they need somebody to remove it. It is entirely illogical, they aren't going to hurt you. But the fear still exists.

Yes helping stop the spread is vitally important. But we can absolutely do that while preserving the dignity and humanity of people infected with HIV.

Just for interest what is about BBV that requires specific consent ?
From my perspective it is not the fact that it is testing for BBV that is the issue at all, it is the fact that it is a screening programme separate to the clinical care required by the patient at the time. I'd feel the same if it was screening for any other condition not directly relevant to the individual's current illness.
There are no doubt very sound reasons for the scheme but that doesn't negate the right of the individual to know that they are participating. Current methods of communication don't seem to be fully effective. I've just read the NHS England Good Practice guide for implementation of the scheme and it does recommend the use of verbal prompts by staff in addition to public facing written information* *in emergency departments. If that recommendation was being followed there wouldn't be an issue as far as I can see, but if this thread is anything to go by it isn't, or at least not consistently.

No, sorry. You're wrong. There is such strong feeling around HIV precisely because we lean into this irrational fear. It is treatable now, but only once detected. Undetected, people get very sick and it spreads.
Testing needs to be routine, alongside robust support for those who receive a positive diagnosis. Nothing else will end transmission and stigma.

From what I have garnered they should have sought your consent to test for HIV. It sounds like yet another case of the health service using their get out clause of implied consent where no consent was actually given.

Tell us how it spreads in untreated people?

When I had pneumonia they asked me a few times if I could have HIV/hepatitis and they definitely tested me for it too when taking my bloods. I think it must be standard.

Sex, pregnancy, childbirth, intravenous drug use, breastfeeding. Surely you know this by now?

Mandatory / sleuth testing without informed consent does nothing to end stigma. Pretending stigma doesn’t exist does not end stigma. Testing people without their knowledge or consent - potentially traumatising them with an Unexpected positive diagnosis, does absolutely nothing to ensure they will conform to treatment pathways , or behave in ways to avoid passing it on.
you are wrong sorry and your attitudes are draconian.
We will just have to agree to disagree.

It can be the underlying cause of something like pneumonia, and can make it harder to treat. So that's why.

To have a child and then breastfeed. One must first have sex. If you decide to have unprotected sex or have a child then surely the onus is on you to ensure neither you nor your partner have any communicable disease. The responsibility for that should not be laid at the door of testing people without their knowlegde or consent.

They are not wrong.
they are pointing out that the stigma is what is slowing down finding all the cases in the U.K. in order to give them the care they need.
point number 8 in the 12 recommendations from the infected blood enquiry is “finding the undiagnosed”
about 2000 people who still don’t know they were infected. So this helps find some and avoid them infecting others - they can’t avoid passing it on if they don’t know they have it!

They also can't pass it on if they or their partners partake in safe sex.

But if they are with a partner and on the pill they might choose not to wear condoms. That is their right. Yet they may not know they are infected.

Yes absolutely I agree with all of these points. We need HIV testing- it should be as accessible , available and widespread as possible. Only done above board, with proper education, knowledge and informed consent. This is what will help to end stigma, stop spread and protect the wellbeing and safety of people affected by HIV.