RESEARCH ARTICLE Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital

Background Early diagnosis of human immunodeficiency virus (HIV) allows for appropriately timed inter-ventions with improved outcomes, but HIV screening among asymptomatic persons and the general population in Singapore remains low. In 2008, Singapore’s Ministry of Health implemented HIV voluntary opt-out screening (VOS) for hospitalised adults. We evaluated the outcome of VOS and surveyed reasons for its low uptake in our institution. Methods We assessed the outcomes of the VOS programme from January 2010 to December 2013 at National University Hospital, a 1081-bed tertiary hospital in Singapore. We also exam-ined reasons for opting-in and opting-out using an interviewer–administered structured questionnaire in a representative sample in January 2013. Results 107,523 patients fulfilled VOS criteria and were offered HIV screening, of which 5215 (4.9%) agreed to testing. 4850 (93.1%) of those who opted-in had an HIV test done. Thre