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To the Editor: In their Special Communication, Dr Bartlett and colleagues¹ noted that the benefits and harms of the Centers for Disease Control and Prevention (CDC) recommendations for opt-out testing for human immunodeficiency virus (HIV) in health care settings have yet to be systematically assessed. Although the authors listed some possible metrics, their suggestions did not emphasize several critical potential outcomes and effects of opt-out testing.

I believe that the metrics must include the following: (1) percentage of persons living with HIV aware of their serostatus; (2) percentage of persons newly diagnosed with HIV receiving high-quality, comprehensive health care that includes, but is not limited to, HIV-specific services; (3) percentage of persons testing positive who receive evidence-based, patient-centered HIV prevention services to avoid transmission; (4) percentage of persons testing HIV seronegative but at imminent risk of infection who receive evidence-based, patient-centered HIV prevention services; (5) percentage of persons (stratified by . . . [Full Text of this Article]

David R. Holtgrave, PhD
dholtgrave@jhsph.edu
Department of Health, Behavior and Society
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland

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