492.   Opt-out vs Risk based HIV testing in India
Session: Poster Abstract Session: HIV Testing and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
  • opt out vs risk based screening.pdf (80.9 kB)
  • Background: 

    Demographically the second largest country in the world, India has also the third largest number (2.27 million in 2008) of people living with HIV/AIDS. CDC’s revised recommendations for HIV testing in healthcare settings call for identifying undiagnosed HIV infection by performing non-targeted, opt-out HIV screening in areas where prevalence of undiagnosed HIV infection is above 0.1%. The feasibility of opt-out strategy in India is not tested (adult HIV prevalence 0.29%), where patient initiated voluntary testing is followed universally. The aim of the study was to determine the prevalence of newly diagnosed HIV infection by performing the new opt-out HIV screening when compared to the old risk based targeted HIV testing.


    A cross sectional study was performed in the Apollo Hospital (AH) for a period of 1 month. AH is the largest tertiary referral hospital in South India with an annual hospital census of more than100,000 population. Opt-out HIV testing was offered to the patients undergoing any invasive procedures, and the risk based screening was done to the patients suspected to have HIV infection. HIV testing was done by ELISA method to both the groups. HIV prevalence rate and the patient characteristics were compared between the groups.


    During the study period 1990 patients underwent HIV testing. Seventeen patients (17/1990) were tested positive for HIV with a prevalence of 0.85%. In comparison to the risk based mode triple the number of patients, and more number of females & elderly patients underwent HIV testing in the opt-out mode. The HIV prevalence rate in opt-out mode was marginally higher than the risk based mode.

    Table 1. Patient characteristics and comparisons of those who were tested for HIV



    Opt-out testing

    Risk based testing

    No of people tested



    Median Age



    Females Tested

    41.71% (n-627)

    30.5% (n-149)

    HIV positive patients



    Male: Female




    Opt-out HIV testing tested & identified more number of HIV infected patients. It was acceptable to females and older people. It is time to change to this new strategy from the old risk based screening currently practiced in India.

    Subject Category: H. HIV/AIDS and other retroviruses

    D Sureshkumar, Infectious Diseases, Apollo Hospitals, Chennai, India, Vasanth Nagvekar, Apollo Hospitals, Chennai, India and V. Ramasubramanian, MD, MRCP, Infectious Diseases, Apollo Hospitals Chennai, Chennai, India


    D. Sureshkumar, None

    V. Nagvekar, None

    V. Ramasubramanian, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.