The 2006 Centers for Disease Control and Prevention (CDC) guidelines recommend standardized, nontargeted opt-out HIV testing for individuals aged 13 to 64 years in all healthcare settings [1, 2]. These guidelines have not been universally

adopted and, while the rate of late HIV diagnosis remains high in many countries, at 28–42% [3-5], with associated increased mortality, healthcare costs and risk of onward HIV transmission [6], the debate on opt-out versus physician-directed diagnostic testing continues [7, 8]. Whatever Wortmannin mouse the HIV testing strategy, there are no large studies assessing what patients believe they are tested for when they undergo a ‘blood test’, nor which blood tests they would agree to in specific settings. In Switzerland, HIV testing requires counselling and patient consent. Yet, in our experience, some patients believe that a ‘blood test’, particularly in the context of a preoperative work-up, routinely screens for HIV and, further, that if no result is communicated, the test must be negative. In our centre, a tertiary university hospital where HIV prevalence in the local population is 0.4% [9], all patients undergoing surgery Bleomycin cell line are evaluated by an anaesthetist. Clotting function

is tested in patients over 40 years old and other tests are requested according to the American Society of Anesthesiologists (ASA) classification assessing anaesthetic risk. In this setting, HIV screening is never performed as it would require an additional visit NADPH-cytochrome-c2 reductase to communicate the results (bedside rapid testing is not employed). We sought to evaluate the proportion of patients who believed incorrectly that they had undergone an HIV test as part of their preoperative work-up and the proportion of those who interpreted the lack of result communication as indicating a negative test. We then examined what proportion of patients would agree in principle to HIV screening prior to future surgery. Informed verbal consent was obtained from all participants. The study was approved by our local ethics committee (protocol 54/08, Centre Hospitalier Universitaire

Vaudois and University of Lausanne, Lausanne, Switzerland). We extracted medical records of all patients aged 16 to 70 years who had undergone elective orthopaedic surgery in our hospital between 1 January and 31 December 2007. We selected orthopaedic surgery to maximize patient age range. In May and June 2008, we informed patients in the target group that they would be invited to complete a voluntary telephone questionnaire, a translation of which is provided in the Appendix S1. Three independent nurses who conducted the questionnaire explained that they were conducting a survey on preoperative blood tests. To avoid excessive focus on HIV testing, questions involving HIV were listed with those regarding other blood tests which the patients might have undergone preoperatively.