Requirements for consent for blood borne virus testing vary across European countries and differ across infections in some countries. In many countries explicit informed consent, sometimes accompanied by pre- and post-test counselling, is recommended for HIV testing. In others, a written consent is required. Complicated HIV testing consent procedures are a barrier for testing implementation in many settings, particularly in non-specialist healthcare settings. However, a comprehensive overview of European consent requirements is lacking.

This EuroTEST project aims to assess legal and policy frameworks for blood borne virus (HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) testing consent requirements in the countries of the WHO European Region, including the extent to which requirements differ for HIV and hepatitis testing, and to assess practices for how consent is obtained in reality.

The work was led by a EuroTEST working group consisting of European HIV and hepatitis clinicians and community representatives and supported by colleagues in ECDC and WHO/Europe and the EuroTEST Steering Committee. An initial literature search was conducted to identify published national HIV, HBV and HCV testing policies, guidelines and recommendations in European countries. Yielding limited information about consent requirements, this mapping was supplemented with a dedicated survey on testing consent requirements in the countries of the WHO European Region.

The survey mapped differences between consent requirements for HIV and viral hepatitis testing according to countries’ legal frameworks, national policy/guidelines and how consent is obtained in reality – overall and by setting. Data collection and validation took place during October 2023 - April 2024 and generated 84 responses from 34 countries.

Results were presented in an abstract for the 25^th International AIDS Conference in Munich in July 2024 and was accepted as a poster (see picture below) and are forthcoming in a peer-reviewed publication.

In summary, the work found that written or documented consent remains a requirement for HIV testing in more than a third of the responding countries, while opt-out testing was much more common for viral hepatitis with written/documented consent being a policy requirement in five countries only.