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Objective To identify components of a proposed blood-borne virus (BBV) population screening programme and its associated consent procedure that both the public and health practitioners (HPs) would find acceptable. The proposed BBV screening system would aim to reduce late diagnosis of BBVs and be used in patients undergoing routine blood tests, aided by risk stratification software to target individuals at higher risk of infection. Design A Delphi technique was used to build consensus among two separate groups, public participants and HPs in England. Methods A survey incorporating vignettes was developed, with input from an external panel of experts. Over three rounds, 46 public participants and 37 HPs completed the survey, rating statements on a four-point Likert scale. The survey covered issues around stigma and sensitivity, the use of risk stratification algorithms and ‘limited’ patient consent (ie, preinformed of the option to ‘opt-out’). Consensus was defined as >70% of participants agreeing or disagreeing with each statement. Results Consensus was achieved among both groups in terms of acceptability of the screening programme. There was also consensus on using patient data to risk-stratify screening algorithms and the need to obtain some form of consent around the time of drawing blood. Conclusions This study found that the special protected status of HIV in England is no longer deemed necessary today and hinders appropriate care. We propose that a novel ‘limited consent procedure’ could be implemented in future screening programmes. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented commenting on the failure of travel web site to provide adequate information and advisory on malaria.

Argues that HIV specialists must give asylum seekers the care that they need. The extra burden on the NHS is one of the issues cited in the controversy over the number of asylum seekers entering the United Kingdom. The second view is that most of the HIV positive asylum seekers are either "health tourists" (coming here for treatment they couldn't afford at home) or economic migrants abusing our system, and we shouldn't be using scarce resources on them. I suspect that although most healthcare professionals who come into contact with this group of patients would admit that both sides of the argument have some truth they largely sympathise with the first point of view. Until such universal care is available, HIV specialists have no realistic option, practically or ethically, but to give HIV positive asylum seekers the care they need and to support their applications to remain in Britain.