Implications of the HIV testing protocol for refusal bias in seroprevalence surveys.

Bias is much smaller, and only marginally statistically significant, when the study protocol explicitly allows participants to opt out of post-test counseling and the return of HIV test results.

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First, we identified marginally significant bias under the assumptions of a protocol whereby test results are not returned to respondents.

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In the first binary logistic model (consent levels B and C versus A), the likelihood of being HIV positive is correlated with consent for testing and post-test counseling and highly significant: for each percentage point increase in the likelihood of infection, the odds to consent to testing and post-test counseling (consent level A) decrease by 1.5%.

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