• L R Salkeld, S J McGeehan, E Chaudhuri, and I M Kerslake.
• North Bristol NHS Trust, Frenchay Hospital, Bristol, UK. leesalkeld@hotmail.com
• J Med Ethics. 2009 Jul 1; 35 (7): 402-6.

ObjectiveTo explore the accounts and perspectives of junior doctors who were offered an HIV test by their employing National Health Service (NHS) trust and discuss ethical issues posed by this new policy.DesignQualitative in-depth interview study.Setting4 NHS hospital trusts.Participants24 junior doctors who had been offered an HIV test as part of their pre-employment occupational health checks.ResultsThe manner in which HIV tests were offered to junior doctors varied both between and within the NHS trusts. Overall, the doctors were highly critical of the way the HIV test was offered. Recurrent themes surrounding a lack of discussion and information regarding the indications for the test and implications of a positive result influenced the the doctors' perception of their experiences. As a consequence of the shortcomings of how the test was offered, most of the doctors held the misperception that HIV testing was mandatory and many felt unable to decline the test. The majority of doctors referred to patient protection as adequate justification for being offered an HIV test.ConclusionsJunior doctors offered an HIV test under new Department of Health occupational health guidance were disparaging about how the test was offered. The findings of this study affect thousands of junior doctors in the UK, and the impact of these results is extensive. Participants' suggestions regarding how the process of offering an HIV test can be improved are discussed and ethical issues regarding the new Department of Health policy are highlighted.

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