The law of informed consent exists to reduce the risk of patients being exposed to harms without compensating benefits and to ensure that judgments which are fundamentally ethical and value judgments are made by the patient and not by the physician. Unfortunately, screening programs have not traditionally been conducted with fidelity to these simple principles. The history of mass screening is littered with examples of patients being tested without informed consent and without adequate assessment of the benefits and risks of the screening test. Without substantiation from studies from which a sound basis for action and policy can be generated, long-term and short-term use of screening programs is discouraged due to the unknown benefits, risks, and costs. Good screening programs start with a clear hypothesis and rationale and are tested in a defined population after appropriate institutional review, with careful measurement and assessment of risks and benefits. None of these criteria has been fulfilled sufficiently to warrant widescale HIV testing of child victims of sexual abuse.