| Desperately seeking targets: the ethics of routine HIV testing in low-income countries. | |
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MedLine Citation:
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PMID: 16501715 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) pandemic, and responses to it, have exposed clear political, social and economic inequities between and within nations. The most striking manifestations of this inequity is access to AIDS treatment. In affluent nations, antiretroviral treatment is becoming the standard of care for those with AIDS, while the same treatment is currently only available for a privileged few in most resource-poor countries. Patients without sufficient financial and social capital -- i.e., most people with AIDS -- die each day by the thousands. Recent AIDS treatment initiatives such as the UNAIDS and WHO "3 by 5" programme aim to rectify this symptom of global injustice. However, the success of these initiatives depends on the identification of people in need of treatment through a rapid and massive scale-up of HIV testing. In this paper, we briefly explore key ethical challenges raised by the acceleration of HIV testing in resource-poor countries, focusing on the 2004 policy of routine ("opt-out") HIV testing recommended by UNAIDS and WHO. We suggest that in settings marked by poverty, weak health-care and civil society infrastructures, gender inequalities, and persistent stigmatization of people with HIV/AIDS, opt-out HIV-testing policies may become disconnected from the human rights ideals that first motivated calls for universal access to AIDS treatment. We leave open the ethical question of whether opt-out policies should be implemented, but we recommend that whenever routine HIV-testing policies are introduced in resource-poor countries, that their effect on individuals and communities should be the subject of empirical research, human-rights monitoring and ethical scrutiny. |
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Authors:
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Stuart Rennie; Frieda Behets |
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Publication Detail:
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Type: Journal Article Date: 2006-02-23 |
Journal Detail:
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Title: Bulletin of the World Health Organization Volume: 84 ISSN: 0042-9686 ISO Abbreviation: Bull. World Health Organ. Publication Date: 2006 Jan |
Date Detail:
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Created Date: 2006-02-27 Completed Date: 2006-03-31 Revised Date: 2009-05-29 |
Medline Journal Info:
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Nlm Unique ID: 7507052 Medline TA: Bull World Health Organ Country: Switzerland |
Other Details:
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Languages: eng Pagination: 52-7 Citation Subset: E; IM |
Affiliation:
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Department of Dental Ecology, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599-7450, USA. stuart_rennie@unc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Botswana Developing Countries* Female HIV Infections / diagnosis* Human Rights Humans Informed Consent Male Mass Screening / ethics* Policy Making |
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