Opt-out HIV testing: An ethical analysis of women’s reproductive rights

2011 ◽  
Vol 18 (5) ◽  
pp. 734-742 ◽  
Author(s):  
Loren Fields ◽  
Clair Kaplan
Keyword(s):  
Hiv Testing ◽  
Ethical Issues ◽  
Reproductive Rights ◽  
Standard Of Care ◽  
Perinatal Transmission ◽  
Ethical Analysis ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Opt Out ◽  
In Pregnancy

As the HIV epidemic continues to grow worldwide, women are increasingly and disproportionally affected. With the introduction of anti-retroviral medications that have been found to effectively prevent perinatal transmission of HIV, the approach to HIV testing in pregnant women has grown increasingly more controversial. In recent years, the model of voluntary counseling and testing (VCT) has come into question with opt-out testing now advocated for by the Centers for Disease Control and occurring widely in pregnancy. The benefits of opt-out testing are numerous and may justify its use in replacing the VCT that many have come to see as insufficient. An ethical analysis of opt-out testing suggests it may be at odds with true informed consent and involve a degree of coercion that would not be allowed outside the prenatal setting. If opt-out testing is going to remain the standard of care then the ethical issues it raises must be made transparent. Strategies need to be designed for ensuring that HIV counseling and testing in pregnancy is done in accordance with ethical and reproductive rights principles.

scholarly journals Internet-Facilitated, Voluntary Counseling and Testing (VCT) Clinic-Based HIV Testing among Men Who Have Sex with Men in China

PLoS ONE ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. e51919 ◽  
Author(s):  
Huachun Zou ◽  
Zunyou Wu ◽  
Jianping Yu ◽  
Min Li ◽  
Muhtar Ablimit ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Voluntary Counseling ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Sex With Men

scholarly journals Uptake and utilization of institutional voluntary HIV testing and counseling services among students aged 18-24 in Kenya’s public Universities

1970 ◽  
Vol 19 (4) ◽  
pp. 3190-3199
Author(s):  
Caliph Cheruiyot ◽  
Dennis Magu ◽  
Patrick Mburugu ◽  
Daniel Sagwe
Keyword(s):  
University Students ◽  
Hiv Testing ◽  
Public Universities ◽  
Higher Learning ◽  
Counseling Services ◽  
Voluntary Counseling And Testing ◽  
Hiv Testing And Counseling ◽  
Counseling And Testing ◽  
Testing And Counseling ◽  
Hiv Aids

Background: Kenya is home to an estimated 1.7 million people living with HIV/AIDS. According to the Kenya AIDS Indicator survey KAIS 2012, HIV prevalence in the age group 15-24 stood at 2.2%. Globally, young people aged 15-24 are a highly vulnerable population with respect to HIV/AIDS infection and transmission. HIV testing and counseling services play a critical role as an entry point to care and treatment. However, uptake of HIV testing and counseling services among the youth in Kenya has been reportedly low. Youths at Universities are among the priority populations in HIV/AIDS programs.Objectives: This study aimed to determine the barriers to uptake and utilization of institution-based voluntary counseling and testing VCT services among students aged 18-24 in selected public universities in Kenya. The specific objectives were to determine the factors associated with uptake and utilization and the association between various socio-demographic factors and service uptake in institutional VCT facilities.Methods: This research utilized a descriptive cross-sectional study design where primarily, data was collected using semi-structured questionnaires and through focus group discussions held with the students in the sampled Universities. Data available at Jomo Kenyatta University of Agriculture and Technology JKUAT Hospital VCT were reviewed for the period 2010 and 2016 to give an insight into service utilization rates among students. Multi-stage sampling technique was utilized to reach a student sample size of 305 from the selected public Universities in Kenya.Results: Uptake of institutional VCT services among University students sampled stood at 45% from a population where 84.4% were aware of the presence of these services on their campuses. More males than females utilized the services. Emerging themes from the study indicated that participants utilized the services for different reasons. Accessibility to test site, testing hours, fear to be seen at site and fear of test result were also identified as factors affecting service uptake. These factors also were also reported when students were asked about their desired characteristics of a VCT facility on campus.Conclusion: This study has unraveled the factors that are associated with testing and counseling in institutional facilities. University students seem to seek and utilize VCT services for different reasons. It is also clear that patterns of services utilization vary from group to another as observed in the case of year of study, gender and age category.Recommendations: It is necessary for policy makers in institutions of higher learning together with those tasked with managing healthcare services in these institutions to adopt approaches that will overcome the barriers to utilization of VCT services among students. With knowledge of the factors associated with uptake and utilization of VCT services in institutional facilities, efforts to tackle the barriers and maximize on enhancers should be utilized fully in order to improve uptake and utilization of services. More research should also focus on the persisting risky sexual behaviors among University students despite the high knowledge they have on HIV/AIDS.Keywords: Higher learning institutions, voluntary counseling and testing, HIV, barriers and uptake.

In Reply: HIV Screening in Pregnancy

PEDIATRICS ◽  
1991 ◽  
Vol 88 (3) ◽  
pp. 657-658
Author(s):  
STANLEY A. PLOTKIN
Keyword(s):  
Hiv Testing ◽  
Breast Feeding ◽  
Universal Screening ◽  
Ethical Issues ◽  
Task Force ◽  
Hiv Screening ◽  
Negative Effects ◽  
Pediatric Aids ◽  
The Subject ◽  
In Pregnancy

Parker and Traverse raise the question of universal screening of newborns. The AIDS Task Force recently has completed statements on HIV testing of mothers and newborns and on ethical issues relating to pediatric AIDS. The subject is far too complicated to summarize in a letter. Suffice it to say that the Task Force believes that involuntary testing of newborns is not yet justified by either the risk of breast-feeding or the proven therapeutic options available for the child when one considers the negative effects of involuntary testing.

Uptake of HIV testing during antenatal care in Honduras

2017 ◽  
Vol 29 (6) ◽  
pp. 526-530
Author(s):  
Anne Sebert Kuhlmann ◽  
Eleanor P Bergquist ◽  
Qiang Fu ◽  
Enbal Shacham ◽  
Janine Foggia ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Hiv Testing ◽  
Standard Of Care ◽  
Married Women ◽  
Hiv Counseling And Testing ◽  
Hiv Counseling ◽  
Counseling And Testing ◽  
Vertical Transmission Of Hiv ◽  
Testing Practices ◽  
Mother To Child

In order to interrupt vertical transmission of HIV, the WHO recommends universal HIV testing during antenatal care (ANC), a policy that has been adopted by the Ministry of Health in Honduras. We examined HIV counseling and testing practices during ANC in the Honduras Demographic and Health Survey to understand compliance with this established standard of care. Among currently married women with a child aged five years or younger who attended ANC, only 66% recalled being offered HIV testing during ANC, yet 95% of those got tested. Older, less literate women who lived in a rural area, a small household, or had an older husband were significantly less likely to recall being offered HIV testing. These findings highlight necessary revisions to ANC protocols to ensure that all women in Honduras get HIV testing to interrupt mother-to-child transmission.

scholarly journals Evidence for the importance of community involvement: Implications for initiatives to prevent mother-to-child transmission of HIV

2001 ◽  
Keyword(s):  
Community Involvement ◽  
Hiv Transmission ◽  
Perinatal Transmission ◽  
Companion Paper ◽  
Lessons Learned ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Mother To Child

This paper offers lessons learned from a literature review of community involvement in biomedical and other technologies that can guide appropriate and effective introduction of services for prevention of mother-to-child transmission of HIV. A companion paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about barriers to using voluntary counseling and testing services; stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission of HIV. A separate publication (“Community involvement in the prevention of mother-to-child transmission of HIV: Insights and recommendations”) offers recommendations for community involvement strategies. Placed within the framework of community involvement, an intervention that addresses mother-to-child transmission of HIV offers an enormous opportunity to improve HIV prevention and care. Successful interventions can influence how AIDS is perceived by the community, reduce stigma, and have an effect beyond the immediate prevention of perinatal transmission.

scholarly journals Determinants of Previous HIV Testing and Knowledge of Partner’s HIV Status Among Men Attending a Voluntary Counseling and Testing Clinic in Dar es Salaam, Tanzania

2012 ◽  
Vol 7 (6) ◽  
pp. 450-460 ◽  
Author(s):  
Donaldson Conserve ◽  
Luis Sevilla ◽  
Jessie Mbwambo ◽  
Gary King
Keyword(s):  
Condom Use ◽  
Hiv Testing ◽  
Dar Es Salaam ◽  
Hiv Disclosure ◽  
Sub Saharan Africa ◽  
Hiv Status ◽  
Voluntary Counseling ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Sub Saharan

Voluntary Counseling and Testing (VCT) remains low among men in sub-Saharan Africa. The factors associated with previous HIV testing and knowledge of partner’s HIV status are described for 9,107 men who visited the Muhimbili University College of Health Sciences’ VCT site in Dar es Salaam, Tanzania, between 1997 and 2008. Data are from intake forms administered to clients seeking VCT services. Most of the men (64.5%) had not previously been tested and 75% were unaware of their partner’s HIV status. Multivariate logistic regression revealed that age, education, condom use, and knowledge of partner’s HIV status were significant predictors of previous HIV testing. Education, number of sexual partners, and condom use were also associated with knowledge of partner’s HIV status. The low rate of VCT use among men underscores the need for more intensive initiatives to target men and remove the barriers that prevent HIV disclosure.

Sign in / Sign up

Export Citation Format

Share Document