Desperately seeking targets: the ethics of routine HIV testing in low-income countries
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,...
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| Format: | Article |
| Language: | English |
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The World Health Organization
2006-01-01
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| Series: | Bulletin of the World Health Organization |
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| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000100014 |
| _version_ | 1797287545151684608 |
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| author | Rennie Stuart Behets Frieda |
| author_facet | Rennie Stuart Behets Frieda |
| author_sort | Rennie Stuart |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-07T18:34:43Z |
| format | Article |
| id | doaj.art-11d08075517945bb9dd920c3aac5a23e |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:34:43Z |
| publishDate | 2006-01-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-11d08075517945bb9dd920c3aac5a23e2024-03-02T05:02:43ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862006-01-018415257Desperately seeking targets: the ethics of routine HIV testing in low-income countriesRennie StuartBehets FriedaThe 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.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000100014HIV infections/diagnosisAcquired immunodeficiency syndrome/diagnosisEthics, MedicalHuman rightsInformed consentDeveloping countriesBotswana |
| spellingShingle | Rennie Stuart Behets Frieda Desperately seeking targets: the ethics of routine HIV testing in low-income countries Bulletin of the World Health Organization HIV infections/diagnosis Acquired immunodeficiency syndrome/diagnosis Ethics, Medical Human rights Informed consent Developing countries Botswana |
| title | Desperately seeking targets: the ethics of routine HIV testing in low-income countries |
| title_full | Desperately seeking targets: the ethics of routine HIV testing in low-income countries |
| title_fullStr | Desperately seeking targets: the ethics of routine HIV testing in low-income countries |
| title_full_unstemmed | Desperately seeking targets: the ethics of routine HIV testing in low-income countries |
| title_short | Desperately seeking targets: the ethics of routine HIV testing in low-income countries |
| title_sort | desperately seeking targets the ethics of routine hiv testing in low income countries |
| topic | HIV infections/diagnosis Acquired immunodeficiency syndrome/diagnosis Ethics, Medical Human rights Informed consent Developing countries Botswana |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000100014 |
| work_keys_str_mv | AT renniestuart desperatelyseekingtargetstheethicsofroutinehivtestinginlowincomecountries AT behetsfrieda desperatelyseekingtargetstheethicsofroutinehivtestinginlowincomecountries |