Ethical HIV Testing in Poor Countries Needed

Testing without consent important for HIV surveillance
By A. Agrawal, PhD
HealthDay Reporter

THURSDAY, Jan. 22 (HealthDay News) -- Testing a patient's blood without their consent for HIV is important for HIV surveillance, but needs to be carefully implemented in developing countries to ensure that testing is done ethically, according to an article published online Jan. 20 in PLoS Medicine.

Stuart Rennie, Ph.D., from the University of North Carolina at Chapel Hill, and colleagues note that unlinked, anonymous HIV testing (UAT), where leftover patient's blood given for other purposes is tested without their consent, has been important in HIV surveillance in developed countries, allowing public health interventions, planning and prevention.

However, in low-income countries, the researchers suggest that UAT may present ethical, epidemiological and public health challenges. Confidentiality may be breached, both blood and behavioral data may be collected, or clinics may be set up primarily for surveillance purposes, which are against international ethical guidelines, the authors note. Breeches of confidentiality may particularly harm vulnerable populations such as sex workers, who may be treated unfairly by local authorities, they add.

"Conducting UAT in ethically and epidemiologically sound ways in low-income countries requires a multifaceted approach including local capacity building, community engagement, and increased access to HIV and sexually transmitted infections testing," Rennie and colleagues conclude.

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