TABLE OF CONTENTS
S No Topic Page No
1
Introduction
3
2
Mandatory HIV testing among Pregnant women
4
3
Pros of Mandatory HIV testing for pregnant women
5-6
4
Arguments against Mandatory testing for pregnant women
7
5
Arguments against Mandatory Premarital HIV Testing
8-9
6
Proponents of Mandatory Premarital HIV Testing
10
7
Conclusions
10-11
8
Recommendations
12
9.
References
12-13
Introduction
There are different kinds of HIV testing: voluntary testing, where the person tested makes the decision; mandatory testing, where you are tested whether or not you want to be tested; and routine testing, where, if you got some blood drawn for some other reason, an extra tube of blood would be drawn and sent off for an HIV test. Opt out is
when you choice not to opt in for example to be tested at health facilities
by doctors, opt out is when you decide to be tested on your own time.
Is mandatory testing a better strategy for preventing HIV/AIDS is the main question that is discussed in this document.
This paper discusses various arguments by the proponents and opponents of mandatory HIV testing in two scenarios.
1. Mandatory HIV testing for pregnant women &
2. Mandatory premarital HIV testing.
I personally support the mandatory testing for both the above two groups for some specific conditions though I don’t advocate mandatory testing as the best strategy to be implemented as a prevention strategy for HIV globally.
Arguments for and against mandatory testing for pregnant women can be broadly discussed under the following categories:
1. Legal Arguments: Examples of legal concerns surrounding the practice of mandatory testing include constitutional i...
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...fatal consequences, will result in the coercion of mothers by health care workers who believe, erroneously, that they know with certainty what is best for her baby8. HIV testing should be voluntary, and only performed after women are honestly informed of the likely consequences of a positive test.
1. Laurent Mandelbrot et al., Lamivudine-Zidovudine Combination for Prevention of Maternal-Infant Transmission of HIV-1, 285 JAMA, 2083, 2083-2093 (2001).
2. Wolf LE et al. When Parents Reject Interventions to Reduce Postnatal Human
Immunodeficiency Virus Transmission.Arch Pediatr Adolesc Med. 2001;155: 927-33.
3. Udo Schuklenk, PhD, and Anita Kleinsmidt, LLB, LLM, Rethinking Mandatory HIV Testing During Pregnancy in Areas With High HIV Prevalence Rates: Ethical and Policy Issues, American Journal of Public Health , Vol 97, No. 7, 1179-83, July 2007
The study took advantage of an oppressed and vulnerable population that was in need of medical care. Some of the many ethical concerns of this experiment were the lack of informed consent, invasion of privacy, deception of participants, physical harm, mental harm, and a lack of gain versus harm. One ethical problem in this experiment was that the benefits did not outweigh the harm to participants. At the conclusion of the study there were virtually no benefits for the participants or to the treatment of syphilis. We now have
The government played a major part in the AIDS situation. The government’s blood banks did not wish to check blood with a test developed by the CDC because it was not “cost-efficient.” The government also neglected the CDC of large sums of money needed in the pursuit of a cure or vaccine in the disease and thought more of dollar signs that the lives of people.
The stigmatization and discrimination that goes hand and hand with a positive diagnosis of HIV/AIDS is overwhelming. FreeDictonary.com defines discrimination as the “treatment or consideration based on class or category rather than individual merit; partiality or prejudice.” In essence, discrimination is about actions and stigma relates to beliefs and attitudes. Both however are built up on negative views of a person just because they are apart of a specific group. All over the world, there are well-documented cases of people living with HIV that are being denied the right to health- care, work, education, and freedom of movement, among others. (UNAIDS 2005) This stigma and discrimination exist globally, although it appears differently...
...be pathway to autonomy by supporting a person’s entitlement to make decisions about their own health and health care (Feinsod & Wagner, 2008). It is a person’s right to know when they seek medical treatment it will be delivered with no bias or discrimination. This can be achieved by continuing AIDS education in health care facilities and to their staff. The education would also benefit society. The health care community has an ethical duty to do whatever is needed to ensure that all patients, including those with AIDS, gain from the most current treatments. Nurses have many roles in patient care. Expanding some of those roles, in order to determine the various aspects of a patient’s life, to help organize services to start/continue the most current treatment available to AIDS patients, may assist in minimizing the fear of discrimination in the clinical setting.
Athletes have constitutional rights that could be violated by mandated HIV testing. There are protections under the Fourth and Fifth Amendments relating to ones right to privacy, protection against unreasonable searches in blood testing, and protection against self-incrimination if athletes had to publicly disclose their HIV status (Anderson
Spink, Gemma. "AIDS." AVERTing HIV and AIDS. 23 Dec 2009. Web. 11 Jan 2010. .
In the US, home HIV-testing kits are available, which hopefully leads to more people knowing their status. If there is access to these self-testing kits in other countries, as well as a higher availability of confidential testing and education materials, more people may be encouraged to get tested.
...trive to live normal lives. Scientists also struggle to create a vaccine to get rid of HIV permanently. It is an important live saving decision to practice safe sex or abstinence and also to avoid the using needles to inject drugs.
I am positive; the simplest statement suddenly carries a huge weight when the words HIV or AIDS are followed right after. In the 1980’s HIV meant AIDS and AIDS meant a rapid and awful death. Death always seemed to be the end result in a world where we did not understand the disease that seemed to come from nowhere but was killing at an expedited rate. Thirty plus years later there is still no cure but there is now hope. Having HIV or AIDS is no longer an immediate death sentence. People infected with the virus can live a long and relatively normal life (2).
Informed consent is a very serious decision a patient has to make when it comes to their health and consenting to procedures that are believed to cure or treat their current health status. It is important to address the effectiveness of the role a physician play in the informed consent process assuring that the patient has given truly informed consent and what safeguards can be put in place to assure the patient is exercising informed consent. Informed consent is based on the fact that the person consenting is a rational individual that is aware of the action to which he/she is consenting. Allen and McNamara (2011) notes that "On the standard understanding, the important elements of informed consent are the provision of information, the voluntariness of the choice and the competence of the chooser to make the choice— so the potential research participant should be provided with information relevant to the decision to participate, they should be able to choose freely about their participation and they should be competent to decide.
...ld Health Organization (WHO) report shows that, most people living with HIV or at risk for HIV do not have access to treatment, care and prevention and there is still no cure. In spite of these challenges, there have been successes. Global efforts have been made to address the epidemic, specifically in the last decade. The HIV prevalence rates have been reduced in a small but growing number of countries due to prevention and new HIV infections are believed to be on the decline. In addition to this, the number of people with HIV receiving treatment in resource poor countries has increased 10 times since 2002, nearing an estimated 4 million by 2008.
Although HIV testing has its benefits, it seems that any type of mandatory testing and subsequent "public disclosure" could potentially outweigh these positives via the harm and stigmas that arise as a result. Accordingly, it seems that a voluntary approach should be the course of action that is taken, while being advocated for both by the general public, and by health care providers together. That way the people that are infected can be educated about high risk behavior, so as to begin to help stop the spread of the disease. Otherwise, mandatory tests and disclosure only work to identify the infected individuals, but really do not provide much to help their plight. With the help of advocacy for voluntary testing, perhaps society can glean the benefits from the tests and privately identify those individuals or groups at risk that wish to remain anonymous, without the negative discrimination and stigmatisms that may result from direct identifiers in terms of mandatory testing and subsequent disclosure.
“Two decades after HIV first appeared an estimated 30 million people worldwide have contracted the virus; 11.7 million people have dies of AIDS” (Frankowski xi). This deadly virus has continually and rapidly spread to all different people. Around the world this virus is a major problem and is affecting more women and children then ever before. Although when this disease first appeared it was male dominated, but they have passed it on to the women and in which case they pass on to their children when they are in the womb.
According to www.aids.gov, 1.2 million people have HIV in the United States. 1 out of 8 living with HIV are unaware that they have the illness. HIV affects people and families all over the world, but should people be able to take their own HIV test? This topic has had a lot of controversy in the previous years. HIV is an illness that affects a lot of people. Walgreens got the permission to give HIV tests. The test is called OraQuick. It works this way, you buy a kit at Walgreens or other stores that supply it. Then in the kit there is a tube with liquid in it and a stick with pads. First you take the tube and put it in a tube holder, with the stick you rub your upper gums once and your lower gums once. After, you put that in the liquid and you get results in twenty minutes. It is very private and you wouldn’t have to tell anyone you even did the test. A doctor should always be aware of your conditions because being HIV positive can lead to depression and you can’t trust the take home kits as much as you can trust a doctor’s work.
The emergence of HIV/AIDS is viewed globally as one of the most serious health and developmental challenges our society faces today. Being a lentivirus, HIV slowly replicates over time, attacking and wearing down the human immune system subsequently leading to AIDS (Acquired Immunodeficiency Syndrome) at which point the affected individual is exposed to life threatening illnesses and eventual death. Despite the fact that a few instances of this disease have been accounted for in all parts of the world, a high rate of the aforementioned living with HIV are situated in either low or medium wage procuring nations. The Sub-Saharan region Africa is recognized as the geographic region most afflicted by the pandemic. In previous years, people living with HIV or at risk of getting infected did not have enough access to prevention, care and treatment neither were they properly sensitized about the disease. These days, awareness and accessibility to all the mentioned (preventive methods, care etc.) has risen dramatically due to several global responses to the epidemic. An estimated half of newly infected people are among those under age 25(The Global HIV/AIDS Epidemic). It hits hard as it has no visible symptoms and can go a long time without being diagnosed until one is tested or before it is too late to manage.