“Opt-out” testing for HIV in Africa: a caution

Csete, Joanne; Schleifer, Rebecca; Cohen, Jonathan

doi:10.1016/s0140-6736(04)15509-8

Cited by 31 publications

(26 citation statements)

References 3 publications

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“…The availability of individual pre-test counseling as an option, after group education, was poorly understood by the women surveyed despite its potential benefits especially to women who may is of paramount importance to the women (Bruyn & Paxton, 2005;Csete et al, 2004;Brou et al, 2005;Issiaka et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…The routine offer of HIV testing approach has been stated as being ethically unacceptable unless additional protection assures access to care and confidentiality even in high HIV prevalent settings (De Bruyn & Paxton, 2005;Rennie & Behets, 2006;Gostin, 2006;Csete et al, 2004). Informed consent by the patient/client, as the World Health Organization (WHO) advocates, should be one of the key principles to be adhered when applying the routine offer of HIV testing model (UNAIDS & WHO, 2006), and is one of the major concerns raised on the ethics of routine testing.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An assessment of the understanding of the offer of routine HIV testing among pregnant women in rural Zimbabwe

Mugore¹,

Engelsmann²,

Ndoro³

et al. 2008

AIDS Care

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An assessment of the understanding of the offer of routine HIV testing among pregnant women in rural Zimbabwe

Mugore¹,

Engelsmann²,

Ndoro³

et al. 2008

AIDS Care

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“…Although this is contentious, [3][4][5] international agencies and local governments are making a concerted effort to recast HIV testing and are promoting testing outside the traditional parameters of voluntary counselling and testing:…”

mentioning

confidence: 99%

Women’s expectations of treatment and care after an antenatal HIV diagnosis in Lilongwe, Malawi

Levy

2009

Reproductive Health Matters

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“…In developing countries, HIV is still a major health threat due to lack of access to anti-retroviral medications, and stigma and discrimination are prevalent (Csete, Schleifer, & Cohen, 2004;Haji, Deressa, Davey, & Fogarty, 2014). This may account for HCPs' concerns and render opt-out testing less feasible and possibly unethical (April, 2010;Csete et al, 2004;Rennie & Behets, 2006).…”

Section: Discussionmentioning

confidence: 99%

Health-care providers’ experiences with opt-out HIV testing: a systematic review

et al. 2015

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HIV is now a manageable chronic disease with a good prognosis, but early detection and referral for treatment are vital. In opt-out HIV testing, patients are informed that they will be tested unless they decline. This qualitative systematic review explored the experiences, attitudes, barriers, and facilitators of opt-out HIV testing from a health-care provider (HCP) perspective. Four articles were included in the synthesis and reported on findings from approximately 70 participants, representing diverse geographical regions and a range of human development status and HIV prevalence. Two synthesized findings emerged: HCP attitudes and systems. The first synthesized finding encompassed HCP decision-making attitudes about who and when to test for HIV. It also included the assumptions the HCPs made about patient consequences. The second synthesized finding related to systems. System-related barriers to opt-out HIV testing included lack of time, resources, and adequate training. System-related facilitators included integration into standard practice, support of the medical setting, and electronic reminders. A common attitude among HCPs was the outdated notion that HIV is a terrible disease that equates to certain death. Some HCPs stated that offering the HIV test implied that the patient had engaged in immoral behaviour, which could lead to stigma or disengagement with health services. This paternalism diminished patient autonomy, because patients who were excluded from opt-out HIV testing could have benefited from it. One study highlighted the positive aspects of opt-out HIV testing, in which participants underscored the professional satisfaction that arose from making an HIV diagnosis, particularly when marginalized patients could be connected to treatment and social services. Recommendations for opt-out HIV testing should be disseminated to HCPs in a broad range of settings. Implementation of system-related factors such as electronic reminders and care coordination procedures should be considered, and a social-justice commitment among HCPs should be encouraged.

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“Opt-out” testing for HIV in Africa: a caution

Cited by 31 publications

References 3 publications

An assessment of the understanding of the offer of routine HIV testing among pregnant women in rural Zimbabwe

An assessment of the understanding of the offer of routine HIV testing among pregnant women in rural Zimbabwe

Women’s expectations of treatment and care after an antenatal HIV diagnosis in Lilongwe, Malawi

Health-care providers’ experiences with opt-out HIV testing: a systematic review

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