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Opt-out HIV testing: an ethical analysis of women's reproductive rights.

Authors
  • Fields, Loren
  • Kaplan, Clair
Type
Published Article
Journal
Nursing Ethics
Publisher
SAGE Publications
Publication Date
Sep 01, 2011
Volume
18
Issue
5
Pages
734–742
Identifiers
DOI: 10.1177/0969733011403555
PMID: 21642334
Source
Medline
License
Unknown

Abstract

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.

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