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Thought experiment examining the ethics of HIV testing policies. Hans P. Schlecht, MD, MMSc Drexel University College of Medicine No Conflicts. HIV Testing Policy. WHO Guidelines – 3 C’s Confidential Be accompanied by Counseling Consent, both Informed and Voluntary US Guidelines
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Thought experiment examining the ethics of HIV testing policies Hans P. Schlecht, MD, MMSc Drexel University College of Medicine No Conflicts
HIV Testing Policy • WHO Guidelines – 3 C’s • Confidential • Be accompanied by Counseling • Consent, both Informed and Voluntary • US Guidelines • Voluntary Counseling and Testing (VCT) • Opt Out (Since September 2006) • all persons aged 13–64 years be screened for HIV in health-care settings in which the prevalence of undiagnosed HIV infection is >0.1%, and that persons with increased risk for HIV be retested at least annually • Mandatory (eg organ donors, immigrants…)
Summary • VCT and Opt-out testing are the only methods to fully meet ethical expectations. • Incentivized testing may potentially be coercive similar to research subject stipends. • Barriers to greater uptake of opt-out testing must be removed so that broad application of Opt-out testing and early treatment can hopefully arrest the spread of HIV.