Rethinking mandatory HIV testing during pregnancy in areas with high HIV prevalence rates: ethical and policy issues.
We analyzed the ethical and policy issues surrounding mandatory HIV testing of pregnant women in areas with high HIV prevalence rates. Through this analysis, we seek to demonstrate that a mandatory approach to testing and treatment has the potential to significantly reduce perinatal transmission of HIV and defend the view that mandatory testing is morally required if a number of conditions can be met. If such programs are to be introduced, continuing medical care, including highly active antiretroviral therapy, must be provided and pregnant women must have reasonable alternatives to compulsory testing and treatment. We propose that a liberal regime entailing abortion rights up to the point of fetal viability would satisfy these requirements. Pilot studies in the high-prevalence region of southern African countries should investigate the feasibility of this approach.
Schuklenk
Udo
U
Centre for Ethics in Public Policy and Corporate Governance, Glasgow Caledonian University, Glasgow, Scotland. udo.schuklenk@gmail.com
Kleinsmidt
Anita
A
D015492:AIDS Serodiagnosis / Q000941:ethics; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003219:Confidentiality; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission*; D006291:Health Policy; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D037141:Mandatory Programs / Q000941:ethics*; D008429:Maternal Welfare; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D037841:Pregnant People; D011295:Prenatal Care; D015995:Prevalence; D018570:Risk Assessment
D019380:Anti-HIV Agents