title: Dynamics of care, situations of choice: HIV tests in times of ART.
abstract: In the 1990s, African AIDS programs followed a voluntary counseling and testing (VCT) approach to HIV testing. In the wake of large scale AIDS treatment programs, policymakers opted for routine provider-initiated testing (PITC) with less emphasis on counseling, which led to concerns about the ethical conduct of HIV testing. Inspired by Annemarie Mol, we ask if PITC can be framed as good care, rather than as medical domination that threatens to violate patients' rights. Based on fieldwork in Ugandan and Kenyan health facilities, we reveal that situations of choice vary: patients in hospital wards, are given time to decide whether they want a test, while in antenatal care testing women find it very hard to opt-out. We argue that the medical context inherent in PITC provides an attractive moral space for people to undergo HIV tests.
authors.affiliation: Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Amsterdam, The Netherlands. a.p.hardon@uva.nl
authors.forename: Anita
authors.initials: A
authors.lastname: Hardon
authors.forename: Emmy
authors.initials: E
authors.lastname: Kageha
authors.forename: John
authors.initials: J
authors.lastname: Kinsman
authors.forename: David
authors.initials: D
authors.lastname: Kyaddondo
authors.forename: Rhoda
authors.initials: R
authors.lastname: Wanyenze
authors.forename: Carla Makhlouf
authors.initials: CM
authors.lastname: Obermeyer
mesh_terms: D015492:AIDS Serodiagnosis; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003376:Counseling; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006761:Hospitals; D006801:Humans; D007630:Kenya; D008297:Male; D008403:Mass Screening / Q000379:methods; D014454:Uganda; D035141:Voluntary Programs
chemical_list: D044966:Anti-Retroviral Agents