title: Is the absolute requirement for informed consent before HIV testing a barrier to public health? A case report and management challenges.
abstract: Clinicians in sub-Saharan Africa are faced with a major challenge of parental refusal to test their children for HIV. We present a case of a nine-month-old child with a clinical presentation suggestive of HIV infection whose mother persistently declined HIV testing of the child or herself. The case illustrates the difficulties faced by the clinicians caring for the child in an isolated location in West Africa. While not eliminating these difficulties, an opt-out approach to paediatric HIV testing in sub-Saharan Africa may increase the proportion of children who access treatment when they need it, particularly when this is backed by the development of more effective national and regional clinical and legislative frameworks for HIV testing in children.
authors.affiliation: a Medical Research Council Unit , Fajara and Basse Stations , The Gambia.
authors.forename: David
authors.initials: D
authors.lastname: Ameh
authors.forename: Uchendu O
authors.initials: UO
authors.lastname: Uchendu
authors.forename: Oyedeji A
authors.initials: OA
authors.lastname: Adeyemi
authors.forename: Readon C
authors.initials: RC
authors.lastname: Ideh
authors.forename: Bernard E
authors.initials: BE
authors.lastname: Ebruke
authors.forename: Grant
authors.initials: G
authors.lastname: Mackenzie
authors.forename: Stephen
authors.initials: S
authors.lastname: Howie
authors.forename: Tumani
authors.initials: T
authors.lastname: Corrah
mesh_terms: D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control; D006291:Health Policy; D006801:Humans; D007223:Infant; D007258:Informed Consent; D010342:Patient Acceptance of Health Care; D011634:Public Health; D019035:Rural Health Services
keywords: HIV/AIDS; diagnosis; provider-initiated testing and counselling; stigmatisation; sub-Saharan Africa; virological testing; voluntary testing and counselling; ‘opt-out’