HIV testing without treatment? (12)
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Keep in mind that testing without treating happens all the time when
a country sets up sentinel surveillance for HIV among women attending
ante-natal clinics. This is the standard for tracking an HIV epidemic
in the general population.
For those of you who think that offering counseling and testing is
unethical in countries that cannot offer care to the person, I would
like your perspective on how the epidemic will be tracked and under-
stood if we don't know how many people are HIV positive and in what
groups. Testing in ante-natal clinics is anonymous and unlinked
(testing unused blood), but HIV prevalence studies go on all the time
where it is usually assumed (by US/European ethics committees, to be
sure) that is unethical not to provide HIV results and counseling
when you are knowingly taking blood to test for HIV. That doesn't
mean the researchers have any more to offer the person as far as
care, obviously, it just means they feel they ethically have to pro-
vide the test results and provide counseling.
HIV research studies are being conducted all over Africa and often
involve thousands of people. How should the "Don't test if you can't
treat" motto be applied in these situations? Maybe these studies
should measure HIV prevalence and whatever else the research question
is and forget about the idea of providing test results?
Ellen MacLachlan
mailto:eew7@cdc.gov
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