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R Bayer

Publications and source records attributed to R Bayer.

150 records · Page 9Linked to original sources
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[Legal and ethical aspects related to AIDS].

Ethics, law, and politics converge in three areas relating to AIDS: discrimination against HIV-infected persons, confidentiality of diagnosis, and exercise of the coercive powers of the State. An analysis is made of these areas, with particular emphasis on experience in the United States. Discrimination against HIV-infected persons is objectionable for moral reasons and may be counterproductive to public health. Irrational beliefs regarding the ease of contracting HIV infection are not uncommon and lead to the exclusion of infected persons from workplaces and schools. Such discrimination could lead to resistance to voluntary testing and to all contact with health care services, and could, in the final analysis, produce harmful effects. Confidentiality with regard to medical diagnosis of AIDS was considered very important in the United States during the first years of the epidemic, but health authorities subsequently began to require notification of the names of infected persons for inclusion in a confidential registry. In September 1985 the State of Colorado made it compulsory to notify the health authorities of positive results of HIV antibodies tests, and 18 states have followed suit. Notification of third parties poses complex problems. Generally speaking, it is considered that health personnel have the right, but not the obligation, to inform those who are exposed to risk. The notion of coercion with regard to AIDS has been favored by disapproval of behavior linked to transmission of the infection. Isolation policies that have been put into effect in certain countries have been vigorously debated. In several nations certain behavior entailing risk of transmitting the infection has been penalized.

Acquired Immunodeficiency Syndrome↗
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A balancing act: the tension between case-finding and primary prevention strategies in New York State's voluntary HIV counseling and testing program in women's health care settings.

This study sought (1) to identify factors that influence women's willingness to accept voluntary HIV counseling and testing at New York State Family Planning Programs (FPPs) and Prenatal Care Assistance Programs (PCAPs) and (2) to evaluate the effectiveness of such a voluntary counseling and testing program. Telephone interviews elicited organizational-level data from 136 agencies; a combination of telephone and face-to-face interviews was used to gather provider data from 98 HIV counselors; and client data were gathered from 354 women in face-to-face interviews at counseling sites. Slightly fewer than 60% of women agreed to be counseled, and, of those, under half consented to an HIV test at the counseling site. Approximately two thirds of the women who were tested returned for their results and posttest counseling. Clients' recall of pretest counseling content was relatively poor. Bivariate and regression analyses suggest that client, provider, and organizational factors are all associated with rates of pretest counseling and testing. The current voluntary counseling and testing program is achieving only moderate success. Although a substantial number of clients accept HIV counseling, many women remain reluctant to consent to HIV testing, and many who accept testing do not return for their results. Moreover, among those who receive pretest counseling, many do not recall important informational content, which suggests variation may exist in the quality of counseling or that one-time HIV counseling interventions are insufficient to communicate complex information. Medical Subject Headings (MeSH): AIDS, HIV serodiagnosis, women's health, patient education.

AIDS Serodiagnosis↗