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At least 19 recordsLinked to original sources
PubMed1989

HIV testing in prisoners: is mandatory testing mandatory?

We studied 977 newly incarcerated Oregon inmates to compare voluntary versus mandatory human immunodeficiency virus antibody (HIVAb) testing in the prison setting. All inmates were offered HIVAb counseling and testing. Blood drawn for routine syphilis serology from those who declined this offer was also tested for HIVAb after personal identifiers had been removed. Only 1.2 percent (12) prisoners were HIV positive. However, 62.5 percent (611) inmates were at risk for HIV infection by being an intravenous drug user, a male homosexual, or hepatitis B core antibody (HBcAb) positive. The ratio of at-risk, as yet uninfected inmates to those already HIV infected was 53 to 1. Two-thirds of all inmates including those at-risk chose to receive counseling and testing. In areas where most at-risk inmates are not yet infected, it may be more appropriate for HIV prevention activities in prison to focus on voluntary programs that emphasize education and counseling rather than mandatory programs that emphasize testing.

Adolescent↗
PubMed1989

What about mandatory AIDS testing?

Mandatory testing for AIDS is controversial. Such screening has been suggested for prisoners, immigrants, prostitutes, military personnel, and persons contemplating marriage or pregnancy. Quarantining and even tatooing have also been recommended for persons with AIDS. The advent of mass testing raises the issues of (1) proper allocation of scarce AIDS resources; (2) the need for confidentiality of examination reports; (3) the value of this assessment without the existence of a definitive treatment; (4) the possibility of both false positive and false negative results; and (5) the provision of counseling for people with positive testing. Other concerns involve public health needs versus individual rights, and the confidentiality of the doctor-patient relationship. Past epidemics serve as paradigms for the role of mandatory screening and quarantine in a public health crisis. As testing for AIDS is expanded, anticipate that adverse reactions such as panic, depression, grief, compulsive behavior, and suicide attempts will increase. The physician must provide counsel on such matters as "safe sex" practices, avoidance of needle sharing, and early warning signs of AIDS and ARC.

AIDS Serodiagnosis↗
PubMedDate not supplied

Voluntary human immunodeficiency virus testing, recidivism, partner notification, and sero-prevalence in a sexually transmitted disease clinic: a need for mandatory testing.

Universal, voluntary testing for antibodies to the human immunodeficiency virus (HIV) was offered to 17,092 eligible clients attending a public sexually transmitted disease clinic between March, 1988 and June, 1989. In an environment of legally mandated reporting and partner notification, 15,649 (91.6%) clients were tested, 160 of whom were HIV sero-positive. Client acceptance of testing is discussed, and the serologic data compared with results of a federally funded sero-prevalence survey conducted in-clinic. A recidivism rate of 20% was observed among sero-positive individuals. Of 159 contacts for whom HIV sero-status was determined, 66 (42%) were seropositive. It is proposed that, in the setting of sexually transmitted disease clinics, HIV testing be changed from a voluntary service to a mandatory test. Some benefits of this change are defined.

AIDS Serodiagnosis↗
PubMed1989

Mandatory testing for the AIDS antibody.

The appearance of Acquired Immune Deficiency Syndrome (AIDS) has brought suffering and death to those who are afflicted. At the same time, this disease has posed enormous challenges to those who care for the sufferers, to biomedical scientists, and to those responsible for public health and social policy. The issue addressed in this article is whether the implementation of mandatory testing for the AIDS antibody is an appropriate and effective strategy to use in coping with the AIDS epidemic. The goal of an AIDS prevention program is to prevent transmission of Human Immunodeficiency Virus (HIV) infections. The pro and con aspects of using mandatory AIDS antibody testing to achieve this goal are given in issue statements. The opinions of leading authorities are presented, followed by a general review of the literature. The literature is then reviewed concerning the issue as it effects the nurse as an individual, the nursing profession, and the health-care delivery system. A position is taken and specific recommendations are proposed for the profession in the areas of practice, legislation, and research.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Prevalence of human immunodeficiency virus and hepatitis B virus in unselected hospital admissions: implications for mandatory testing and universal precautions.

The prevalence of human immunodeficiency virus (HIV) and hepatitis B virus in serial unselected hospital admissions was determined to examine the potential efficacy of a system of universal blood and body fluid precautions versus a system based on selected or unselected screening. Serum was obtained from 616 (97%) of the 636 patients admitted during a 1-month period and interviews were completed on 540. Of the 616, 23 (3.7%) were confirmed positive for HIV, and 12 (2.0%) of 612 for hepatitis B surface antigen. Of 33 infected persons, only 8 were known to be positive on admission and only 22 were in "high-risk" groups; therefore, selective precautions would not have been effective. Mandatory testing would have required 1216 tests to identify 25 infected persons and would leave in doubt the presence of other transmissible diseases. On the basis of these data, it appears that universal precautions are a logical system of infection control.

Communicable Disease Control↗
PubMed2006

Mother-to-child transmission of HIV in Botswana: an ethical perspective on mandatory testing.

Mother-to-child transmission (MTCT) of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub-Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two-thirds of the MTCT are believed to occur during pregnancy and delivery, and about one-third through breastfeeding. As the number of women of child bearing age infected with HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15-24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives -- mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible.

Africa South of the Sahara↗
PubMed2000

Value of mandatory testing for human immunodeficiency virus in a sub-Saharan hospital population.

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are currently hyperendemic in sub-Saharan Africa. HIV and AIDS have a special impact on working-age populations, economic resources, certain illnesses, and health care facilities. Assessment of HIV serostatus of hospitalized patients is rarely performed, however, because of a reluctance to intrude on patient confidentiality, a perceived lack of benefit (no antiretroviral therapy is available), and societal denial. We evaluated the effect on health care of HIV testing of patients routinely admitted to medical wards in the 2 major city hospitals in Harare, Zimbabwe. Of 196 patients tested, 58% were HIV positive with strong associations with infectious diseases, and with youth and weight loss, but not with cardiac, pulmonary, endocrinologic, or renal diagnoses, and not with rural versus urban location, occupation, sex, mortality, or cost of hospitalization. The clinical estimate of patients' HIV serostatus was largely inaccurate. Mandatory HIV testing of all hospitalized patients would improve diagnosis of infectious diseases, clarify patient prognosis, allow for individual counseling with regard to HIV prevention, and focus national health efforts by providing alarming, realistic statistics.

Acquired Immunodeficiency Syndrome↗