Ethical issues in Screening for HIV in Indian villages

[Guest guest]

Dear Dr. Madhukar,

I read your mail about mass screening for HIV along with blood tests for sugar,

chest X- rays and so on. I have a few questions:

Are you planning to have pre- and post- test counselling? If yes, what would be

the profile of persons doing the counselling?

If no, then how would you ensure that the testing is voluntary and based on

informed consent?

What happens to those who test positive? Where would be referred for

psycho-social support? What are the meassures for follow- up?

I am raising these questions to highlight some of the issues involved in HIV

testing, which you are also perhaps aware of- ensuring that it is based on

informed consent, ensuring confidentiality, providing counselling support before

and after testing for dealing with issues like disclosure and so on.

One of the challenges assocaited with HIV counselling is to provide space and

time for long- term follow-up.

Considering all these issues and the fact that stigma and discrimination

continues to be very high, the camp approach does not seem like a good strategy.

Also when a person tests positive, i am not sure there would be the time and

space in a camp to deal with the emotional issues that come up.

I would like to know your response.

Akhila

E-mail: " <akhila_punch@...>