Reconsidering HIV testing—consent is still the key
Francis J. BowdenAustralian National University Medical School and Canberra Sexual Health Centre, The Canberra Hospital, Canberra, ACT 2605, Australia. Email: frank.bowden@act.gov.au
Sexual Health 2(3) 165-167 https://doi.org/10.1071/SH05016
Submitted: 21 March 2005 Accepted: 19 May 2005 Published: 20 September 2005
Abstract
The high quality and easy accessibility of HIV testing in Australia has been one of the reasons for Australia’s effective response to the epidemic. However there have been a number of changes in the epidemiology of HIV and new technologies and treatments have emerged since the last Australian HIV policy was released in 1998. Antenatal testing to prevent vertical transmission, the licensing of rapid, point-of-care test kits in the United States and the problem of late diagnosis of infection in some populations are important issues to consider in the context of the drafting of a new HIV testing policy. The terms ‘pre- and post-test counselling’ are seen, by some, as barriers to HIV testing in the broader community. Reframing the process with a focus on the desired result (i.e. informed consent for voluntary testing) rather than on the process (i.e. pre-test counselling) could be one way to increase the rate of appropriate testing.
[1] Weber B, Gurtler L, Thorstensson R, Michl U, Mühlbacher A, Bürgisser P, et al. Multicenter evaluation of a new automated fourth-generation human immunodeficiency virus screening assay with a sensitive antigen detection module and high specificity. J Clin Microbiol 2002; 40(6): 1938–46.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[2] Manavi K, Welsby PD. HIV testing. BMJ 2005; 330(7490): 492–3.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[3] Centers for Disease Control and Prevention Advancing HIV prevention: new strategies for a changing epidemic–United States, 2003. MMWR Morb Mortal Wkly Rep 2003; 52(15): 329–32.
| PubMed |
[4]
[5] Centers for Disease Control and Prevention Zidovudine for the prevention of HIV transmission from mother to infant. MMWR Morb Mortal Wkly Rep 1994; 43(16): 285–7.
| PubMed |
[6]
[7] Taylor S, Boffito M, Vernazza PL. Antiretroviral therapy to reduce the sexual transmission of HIV. J HIV Ther 2003; 8(3): 55–66.
| PubMed |
[8] Thorne C, Newell ML. Prevention of mother-to-child transmission of HIV infection. Curr Opin Infect Dis 2004; 17(3): 247–52.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Elford J, MacDonald MA, Gabb RG, Ryan MM, Kaldor JM. Antenatal HIV antibody testing in Australia. Med J Aust 1995; 163(4): 183–5.
| PubMed |
[10] Hunt JM, Lumley J. Are recommendations about routine antenatal care in Australia consistent and evidence-based? Med J Aust 2002; 176(6): 255–9.
| PubMed |
[11] Graves N, Walker DG, McDonald AM, Kaldor JM, Ziegler JB. Would universal antenatal screening for HIV infection be cost-effective in a setting of very low prevalence? Modelling the data for Australia. J Infect Dis 2004; 190(1): 166–74.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[12] Spielberg F, Levine RO, Weaver M. Self-testing for HIV: a new option for HIV prevention? Lancet Infect Dis 2004; 4(10): 640–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[13] Liddicoat RV, Horton NJ, Urban R, Maier E, Christiansen D, Samet JH. Assessing missed opportunities for HIV testing in medical settings. J Gen Intern Med 2004; 19(4): 349–56.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[14] Manavi K, McMillan A, Ogilvie M, Scott G. Heterosexual men and women with HIV test positive at a later stage of infection than homo- or bisexual men. Int J STD AIDS 2004; 15(12): 811–4.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[15] Centers for Disease Control and Prevention Late versus early testing of HIV–16 Sites, United States, 2000–2003. MMWR Morb Mortal Wkly Rep 2003; 52(25): 581–6.
| PubMed |