UNAIDS WHO AIDS testing on the policy statement
Posted by sldol on October 18, 2008 in Aids
Background
In low-and middle-income countries on antiretroviral therapy growing, is AIDS prevention the key to expanding opportunity. As we all know, prevention of HIV infection to AIDS epidemic is still the major means. Lack of effective preventive measures, there will be more and more people need anti-virus treatment. A number of interventions in terms of AIDS treatment or prevention plays an important role in all, AIDS testing and counselling is most important.
At present, AIDS testing services is still far from ideal: in low-and middle-income countries, may have been due to exposure to the risk of HIV infection and voluntary counselling and testing needs of those, only 10 percent can receive these services. In many countries, even in the conventional voluntary counselling and testing (such as the existence of the prevention of mother to child transmission project) environment, these services can benefit the people are still very few. The reality is: people still refuse to accept AIDS testing, because they are afraid of stigma and discrimination.
To solve this problem, expanded testing, to be followed by some basic principles, including the effective protection against stigma and discrimination and to ensure that people are able to access, including prevention, treatment and care, integrated services. Respect for human rights on the basis of detection work, people only willing to accept. Human rights are protected, the corresponding ethical principles to be respected and observed. (See Appendix 1). By providing confidential, targeted health services, the demand for young people to get special attention and resolution. Public health strategies and measures to protect human rights are mutually reinforcing.
Since the 1985 AIDS testing has been advocated since the “3 C” principle. The so-called “3 C” means that personal testing must be done:
Privacy (confidential)
Advisory (counselling)
Informed Consent (informed consent) the circumstances, that is acceptable to both detect informed, but also voluntary.
In many low-and middle-income countries, the main mode of testing is requested by the clients of voluntary counselling and testing services. Now, in clinical work, health care workers from the proposed detection method is being constantly improved, such as health care personnel conventional detection, and provide prevention and treatment services and referral services. In order to receive treatment who need help, had to be infected with the AIDS population in large-scale testing.
UNAIDS / WHO recommended that the following four types of AIDS testing Biekai to clear areas:
1) voluntary counselling and testing
In order to understand their infection status, clients take the initiative to require testing and counselling. This detection in the effective prevention of the spread of AIDS in the process still plays an important role. UNAIDS / WHO promoted, no matter what mode of transmission through infected people, through effective way should be aware of their infection status. Testing before the advisory can be provided to individuals, can also be carried out advisory group, followed track. UNAIDS / WHO encourages the use of rapid testing, so the results can be timely and proactive as testing positive and negative results for the individuals to provide the first test after the consultation.
2) diagnostic test to show a person with AIDS or AIDS-related diseases or symptoms consistent with the signs, to help clinical diagnosis and management. This includes all TB patients with AIDS testing, this as a routine part of clinical treatment.
3) medical staff to patients following routine AIDS testing, these patients include:
In sexually transmitted infections clinics or other diagnosis and treatment of sexually transmitted infection in the local inspection of the patients - their understanding of AIDS infection can be targeted for advisory services.
In the crowd of maternal-related - to people in need in order to provide anti-retroviral treatment to prevent mother to child transmission.
Living in the AIDS pandemic and can provide anti-virus treatment in asymptomatic people, they can go to clinical medical service organizations or community health service organizations (intravenous drug treatment services, hospital emergency rooms, hospital medical wards, the advisory body) to accept Services.
Need to improve the health care recommended by the AIDS testing service mechanisms, such as acceptance testing for all the people on prevention, detection after consulting services, for all positive referral to the provision of medical and psycho-social support organizations. However, voluntary counseling and testing (VCT) before the detection of confidential advice to follow, advice and agreed to the basic principles to ensure that the consultant informed consent, but it does not need a systematic education and counselling. In order to obtain informed consent, the consultant needs a minimum of information are as follows:
Ø in the prevention and detection of the role.
Ø the right to refuse to
Ø receive follow-up services, and
Ø for the positive test results should still inform the people engaging in dangerous behavior, otherwise these people do not doubt that they have the possibility of HIV infection.
Medical health workers from the proposed test (regardless of their purpose is to diagnose and provide anti-retroviral treatment to prevent mother to child transmission, or to encourage people to know their infection status), who have been detected retain the right to refuse testing, that is, The right to “decide not to participate in the” provided by the testing 1.
4) the mandatory screening of UNAIDS / WHO support for the manufacture of blood transfusion or blood products in all mandatory screening to detect HIV and other blood-borne virus. If you want to a person’s body fluids or body organs, tissue transplantation to another person (such as artificial insemination, corneal transplants and organ transplants), started operation before all the donor must undergo mandatory HIV screening.
UNAIDS / WHO does not support public health as an excuse to carry out mandatory testing of individuals. Voluntary testing more likely to change their behaviour so as to avoid the virus will spread to other people. In view of immigrants in many countries a mandatory AIDS testing of some countries in the recruitment of former soldiers and regular medical examination when a mandatory testing to ensure the health of the soldiers, UNAIDS / WHO recommended that only the HIV-positive and negative individuals are providing advice and positive test results for referral to medical or psychological conditions of social service agencies can be carried out under the mandatory testing.
Appendix 1 to ensure respect for human rights approach in the world, has been widely carried out AIDS prevention work, especially through the test so that more people receiving treatment, but this process must be based on good public health system, and to respect, protect and implement Human rights norms and standards of the foundation.
The principle of voluntary testing should be for all the AIDS policy and the core of the project, the only way to harmony with the principles of human rights, to ensure continued access to public health benefits.
Attention should also be paid the following key elements of the interaction between them is:
1 to ensure that detection process in line with ethical principles, including the detection of clear purpose and bring the benefits of being tested; ensure that consideration of detection, treatment, care and other services to the links between the premises to ensure that all of these places can be kept confidential medical information;
2, the positive test results to solve the problems, including non-discrimination were infected and to help their access to sustainable treatment and care services.
3, with the overall decline in AIDS-related stigma and discrimination, especially in the health care system.
4, ensure the establishment of a supportive legal and policy environment, help to strengthen the AIDS response and protection of the human rights of infected persons.
5, to ensure that health care system can effectively address these problems; training sufficient numbers, in order to face the people of detection, treatment and related services, an increasing demand for the situation.
UNAIDS global AIDS and human rights issues Advisory Group
June 2004 —————————————–
1 in the following rare circumstances even without the informed consent can also carry out AIDS testing: patients with unclear consciousness, his or her parent or guardian is not present, and in order to get the best treatment of patients must be aware of the infection.
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