Ethical considerations of providers and clients on HIV testing campaigns in Burkina Faso

BMC International Health and Human Rights

Research Article

Carla Makhlouf Obermeyer¹  Alice Desclaux²  Odette Ky-Zerbo³  Jean-François Somé⁴ 

[1] Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon;Institut de Recherche pour le Développement, TransVIHMI UMI 233 (IRD, Université Montpellier 1, Université Cheikh Anta Diop de Dakar, Université de Yaoundé 1), Dakar, Senegal;IRD/CRCF, BP 1386, 18524, Dakar, Senegal;Programme d’Appui au Monde Associatif et Communautaire (PAMAC), Ouagadougou, Burkina Faso;UNDP, Lomé, Togo;

关键词: HIV;    Testing campaign;    Ethics;    Burkina Faso;    Individual rights;    Global norms;    Stigma;    Africa;   

DOI  :  10.1186/1472-698X-14-27

 received in 2014-05-12, accepted in 2014-09-24,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundCampaigns have been conducted in a number of low HIV prevalence African settings, as a strategy to expand HIV testing, and it is important to assess the extent to which individual rights and quality of care are protected during campaigns. In this article we investigate provider and client perceptions of ethical issues, including whether they think that accessibility of counseling and testing sites during campaigns may hinder confidentiality.MethodsTo examine how campaigns have functioned in Burkina Faso, we undertook a qualitative study based on individual interviews and focus group discussions with 52 people (providers and clients tested during or outside campaigns and individuals never tested). Thematic analysis was performed on discourse about perceptions and experiences of HIV-testing campaigns, quality of care and individual rights.ResultsRespondents value testing accessibility and attractiveness during campaigns; clients emphasize convenience, ripple effect, the sense of not being alone, and the anonymity resulting from high attendance. Confronted with numerous clients, providers develop context-specific strategies to ensure consent, counseling, confidentiality and retention in the testing process, and they adapt to workplace arrangements, local resources and social norms. Clients appreciate the quality of care during campaigns. However, new ethical issues arise about confidentiality and accessibility. Confidentiality of HIV-status may be jeopardized due to local social norms that encourage people to share their results with others, when HIV-positive people may not wish to do so. Providers’ ethical concerns are consistent with WHO norms known as the ‘5 Cs,’ though articulated differently. Clients and providers value the accessibility of testing for all during campaigns, and consider it an ethical matter. The study yields insights on the way global norms are adapted or negotiated locally.ConclusionsFuture global recommendations for HIV testing and counseling campaigns should consider accessibility and propose ways for testing services to respond to new ethical issues related to high demand.

【 授权许可】

CC BY   
© Desclaux et al.; licensee BioMed Central Ltd. 2014