HIV-Related Ethics, Research Paper Example

There are a substantial number of questions surrounding the ethics of HIV.  Respective of the testing, association with other tendencies, and even in the criminal justice system, these dynamics institute a number of ethical questions.  These questions should be analyzed further to seek clarity to the procedures, screening, testing, and association of individuals who have or may have HIV.

Provider-Initiated Testing and Counseling

Research conducted by Gruskin, Ahmed, and Ferguson in regards to provider-initiated HIV testing and counseling (PITC) raise a number of questions regarding the ethics of this act (2007).  Pertinent to pregnant women in this research, it also extends to the needs of other individuals who have or may have HIV.  In this the researchers identify a number of considerations that must be considered in ethical concerns for those with HIV.

Need

It is appropriate to say that PITC is needed within the health care setting.  Relevant in this study for pregnant women, it is something that has been identified as necessary for many types of individuals.  For instance, as the researchers make clear, the World Health Organization (WHO) and the Join United Nations Programme on HIV/AIDS (UNAIDS) have stated that PITC is beneficial and have released material to guide health care professionals in such facilities (2007).

However, it is not that simple.  Relative to all individuals’ rights may be infringed upon if this is carried out to an extreme level.  Relevant to pregnant women, but finding meaning on other groups of individuals in this respect, elements of ethics and patient rights come into play, which makes this an area where focus is needed.

Implications for Pregnant Women and Others for PITC

PITC should be carried out carefully, according to the guidelines set for by WHO and UNAIDS.  It should be provided to women in the postpartum period of unknown HIV status, and counseling should be given in regards to infant feeding, safety measure if tested negative to prevent them from becoming infected during the pregnancy, and to encourage one’s partner to be tested for HIV.  Additionally, such measures should be taken according to the risks associated in the area, such as the country or community.

Briefly addressing other concerns, there are many more areas in which health care professionals must be aware of in regards to PITC.  Informed consent, patient confidentiality, and stigma and discrimination are areas that have been identified in the research (2007).  Health care professionals must take care in these important areas to ensure the environment needed to be sensitive to these relevant issues.  Public policy at the governmental level should also be developed to ensure the positive awareness surrounding HIV in its detection and prevention for individuals.

Individuals with Mental Illnesses or Substance Abuse

The Center of Mental Health Services (CMHS) of the Substance Abuse & Mental Health Services Administration (SAMHSA) has updated the relationship between mental illnesses and substance abuse in that of HIV in the 2008 biopsychosocial update (2008).   Relevant to the previous set of issues, it is important to look at these groups of individuals as well.  They, along with pregnant women for instance, also require a level of cognizance from health providers and others within these groups to be able to identify such factors for HIV.

Severe Mental Illnesses (SMI)

CMHS reports from previous studies the prevalence of HIV in individuals with and without SMI.  Among individuals with SMI, the prevalence rate was 1.0% compared to 0.5% of those without SMI (2008).  The results demonstrate the association of SMI to HIV.

As a result it is important to keep this into perspective in testing and preventing for HIV.  Those within the community should be aware of this relationship.  Health care providers should also be aware of the relationship in order to identify and prevent individuals in regards to HIV with procedure and counseling efforts.

Substance Abuse

CMHS also reports a direct relationship between sexual experiences and alcohol use, which promotes HIV risk (2008).  This tendency also bodes for users of other drugs as well.  From the CMHS it was documented that there were no differences in gender, that men and women were both similarly predictable in regards to the risk (2008).

HIV awareness in the appropriate communities here as well is predicted to be effective.  Leaders within these communities could help to raise awareness of HIV risks in association with substance abuse.  Health care professionals as well can help identify those who may be at risk, and also to help individuals who are dealing with substance abuse prevent such risks from being realized.

The Decriminalization of HIV

Wainberg argues that HIV transmission should be decriminalized (2008) upon grounds of ethical concerns and HIV prevention programs.  Such dynamics can undermine the force of prevention programs.  Furthermore, Wainberg argues that decriminalizing HIV transmission would in fact help efforts in the battle against HIV and for HIV awareness for many individuals around the world.

Potential Charge of HIV Transmission

Wainburg identifies the consequences of an individual possibly being charge with HIV (2008).  These effects are centered around the ground that an individual will not want to be tested if this may occur.  As a result, a potential charge of HIV transmission is in itself a deterrent to being tested for HIV.

HIV spread is seen as one major consequence of the deterrent.  According to research presented by Wainburg, those who are aware of their infection will not engage in sexual activities that could put others at risk (2008).  As a result, if more people are unaware due to this deterrent, the spread of HIV is likely.

The other primary consequence involves the point at which individuals will be aware of their status with the infection.  If they are deterred from testing for HIV due to the potential charge of HIV transmission, they will not be aware of this infection if they have it, according to Wainburg (2008).  Thus, more individuals will be aware of their HIV status at a later time, which can be potentially life-threatening and certainly more dangerous if they were aware of their status and began treatment earlier.

Decriminalizing HIV Transmission

From these reasons, Wainburg believes that HIV transmission should not be considered a crime.  It acts as a major deterrent to being tested for HIV, which results in the spread of HIV and in the later diagnosis of individuals with HIV.  Both of these incur severe consequences for individuals with HIV.

This decriminalization should also come with some warnings.  This is not meant to be confused with rapists and other suspects who intend on harming someone on this way with HIV.  Wainburg also warns that these means should not be construed to promote sexual promiscuity.  Rather, this represents a deterrent to HIV testing and should not remain.

Significance

From this set of issues, it is clear that there is progress to be made in how HIV-sensitive topics are handled.  From awareness to actual legal changes, it seems as if there are ways in which the fight against HIV can be promoted positively.  In these ways the public and governmental bodies need to find clarity to these issues in order to successfully treat these HIV-related issues properly.

Health Care Providers and Leaders within Communities

The primary area that can help change the landscape of HIV is with regards to health care providers and leaders within communities.  These figures represent influential individuals that have contact with patients, at-risk individuals, and groups that can reach out to those involved with HIV.  They remain one of the most integral set of people in this topic.

The leaders within communities can help to shape community awareness.  This reigns true for any level, to a small community to a federal level.  Lawmakers and community leaders should examine legal issues, such as the decriminalization of HIV transmission and guidelines for PITC.  HIV awareness groups could be improved or founded as needed in order to reach out to at-risk individuals and to help raise awareness within communities.

Extending beyond the public and government, health care professionals are also integral to the fight against HIV.  Health care professionals must be aware of the relationships between HIV and other factors, such as SMI, substance abuse, and other factors not covered in this analysis.  Their awareness can help shape the landscape in regards to HIV awareness for many individuals.

Health care professionals can help identify at-risk individuals and screening, testing, and awareness of HIV.  Those who are at-risk can test for HIV and receive the appropriate treatment and counseling if they are positive or negative for the infection.  Additionally, through awareness at this level, health professionals can help raise awareness at this personal level.

Health care professionals and leaders within communities represent two groups that can improve HIV-related elements within at-risk and infected individuals, as well as in the general public.  By improving on the ethical issues and establishing awareness of HIV, these relationships and concerns regarding HIV can be used to change the way HIV is dealt with and regarded, which will help in the fight against HIV.

Conclusion

It is clear that there are many ethical concerns regarding HIV.  With regards to the relationship between HIV and other elements, such as drugs, PITC, and legal concerns, there are certainly ways that could benefit those in and outside of the HIV-related community.  These ethical concerns identify ways that could promote the awareness and proper handling of HIV.

In these ethical concerns, it is important that lawmakers, community leaders, and health care professionals react properly.  With proper care and action HIV can be handled in a way that promotes testing and the identification of risk with certain individuals.  Perhaps the spread of HIV can be lessened with proper action and awareness.  Moreover, current individuals who carry HIV can receive the proper treatment, not to mention those who are unaware that they carry the infection.

References

Center for Mental Health Services. (2008). Biopsychosocial Update. Mental Health Aids, Volume 9 (2). Retrieved from http://mentalhealthaids.samhsa.gov/winter2008/prevention1.asp

Gruskin, Sofia, Shahira Ahmed and Laura Ferguson. (2007). Provider-Initiated HIV Testing and counseling in Health Facilities – What Does This Mean for the Health and Human Rights of Pregnant Women? Developing World Bioethics, Volume 8 (1), 23-32.

Wainberg, Mark. (2008). HIV transmission should be decriminalized: HIV prevention programs depend on it. Retrovirology 2008, Volume 5 (108), Retrieved from http://www.retrovirology.com/content/5/1/108