080917L – ETHICO-LEGAL ISSUES RELATING SEXUALLY TRANSMITTED DISEASE-HIV AS A PROTOTYPE

Background reading for Year 2 Semester 1 Medical Student PPSD session on 17^th September 2008 by Professor Omar Hasan Kasule Sr.

INTRODUCTION

HIV is a sexually-transmitted infection (STI) that can also be transmitted by blood transfusion or intravenous drug injection. It raises more interest than other STIs mainly because of its incurability and association in some communities with homosexuality. Victims of HIV infection are more likely than victims of other STIs to be stigmatized, marginalized, and discriminated.

ETHICO-LEGAL ISSUES IN TESTING FOR HIV

1. Compulsory testing of people at risk who are sexually active (commercial sex workers, gays etc)
2. Testing at the workplace for workers likely to transmit the infection (health care workers, fire, police)
3. Testing of prisoners and sex offenders
4. Testing and disclosure for victims of rape
5. Pre-marital HIV testing
6. Ante-natal testing of pregnant mothers
7. Anonymous testing of donated blood for epidemiological purposes
8. Anonymous testing of ante-natal mothers for epidemiological purposes
9. Disclosure of test results to the spouse or sexual contact
10. Disclosure of test results to the employer
11. Disclosure of positive results in anonymous testing
12. False negative and false positive results
13. Pre-testing and post-testing counseling

ETHICO-LEGAL ISSUES IN TREATMENT OF HIV

1. Compulsory anti-retroviral treatment of pregnant HIV+ mothers
2. Provision of free anti-retroviral treatment for all HIV+ve patients
3. patents making anti-retroviral drugs prohibitively expensive

ETHICO-LEGAL ISSUES IN PREVENTION OF HIV

1. Provision of condoms vs. teaching abstinence in schools
2. Health education (general and targeted) in the community
3. Provision of free condoms for at risk groups who are sexually active (commercial sex workers, gays etc)
4. Provision of free sterile needles for intravenous drug users
5. Compulsory contact tracing
6. Mandatory reporting of new HIV cases

HUMAN RIGHTS OF HIV+ PERSONS

1. Social discrimination and ostracization
2. Discrimination in employment, immigration, and medical care