@article{fdi:010060707,
  title = {{HIV} testing and care in {B}urkina {F}aso, {K}enya, {M}alawi and {U}ganda : ethics on the ground},
  author = {{O}bermeyer, {C}. {M}. and {B}ott, {S}. and {B}ayer, {R}. and {D}esclaux, {A}lice and {B}aggaley, {R}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he ethical discourse about {HIV} testing has undergone a profound transformation in recent years. {T}he greater availability of antiretroviral therapy ({ART}) has led to a global scaling up of {HIV} testing and counseling as a gateway to prevention, treatment and care. {I}n response, critics raised important ethical questions, including: {H}ow do different testing policies and practices undermine or strengthen informed consent and medical confidentiality? {H}ow well do different modalities of testing provide benefits that outweigh risks of harm? {T}o what degree do current testing policies and programs provide equitable access to {HIV} services? {A}nd finally, what lessons have been learned from the field about how to improve the delivery of {HIV} services to achieve public health objectives and protections for human rights? {T}his article reviews the empirical evidence that has emerged to answer these questions, from four sub-{S}aharan {A}frican countries, namely: {B}urkina {F}aso, {K}enya, {M}alawi and {U}ganda. {D}iscussion: {E}xpanding access to treatment and prevention in these four countries has made the biomedical benefits of {HIV} testing increasingly clear. {B}ut serious challenges remain with regard to protecting human rights, informed consent and ensuring linkages to care. {P}olicy makers and practitioners are grappling with difficult ethical issues, including how to protect confidentiality, how to strengthen linkages to care, and how to provide equitable access to services, especially for most at risk populations, including men who have sex with men. {S}ummary: {T}he most salient policy questions about {HIV} testing in these countries no longer address whether to scale up routine {PITC} (and other strategies), but how. {I}nstead, individuals, health care providers and policy makers are struggling with a host of difficult ethical questions about how to protect rights, maximize benefits, and mitigate risks in the face of resource scarcity.},
  keywords = {{E}thics ; {M}edical ; {HIV} {I}nfections/diagnosis/drug therapy/prevention & ; control/transmission ; {I}nformed consent ; {C}onfidentiality ; {C}ounseling ; {HIV} ; {S}eropositivity/diagnosis/transmission ; {H}ealth {S}ervices {A}ccessibility ; {A}dult ; {H}ealth policy ; {M}ass screening ; {BURKINA} {FASO} ; {KENYA} ; {MALAWI} ; {OUGANDA}},
  booktitle = {},
  journal = {{B}mc {I}nternational {H}ealth and {H}uman {R}ights},
  volume = {13},
  numero = {},
  pages = {6},
  ISSN = {1472-698{X}},
  year = {2013},
  DOI = {10.1186/1472-698x-13-6},
  URL = {https://www.documentation.ird.fr/hor/fdi:010060707},
}