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 the aforementioned 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.