Ethical scrutiny of HIV testing in the ante-natal clinic of a secondary health care facility in Rivers State, Nigeria.

Abstract

Background: HIV testing has been shown to be a crucial gateway to treatment, prevention, and support services; hence the urgent need to swiftly scale-up testing in a wide range of clinical encounters, as a means of controlling the pandemic. Fears have however been expressed that such swift scale-ups might result in unethical practices, especially in developing countries without strong civil institutions and legal protection. Aim: To carry out an ethical scrutiny of HIV testing, in a secondary health care facility, in an urban community in south-south Nigeria. Methods: The study was carried out in March 2006, in Omoku General Hospital, a secondary health care facility, with the full complement of staff and facilities. In-depth interviews were held with the relevant staff of the hospital, to ascertain the HIV testing procedure in the ante-natal clinic of the hospital. These were corroborated with exit interviews of women attending the clinic. Results: The HIV testing procedure showed several ethical breaches. The women that attended the ante-natal clinic had mandatory HIV test, were inadequately counselled, and tested without proper linkage with prevention, care and treatment facilities. Conclusion: Most of the ethical breaches stemmed from poor funding, and improper linkage with other services. Funding of HIV testing programmes must go beyond the provision of test kits. Keywords: HIV testing, Ethics, Ante-natal clinic, Secondary health care facility, Rivers State, NigeriaPort Harcourt Medical Journal Vol. 3 (1) 2008: pp. 32-36