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; espe- cially 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 comple- ment 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