Testing times

Until recently testing for HIV was centered on the rights of individuals-with consent and counselling needed before the test can be done. Now, HIV testing is becoming the norm in many countries, and a global drive to broaden the uptake of treatment for HIV is gaining momentum.

In the 1980s and '90s HIV/AIDS prevention strategies strove to protect the rights of individuals. Medical ethics gave special status to HIV testing because of the stigma surrounding a positive result and the lack of medical treatment available. This “HIV exceptionalism” meant a test required specific consent, often in written form, and special counselling sessions.

New treatments have improved the prognosis for people living with HIV, particularly in developed countries. Management of HIV/AIDS now advocates mass treatment in addition to prevention. For example, the “3 by 5” initiative of the World Health Organization and UNAIDS tried, albeit unsuccessfully, to get antiretroviral drugs to three million HIV positive people in poor and middle income countries by the end of 2005.

Treatment that is increasingly effective, and more available, gives people an incentive to know their HIV status. However, some …