Case Study

Is the absolute requirement for informed consent before HIV testing a barrier to public health? A case report and management challenges

Published in: African Journal of AIDS Research
Volume 13, issue 1, 2014 , pages: 93–98
DOI: 10.2989/16085906.2014.901978
Author(s): David AmehMedical Research Council Unit, The Gambia, Uchendu O UchenduMedical Research Council Unit, The Gambia, Oyedeji A AdeyemiMedical Research Council Unit, The Gambia, Readon C IdehMedical Research Council Unit, The Gambia, Bernard E EbrukeMedical Research Council Unit, The Gambia, Grant MackenzieMedical Research Council Unit, The Gambia, Stephen HowieMedical Research Council Unit, The Gambia, Tumani CorrahMedical Research Council Unit, The Gambia

Abstract

Clinicians in sub-Saharan Africa are faced with a major challenge of parental refusal to test their children for HIV. We present a case of a nine-month-old child with a clinical presentation suggestive of HIV infection whose mother persistently declined HIV testing of the child or herself. The case illustrates the difficulties faced by the clinicians caring for the child in an isolated location in West Africa. While not eliminating these difficulties, an opt-out approach to paediatric HIV testing in sub-Saharan Africa may increase the proportion of children who access treatment when they need it, particularly when this is backed by the development of more effective national and regional clinical and legislative frameworks for HIV testing in children.

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