Routine Hospital HIV Testing and Prophylactic AZT.
December 6, 1997
in response to:
December 4, 1997
Songwathana, Songkla, Thailand
appreciate your comments on routine testing for hospitalised patients. I
have been interested in this issue as well, since I have been involved with research on AIDS care at
hospital, home and community levels. During my career
as a nurse, I found this issue of great concern among health care workers
regarding ways to protect from HIV risk and danger to contact. Universal precaution may not be completely used
among all hospitalised patients and the
greater precaution techniques were used in patients with HIV/AIDS.
do not agree that testing should be done in all patients unless there is concern
that they are prepared for the outcome of testing. As far as I know, most hospitalised patients have not been
informed formally or informally about the
HIV test and when the result shows positive blood test, the psychosocial
issue is of great concern and also causes much trouble.
am now preparing a
project to develop a possible system for testing and counseling and also
follow-up patients in my hospital
in southern Thailand.
suggestions and ideas would be very appreciated. I look
forward to hearing from you.
of Nursing, Prince of Songkla University
Songkla, Thailand 90112
Thank you for your thoughtful response to my posting about testing in
a hospital setting. I typically do not offer detailed solutions, but rather
try to pose the problem and encourage experimentation that discovers the
best or most appropriate solution. If enough groups do enough experiments,
and the results get widely disseminated, then we all benefit.
to trouble me, however, is the narrow view that many hold in the HIV/AIDS
community, that limits their imagination of potential solutions. There
is a near-religious voicing of human rights concerns (usually focused more
on the rights of the infected to avoid detection than the rights of susceptible
to remain free of infection) that seems to permeate most policy discussions
in the HIV/AIDS arena. The psychological effect is a narrowing of thought,
a unwillingness to experiment, and as a result, a shortage of truly effective
intervention or prevention strategies. Perhaps this is why we continue
to see a dramatic rise of HIV in various regions of the world (up from
a cumulative world total of about 13 million at the end of 1992 to a prevalence
of 30 million at the end of 1996).
We are experiencing similar ideological
debates in the reproductive field (i.e., pro- and anti-abortion groups),
in animal production (i.e., pro and anti-fur animal groups), and even in
biological/medical experimentation (i.e., animal rights groups). The inevitable
consequences of these intense interactions are slowing of research and
limitations on programs, effects that hurt many people.
after all does have its price. I encourage you move forward
with your investigations, keeping in mind both cost and sustainability
as well as epidemiological effectiveness, and let others know of your findings.