Scale-up of provider-initiated HIV testing and counselling of pregnant women: The South African experience. By Johanna Kehler, Amber Howard Cornelius, Sindi Blosse and Promise Mthembu.
As early as 2002, calls were made within the public health spheres to move away from the voluntary HIV counselling and testing approach to a more ‘routine offer’ of HIV testing in public health centres in order to increase the uptake of HIV testing.
In 2007, UNAIDS and WHO released guidance on provider-initiated testing and recommended, amongst others, that provider-initiated opt-out testing and counselling should be prioritised in antenatal, child birth and post natal healthcare services, despite recognising that women may be more at risk than men of discrimination, violence, abandonment or ostracism when their HIV status becomes known.
This ‘targeting’ of women in the scale-up of HIV testing, whilst recognising women’s greater risks of rights violations in this process, arguably highlights the extent to which the ‘public health need’ of HIV testing scale-up can override the need to reduce women’s risks and vulnerabilities to HIV-related rights abuses.
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