[procaare] Re: Talking about Testing..(5)

[Gardiner and Rohde <procaare@healthnet.org>]

Re: Talking about Testing..(5)
- 1. Bernard Gardiner, International Federation of Red Cross and Red Crescent Societies.
- 2. Jon Rohde, South Africa
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1. Bernard Gardiner, International Federation of Red Cross and Red Crescent Societies.

Forum Members,

In relation to Dr Rahman's invitation to discuss making testing 'routine', I am pleased to
see replies placing so much emphasis on the psychological implications of testing.

I see from news stories that the theme for the USA's National HIV Testing Day on June 27th
is 'Take the Test, Take Control'. Controlling what you can is the key, particularly as so
many aspects of living with HIV feel so out of control.

I worry when doctor's start talking about making tests 'routine' as this seems to imply
cutting corners and just ordering the test without consent and pre-test counselling. Such
an approach removes control from the client, and this is definitely not a 'benefit'.

It is crucial that people living with HIV have control over the testing process, and who
knows the test result. Testing without consent is psychologically damaging, and in many
places against the law for good reason.

It takes time and skill to do things properly, but it is well worth it in the long run.
Fortunately many doctors and counsellors are very supportive.

Some Red Cross Red Crescent programmes attempt to mitigate the damage done to people
tested without consent and counselling in prisons, especially so called 'drug
rehabilitation centres', but it is clear this damage should be avoided.  Doctors who carry
out this violation are not living up to their professional ethic to first do no harm.

Bernard Gardiner
Manager
HIV/AIDS Global Programme
International Federation of Red Cross and Red Crescent Societies.
Email: Bernard.Gardiner@ifrc.org

***************************

2. Jon Rohde, South Africa

Colleagues,

Testing is the first step to dealing with reality - ARVs is not the only response -
indeed, with Nevirapine, it seems all PLHA's should be encouraged to be tested - all those
with TB and STIs as well.

Prevention flows best from informed clients - no doubt, HIV testing should NOT be done
without counselling, but we find that lay counsellors are often more effective than
professional ones, especially where the epidemic is extensive - they have "seen it all"!

ARVs are not apart of the available regimen yet, but can be readily added when available
(that has other problems of compliance, lab monitoring and costs, of course)


Jon Rohde, MD
Senior Technical Advisor
MSH, EQUITY Project
Box 214, BISHO, 5605
South Africa
Email: JonRohde@equityproject.co.za
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