Scott P Anne
School of Nursing and Human Sciences, Dublin City University, Collins Ave, Dublin 9, Ireland,
AIDS Behav. 2014 Jul;18 Suppl 4:S438-44. doi: 10.1007/s10461-014-0833-9.
The use of unsupervised self-testing as part of a national screening program for HIV infection in resource-poor environments with high HIV prevalence may have a number of attractive aspects, such as increasing access to services for hard to reach and isolated populations. However, the presence of such technologies is at a relatively early stage in terms of use and impact in the field. In this paper, a principle-based approach, that recognizes the fundamentally utilitarian nature of public health combined with a focus on autonomy, is used as a lens to explore some of the ethical issues raised by HIV self-testing. The conclusion reached in this review is that at this point in time, on the basis of the principles of utility and respect for autonomy, it is not ethically appropriate to incorporate unsupervised HIV self-testing as part of a public health screening program in resource-poor environments.
在艾滋病毒高流行率的资源匮乏环境中，将无监督自我检测用作国家艾滋病毒感染筛查计划的一部分，可能具有诸多吸引人的方面，比如增加难以接触到和孤立人群获得服务的机会。然而，就这些技术在该领域的使用和影响而言，其尚处于相对早期阶段。在本文中，一种基于原则的方法被用作一个视角来探讨艾滋病毒自我检测引发的一些伦理问题，该方法认识到公共卫生本质上的功利性并关注自主性。本综述得出的结论是，基于功利和尊重自主性的原则，目前在资源匮乏环境中将无监督艾滋病毒自我检测纳入公共卫生筛查计划在伦理上是不合适的。
