Culbert Gabriel J, Earnshaw Valerie A, Levy Judith A
Health Systems Science, College of Nursing, University of Illinois at Chicago, IL, USA.
Center for HIV Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.
J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958219880582. doi: 10.1177/2325958219880582.
Partner services provide a safe and humane way for people living with HIV (PLWH) to alert their sex and/or drug-injecting partners to the possibility of HIV exposure and the need for HIV testing, yet little is known about the ethical challenges of delivering partner services in prisons. In this article, we consider 7 key ethical and methodological questions that should be considered when developing, testing, or implementing partner services in prison settings. These questions relate to the ethics of: (1) mandatory HIV testing, (2) health illiteracy, (3) level of prison staff involvement, (4) protecting confidentiality, (5) minimizing harm, (6) achieving equivalency with community standards of care, and (7) providing HIV prevention and treatment services to index patient and their partners. By assisting PLWH in prison to inform partners with whom they may have shared HIV exposure either before or during incarceration, partner services can help to identify cases of undiagnosed HIV infection for testing and linkage to medical care. The acceptability and effectiveness of a future partner services model for PLWH in prison depends critically on answering these 7 questions to assure the highest ethical standards of research and practice.
同伴服务为感染艾滋病毒者（PLWH）提供了一种安全且人道的方式，使其能够提醒自己的性伴侣和/或注射毒品的伴侣，告知他们存在艾滋病毒暴露的可能性以及进行艾滋病毒检测的必要性，然而，对于在监狱中提供同伴服务所面临的伦理挑战，我们却知之甚少。在本文中，我们探讨了在监狱环境中开展、测试或实施同伴服务时应考虑的7个关键伦理和方法问题。这些问题涉及以下伦理方面：（1）强制艾滋病毒检测；（2）健康素养低下；（3）监狱工作人员的参与程度；（4）保护隐私；（5）尽量减少伤害；（6）达到与社区护理标准相当的水平；（7）为索引患者及其伴侣提供艾滋病毒预防和治疗服务。通过协助监狱中的感染艾滋病毒者告知那些在监禁前或监禁期间可能与其有过艾滋病毒暴露接触的伴侣，同伴服务有助于识别未确诊的艾滋病毒感染病例，以便进行检测并与医疗护理建立联系。未来针对监狱中感染艾滋病毒者的同伴服务模式的可接受性和有效性，在很大程度上取决于对这7个问题的回答，以确保研究和实践达到最高的伦理标准。
