Lovvorn A E, Quinn S C, Jolly D H
Family Health International, Research Triangle Park, NC 27709, USA.
J Public Health Policy. 1997;18(4):401-32.
The promising findings of ACTG 076, which identified a hopeful strategy for substantially reducing HIV transmission from mother to fetus, has stimulated a debate on counseling and testing protocols for pregnant women. This article presents an analysis of five state policy alternatives that address HIV counseling and testing. The policy analysis utilizes vertical and horizontal equity, user preference including avoidance of stigma and the right to privacy, effectiveness, and feasibility as evaluative criteria for examination of the policies. Interviews with state health department personnel enhance the policy analysis. While universal HIV counseling and voluntary testing for pregnant women emerges as the most acceptable policy, public health professionals must assume a vital role in facilitating the adoption of ethical and just state policies in an atmosphere sometimes hostile to women at risk for HIV.
美国国立过敏与传染病研究所艾滋病临床试验组076研究取得了很有前景的结果，该研究确定了一种有望大幅降低艾滋病毒母婴传播的策略，这引发了一场关于孕妇咨询和检测方案的辩论。本文对针对艾滋病毒咨询和检测的五种州政策选择进行了分析。政策分析将纵向和横向公平、包括避免污名化和隐私权在内的用户偏好、有效性和可行性作为评估这些政策的标准。对州卫生部门人员的访谈加强了政策分析。虽然孕妇普遍接受艾滋病毒咨询和自愿检测成为最可接受的政策，但在有时对感染艾滋病毒风险较高的女性怀有敌意的氛围中，公共卫生专业人员必须在推动采用符合伦理和公正的州政策方面发挥至关重要的作用。
