AP/CNN.com Examines Botswana’s Routine HIV Testing Policy

The AP/CNN.com on Thursday examined the effect of Botswana's change from voluntary to routine HIV testing in the beginning of 2004 (AP/CNN.com, 1/5). President Festus Mogae in October 2003 announced the new HIV testing policy, which provides opt-out HIV tests as part of routine medical checkups in public and private clinics (Kaiser Daily HIV/AIDS Report, 6/14/04). Some international HIV/AIDS advocates voiced concerns that the policy change could violate patients' rights to informed consent and confidentiality, but some doctors in Botswana said voluntary testing followed by mandatory "extensive counseling" caused patients to be intimidated and helped "fuel the stigma that ke[pt] patients from getting help," according to the AP/CNN.com. Physicians estimate that up to 35% of the 1.7 million people living in the country now know their HIV status. Christine Stegling, director of the Botswana Network on Ethics, Law and HIV/AIDS, said the number of people getting tested is increasing in part because residents are seeing the effect of the country's antiretroviral drug program (AP/CNN.com, 1/5). Botswana in 2002 pledged to begin providing widespread access to antiretroviral treatment at no cost, and the government currently pays for more than 90% of the cost of providing drugs. About half of Botswana's roughly 110,000 HIV-positive residents in need of antiretroviral drugs currently have access to them (Kaiser Daily HIV/AIDS Report, 1/3). HIV-positive men "continue to be underrepresented" in the country's antiretroviral drug program in part because women more frequently visit health clinics because of pregnancies, the AP/CNN.com reports. The World Health Organization and UNAIDS recommend routine HIV testing in all regions where antiretroviral drugs are available (AP/CNN.com, 1/5).