A Human Rights Approach to Routine Provider-Initiated HIV Testing

Abstract

This Article describes the ethical, legal and public health implications of routine HIV testing - that is, testing such that individuals receive a routine offer of an HIV test whenever they come into contact with the health care system. In recent months, the consensus in favor of voluntary testing has yielded to a debate over whether efforts to curb the spread of HIV and to treat individual patients themselves would benefit from health care providers initiating testing. This Article first describes the history of HIV testing policy in the United States and internationally. It outlines the arguments in favor of routine provider-initiated testing and responds to objections that have been raised in the literature. Finally, it describes a proposal for an ethical routine testing regime that is consistent with human rights principles as well as U.S. and international statutes and case law on testing. This Article also proposes model legislation that addresses the issues of counseling, confidentiality, and informed consent in the context of routine-offer HIV testing.