Hiv Testing

Few diagnostic tests or screening procedures have drawn as much deliberation

and controversy as the human immunodeficiency virus (HIV) test. Because of the

transmittable and highly fatal nature of the virus, it has been recommended that all

Americans receive HIV screening. However, according to Branson (2006), "an estimated

one quarter of the approximately 1 to 1.2 million of HIV-infected persons in the United

States are unaware that they are infected" (para. 3). Despite hospital admissions and

frequent visits to primary care physicians, the virus often remains undiagnosed due to the

absence of routine screening. In recent years, various treatments for HIV, namely

medications, have been uncovered, proving to minimize symptoms, delay progression of

the virus, and increase longevity. As a result, clinicians and public health officials have

increasingly called for routine screening, and the Centers for Disease Control and

Prevention (CDC) recently recommended HIV screening in health care settings for all

patients aged 13 to 64 (Branson, 2006). Still, even after people undergo screening for the

virus, the issue remains that a number of those people never return to learn the results.

Thus, it has become a community health goal in various regions of the country to not

only increase screening among the population but also ensure that those screened are

receiving the results in a timely manner.

The Newspaper Article

On January 1, 2007, the Philadelphia Inquirer published an article addressing

Philadelphia's plans to increase screening for HIV through new mobile units and rapid

tests. These three mobile units and 16,500 rapid screening kits "will be paid for out of

$1.5 million in new state funds, nearly all of which will go toward testing" (Wagh, 2007).

Workers at various agencies are being trained for certification using these rapid tests; the

tests take approximately 20 minutes to produce results that are 99.8 percent accurate

(Wagh, 2007).

The community described in the article encompasses those people residing in

Philadelphia who do not have routine access to medical care. John Cella, the director of

the AIDS Activities Coordinating Office, maintains that the city hopes to make the rapid

tests available through emergency rooms, homeless shelters, substance abuse clinics, and

halfway houses (Wagh, 2007).

As the article suggests, there are significant means available to the city in order to

address the concern. The state is providing considerable revenue to fund the operation of

the mobile units and the rapid screening kits. Presumably, the state revenue is also

funding training for health professionals and other city workers, so that they may be

competent in conducting the test. Nonetheless, there is no mention in the article about

whether those working from the mobile units are receiving pay or are simply

volunteering their services. Finally, because the rapid test analyzes fluid obtained by

swiping the gums, there is no need to dispose of needles or other medical waste, which

would cost significantly more (Wagh, 2007). Accordingly, there is virtually no risk of

workers coming in contact with infected bodily fluids; such contact would lead to further

testing and sometimes immediate treatment with HIV medications, an additional cost.

Ethical Issues

Despite widely available testing and medications, it is estimated that a quarter of

Americans with HIV are unaware of their status. According to Clark (2006), "The result

is that these individuals are continuing to spread this lethal infection unknowingly and are

failing to obtain the powerful drug therapies that have been proven to extend their lives"

(p. 8). Therefore, the ethical issue related to the failure to screen individuals for HIV is

the potential that others will be unknowingly infected. Moreover, those currently infected

will not receive the necessary treatment, thus leading to such adverse effects as rapid

progression of the virus and increased mortality related to AIDS.

Similarly, many communities have difficulty routinely conveying test results to

those who have been tested for the virus. "Traditional HIV tests require a week to get

results, and at least a third of those tested fail to come back to learn the outcome (Wagh,

2007). So, those individuals who have tested positive for HIV may never be informed of

their condition. Consequently, they do not receive