Perceptions of people living with HIV regarding their diagnosis and treatment processes in Turkey (HIV ile Yaşayan Kişilerin Tanı ve Tedavilerinde Yaşanan Etik Sorunlar)

Senyurek G., Işıl Ülman F. Y. (Yürütücü)

Yükseköğretim Kurumları Destekli Proje, 2017 - 2018

Proje Türü: Yükseköğretim Kurumları Destekli Proje
Başlama Tarihi: Haziran 2017
Bitiş Tarihi: Temmuz 2018

Proje Özeti

HIV, Confidentiality and Partner Notification, a Qualitative Research from Istanbul

Gamze Senyurek, Acıbadem University, Bioethics Master Student

Yesim Isil Ulman, Acibadem Univ. School of Medicine

Background: AIDS (Acquired Immuno- Deficiency Syndrome) is generally associated with the presence of HIV (Human Immunodeficiency Virus) that spread through transmission of bodily fluids such as intimate sexual contact and/or intravenous drug use or in utero mother-to-child transmission. As HIV is fragile outside the body, it is not transmittable through casual contact. AIDS is treatable but not curable. However, HIV/AIDS has major social and cultural implications that raise ethical concerns, such as autonomy, confidentiality, nonmalefficence. This paper aims to focus partner notification for the people living with HIV/AIDS based on the evidence retrieved from a qualitative study that has been recently carried out in Turkey. Ethical concerns arise from the tension between patient autonomy by honoring her/his preferences and preventing harm to others, mainly partner in this case. International guidelines recommend voluntary partner notification as an intervention for STI control, with non-voluntary disclosure to partners only when all other avenues have been exhausted. Voluntary partner notification is still the rule in most countries in Europe.

Method: This research is planned as a qualitative field study. The population consists of a sufficient number of patients living with HIV/AIDS in Istanbul (August 2017, February 2018). The snowball sampling technique is chosen, as it is used when there is insufficient information to create a sample and when it is difficult to reach people to create the research universe. After obtaining informed consent of the volunteers, the interviews are recorded on the voice tape. The voice recordings are transcribed afterwards and the contents of the participants' opinions are systematically analyzed.

Results:

The results, can be elucidated as the breach of confidentiality of the personal health data on non-medical reasons, need in developing partner notification policies and services, attitudes and behaviors infringing right to work and right to marry, issues concerning patient autonomy and obtaining informed consent.

Conclusions: Evidence shows that HIV cases have recently been on the rise in Turkey. Besides its being a considerable human and public health issue, HIV/AIDS hosts ethical concerns of discrimination, stigmatization, bereavement of social rights on part of the patients and their partners. This paper argues that the tension between respecting patient autonomy and confidentiality with the do no harm to others principle can be best balanced through obtaining proper informed consent and developing partner notification services in accordance with the improvement of health policies and strategies nationwide.

Sources:

Jay A Jacobson, Infectious diseases ethics, in: Cambridge Texbook of Bioethics, ed. PA Singer, AM Viens, 3^rd printing, 2009, pp: 481-486.

ECDC Technical Report, Public health benefits of partner notification for sexually transmitted infections and HIV, Stockholm June 2013.

Craig P. Dunn, AIDS, Volume 2. Published Online: 21 Jan 2015 (Accessed: 01.02.2018)