Is it lawful to offer HIV self-testing to children in south Africa?

Health-facility-based HIV counselling and testing does not capture all children and adolescents who are at risk of HIV infection. Self-testing involves conducting an HIV test at home or in any other convenient space without the involvement of a third party. It is increasingly being argued that it sh...

Full description

Saved in:
Bibliographic Details
Published in:Southern African journal of HIV medicine 2013-12, Vol.14 (4), p.151
Main Authors: Strode, A.E, van Rooyen, H, Makusha, T
Format: Article
Language:English
Subjects:
Diagnosis
HIV infection in children
Laws, regulations and rules
Methods
Prevention
Self-examination, Medical
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Health-facility-based HIV counselling and testing does not capture all children and adolescents who are at risk of HIV infection. Self-testing involves conducting an HIV test at home or in any other convenient space without the involvement of a third party. It is increasingly being argued that it should be incorporated into national HIV- prevention programmes as one of a range of HIV counselling and testing approaches. Although this model of HIV testing is being seen as a new way of reaching under-tested populations, no studies have been conducted on offering it to children. HIV self-tests are now available in South Africa and are sold without the purchaser having to be a certain age. Nevertheless, all HIV testing in children must comply with the norms set out in the Children's Act (2005). Here we explore whether offering self-testing to children would be lawful, by outlining the four legal norms that must be met and applying them to self-HIV testing. We conclude that, although children above the age of 12 years could consent to such a test, there would be two potential obstacles. Firstly, it would have to be shown that using the test is in their best interests. This may be difficult given the potential negative consequences that could flow from testing without support and the availability of other testing services. Secondly, there would need to be a way for children to access pre-and posttest counselling or they would have to be advised that they will have expressly to waive this right. The tests are more likely to be lawful for a small sub-set of older children if: (i) it assists them with HIV-prevention strategies; (ii) they will be able to access treatment, care and support, even though they have tested outside of a health facility; and (iii) psychosocial support services are made available to them via the internet or cell phones. DOI: 10.7196/SAJHIVMED.987
ISSN:1608-9693
DOI:10.7196/SAJHIVMED.987