Informed consent for HIV testing in a South African hospital: is it truly informed and truly voluntary?

• Published in: American journal of public health (1971) Vol. 88; no. 4; pp. 637 - 640
• Main Authors: Abdool Karim, Q, Abdool Karim, S S, Coovadia, H M, Susser, M
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.04.1998; American Public Health Association
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; AIDS Serodiagnosis - psychology; Attitude to Health; Biological and medical sciences; Biomedical research; Condoms; Control Groups; Counseling; Disease transmission; Ethics; Ethics Committees, Research; Female; Health Knowledge, Attitudes, Practice; HIV; HIV Infections - diagnosis; HIV Infections - transmission; Hospitals; Human immunodeficiency virus; Humans; Immune system; Infectious Disease Transmission, Vertical; Informed Consent; Medical sciences; Medical screening; Medical tests; Outpatient Clinics, Hospital; Participation; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnant Women; Prenatal Care; Prevention; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Research Subjects; South Africa; Surveys and Questionnaires; Teaching. Deontology. Ethics. Legislation; Therapeutic Human Experimentation; Voluntary Programs; Vulnerable Populations; Womens health; South Africa; Africa; Human; Immunopathology; Participation; Attitude; Volunteer; Retroviridae; Hospital environment; AIDS; Research; Clinical counseling; Medical screening; Immune deficiency; Lentivirus; Knowledge; Infection; Virus; Pregnancy; Viral disease; Informed consent; Female; Human immunodeficiency virus; Public health; Empirical Approach; Health Care and Public Health; King Edward VIII Hospital (Durban); Biomedical and Behavioral Research
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.88.4.637

OBJECTIVE: The purpose of this study was to assess informed consent to human immunodeficiency virus (HIV) testing in a perinatal HIV transmission study in a major referral hospital serving a largely Black population in South Africa. METHODS: First-time antenatal clinic attenders who were randomly selected from those enrolled in the perinatal HIV study (n = 56) answered questionnaires before and after counseling. RESULTS: Knowledge of HIV transmission and prevention, high at the outset, was little improved after counseling. The acceptance rate for HIV testing was high. Despite assurances that participation was voluntary, 88% of the women said they felt compelled to participate in the study. CONCLUSIONS: Informed consent in this setting was truly informed but not truly voluntary.