Skip to main content
Accessibility|Contact|Privacy|Terms|Cookies

Developing Countries need support to Conduct Anonymous HIV Testing

  • Published: 2009-01-21 : Author: Public Library of Science
  • Synopsis: Data collected from HIV surveillance are crucial to guide public health interventions planning and prevention efforts.

Main Document

Data collected from HIV surveillance are crucial to guide public health interventions, planning, and prevention efforts. But developing countries face several challenges to implementing surveillance programs says a team of researchers from the US and the Democratic Republic of Congo in this week's PLoS Medicine.

Developing countries need support to ethically conduct unlinked anonymous HIV testing.

Data collected from HIV surveillance are crucial to guide public health interventions, planning, and prevention efforts. But developing countries face several challenges to implementing surveillance programs says a team of researchers from the US and the Democratic Republic of Congo in this week's PLoS Medicine.

One form of surveillance that can be particularly challenging to conduct, say Stuart Rennie (University of North Carolina at Chapel Hill, USA) and colleagues, is unlinked anonymous testing (UAT), which typically involves using blood that is discarded from specimens collected from patients for routine clinical purposes. UAT commonly does not involve obtaining consent from the person whose discarded blood is tested for HIV. The test is anonymized and unlinked from the person providing the sample and so the results cannot be reported back to patients.

The ethical justification for UAT, they say, includes the usefulness of the surveillance data together with the confidentiality protections afforded by anonymous, unlinked testing; the fact that the residual blood collected for other purposes would be discarded anyway and no one is harmed by its use; and the view that UAT takes place as part of a response to a public health emergency.

While the authors believe that UAT itself is "valuable and ethical," they argue that such surveillance "can be conducted in ethically questionable ways in certain circumstances." They give a series of examples from their own experience in the field, together with guidance on how to improve the conduct of UAT in such circumstances.

One example is that agencies conducting UAT in developing countries, they say, may sometimes collect residual blood from syphilis testing services that they temporarily set up to facilitate HIV surveillance. Such an approach is not in keeping with WHO/UNAIDS guidelines which state that UAT should only be conducted in settings where blood is regularly (not temporarily) collected for other purposes. "If syphilis testing is offered opportunistically to obtain blood for surveillance purposes," say Rennie and colleagues "then the primary purpose of the blood draw is not syphilis testing but surveillance, and consent should be obtained."

The authors outline three strategies to harmonize high quality HIV surveillance with international ethical standards. First, justifications for UAT should be reviewed in local contexts with local stakeholders. "The justifications," they say, "should be directly addressed in surveillance protocols, discussed with local ethics review boards, and communicated in community awareness meetings." Second, one ethical concern surrounding UAT namely that those whose blood tests positive for HIV do not know their HIV status could be addressed by providing confidential voluntary testing in close conjunction with UAT activities. Third, gaining local approval for HIV surveillance activities is important, but insufficient "beyond approval," they say "lies the fundamental ethical requirement to strengthen in-country capacity in epidemiological surveillance, ethics, and health care systems."

Reference: Rennie S, Turner AN, Mupenda B, Behets F (2009) Conducting unlinked anonymous HIV surveillance in developing countries: Ethical, epidemiological and public health concerns. PLoS Med 6(1): e1000004. doi:10.1371/journal.pmed.1000004

• Discussion: Have Your Say! - Add your comment or discuss this article on our FaceBook Page.

Similar Topics

1 : World Mayors Sign Paris Declaration to End AIDS Epidemic : International Association of Providers of AIDS Care (IAPAC).
2 : Major Monoclonal Antibody Drug Trial for HIV Patients Underway : Alessandra Miguel-Descalso.
3 : Cryptococcosis and Meningitis : Thomas C. Weiss.
4 : Edurant a New HIV Treatment Approved by FDA : U.S. Food and Drug Administration.
5 : HIV Vaccine Awareness Day : AIDS Vaccine Advocacy Coalition.
From our HIV - Aids section - Full List (26 Items)


Submit disability news, coming events, as well as assistive technology product news and reviews.


Loan Information for low income singles, families, seniors and disabled. Includes home, vehicle and personal loans.


Famous People with Disabilities - Well known people with disabilities and conditions who contributed to society.


List of awareness ribbon colors and their meaning. Also see our calendar of awareness dates.


Blood Pressure Chart - What should your blood pressure be, and information on blood group types/compatibility.





1 : Eating at Night, Sleeping By Day Alters Key Blood Proteins
2 : Interior Car Temperature Can Become Life-threatening for Children in an Hour
3 : 20 New Episodes of Letters to Lynette with Dr. Lynette Louise to Air on The Autism Channel in 2018
4 : Turnstone Center Designated as Official Paralympic Training Site by US Olympic Committee
5 : Help Your Child in School by Adding Language to The Math
6 : 50% of Retirees Saw Little or No COLA Increase in Net 2018 Social Security Benefits
7 : Turnstone Endeavor Games Concludes with National Records Broken
8 : Spinning in Circles and Learning From Myself by Tsara Shelton


Disclaimer: This site does not employ and is not overseen by medical professionals. Content on Disabled World is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. See our Terms of Service for more information.

Reporting Errors: Disabled World is an independent website, your assistance in reporting outdated or inaccurate information is appreciated. If you find an error please let us know.

© 2004 - 2018 Disabled World™