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Although reporting of HIV infections initially was not done by name, there has been a recent and controversial movement in the U. toward name-based reporting of HIV infection.(10) The debate over name-based reporting has focused on the need for more accurate epidemiological information regarding the spread of the epidemic-especially as antiretroviral therapies have proven successful in delaying progression to AIDS-versus concerns about deterring testing and the risk of discrimination. government policy has recommended that HIV-infected health care workers who perform exposure-prone invasive procedures have their cases reviewed by an expert panel, which will decide whether they may continue to perform such procedures and whether they must inform patients of their infection.

This chapter examines ethical issues related to HIV/AIDS testing, treatment, and research.

Key issues analyzed include confidentiality, informed consent, end of life, research design, conflict of interest, vulnerable populations, and vaccine research. and international legal statutes, regulations, and guidance documents provide the context for the analysis and recommendations.

In addition, some states permit the testing of prisoners and persons accused of sex crimes.

Connecticut and New York also require mandatory HIV testing of newborns,(22,23) which indirectly reveals maternal HIV status.

Mother-to-child transmission of HIV has been a priority area for earlier detection because transmission is significantly reduced if pregnant women identified as seropositive take antiretroviral therapy.(24-28) In 1999, an Institute of Medicine panel on reducing perinatal HIV transmission concluded that pretest counseling and written informed consent requirements for HIV testing were barriers to prenatal HIV testing.

To take advantage of the proven effectiveness of antiretroviral therapy for preventing perinatal HIV transmission, the panel proposed significant changes in HIV testing policies for pregnant women in the United States.

For example, in many states, HIV information may not be disclosed based on a general release of medical information-specific authorization for release of HIV-related information must be obtained. have a duty to report HIV infections and AIDS cases to public health authorities.