性病患者实行就医实名制的利弊及其对策探讨

自从20世纪70年代末性病在我国重新流行以来,性病的流行已经成我国重要的公共卫生和社会问题,而且成为艾滋病流行的重要因素。为了加强性病传染源的控制和管理,国务院法制办于2011年5月公布了《性病防治管理办法(修订征求意见稿)》,该意见稿中正式提出性病报告实行实名制。这项举措带来了对性病患者隐私权的强烈冲击,引起了学术界乃至社会各界的广泛争议。作者针对性病患者的求医行为特点、实行就医实名制的利弊,探讨如何在医疗活动中平衡社会知情权和患者个人隐私权的冲突,如何在保障个人、医疗机构和大众等权利主体的合法利益不受侵犯的前提下,逐步实行性病患者的就医实名制。     

浅析HIV/AIDS病人的隐私权

当前在歧视依然很严重的情况下，保护艾滋病（AIDS）病人和艾滋病病毒（HIV）感染者的合法权利最重要的是隐私权。该文从当前的艾滋病相关规定入手，探讨如何进一步改善法律环境，从而确保艾滋病病人和HIV感染者的隐私权及其他合法权利得到保障。     

浅析HIV感染者/AIDS病人就业保障权的政策矛盾和冲突

艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人(HIV/AIDS病人)的就业保障权是其人权的一部分,应受到社会平等的对待和保护,尤其是《艾滋病防治条例》和《中华人民共和国就业促进法》颁布实施后。但如今他们的就业权屡屡受到侵犯和不平等的对待。人们的认识和社会歧视是原因之一,但是从政策、法律角度看,目前我国颁布实施的涉及HIA/AIDS病人的有关政策和规定之间存在着相互矛盾和冲突。文章从当前我国的涉及HIV/AIDS病人就业权的政策和规定出发,分析了政策和规定间的矛盾冲突及其造成的危害,探讨如何进一步改善法律环境,确保HIV/AIDS病人的就业权得到保障。     

自愿咨询检测在艾滋病防治中的作用

目前在世界各国,艾滋病自愿咨询检测（VCT）已成为防治艾滋病的一个非常重要的环节。VCT可以帮助人们减少高危性行为,以及减少性病和艾滋病病毒（HIV）的传播,使更多的人接受有关艾滋病和HIV检测的基本知识,了解国家有关政策,帮助HIV感染者积极面对生活。如何更好的发挥VCT的作用,将是今后艾滋病疫情控制中的一个至关重要的问题。     

艾滋病预防与控制的政策研究(二)--艾滋病防治政策的制定

（续上期） 前一篇论文,主要论述了艾滋病防治的方法,分析了这些方法中包括的各个方面之间,以及每一个方面的各个要素之间的相互关系。本文主要从艾滋病防治的中长期规划与行动计划,艾滋病防治与人权问题,艾滋病防治与其它社会问题这三个方面来论述艾滋病防治政策的制定。2 艾滋病防治政策的制定 制定艾滋病防治政策,首先要考虑到什么是政策,政策应该包括哪一些具体的内容,以及考虑政策实施时,如何确定有关资源的分配和优先度等问题。 什么是政策?首先,政策是解决问题的方法,解决具有一定的社会性与公共性问题的方法,根据要解     

中国艾滋病法律与公共政策——以权利保障和受影响人群为核心

《艾滋病防治条例》(简称《防治条例》)的出台是一个重大进步,但单靠《防治条例》本身,无法为艾滋病病毒(HIV)感染者和受艾滋病(AIDS)影响的人群提供充分的权利保障。因而,目标明确且以证据为基础的法律改革是必要的,以保证最有需求的人们能够得到帮助和服务。当前的法律环境对这些关键人群在公共健康问题上有着负面的影响,并将导致艾滋病在中国的进一步传播。缺乏有效保障隐私权的规定和制度,以及反歧视相关立法的缺失,对艾滋病流行起到了推波助澜的作用。艾滋病法律需要进行相应的修订,以更好应对疾病流行的新情况。通过系统查阅法律法规和规章及政策资料,以及访谈、会议现场观察、案例搜集等,对法律法规的可操作性、合理性及其内在冲突等进行评估。对包括《防治条例》在内的中国艾滋病相关法律法规、规章进行评估,发现规定和实践中的漏洞和冲突,为改进立法提出建议。     

韶关市无偿献血者抗-HIV检测结果分析

艾滋病是一个全球性的公共卫生问题和社会问题,是我国重点控制的传染病。近年来,HIV感染在人群中呈增长趋势,其主要是通过性接触、吸毒、输血等传播方式。韶关市中心血站为保证临床输血安全预防艾滋病经血液传播,一直严格按照卫生部采供血有关条款规定对无偿献血者血液进行HIV抗体检测。现将韶关市中心血站自1999年-2007年开展无偿献血以来对献血者血液HIV抗体检测结果作如下分析和讨论。     

艾滋病预防与控制的政策研究（一）—艾滋病防治的方法

有关艾滋病预防和治疗的研究既是一项政策性很强的社会系统研究，同时也是一项需要多学科间进行合作的应用性研究。艾滋病防治的方法可主要分为检测和监测、宣传、教育和行为干预，治疗、咨询和支助这三个方面。本文是在分析以上三个方面之间，以及每一个方面的各个要素之间存在着的相互关系的基础上，对艾滋病防治的方法和政策进行系统地研究。并且，关于艾滋病防治政策的研究应该包括制定相应的法律与法规，运用以上的各种艾滋病防治的方法来制定和实施艾滋病防治的规划，解决吸毒、卖淫、非法卖血，改善妇女的社会地位，保障HIV/AIDS的人权等社会问题。最后，必须建立艾滋病防治政策的监测与评价系统。     

世界各国有关艾滋病的立法和立法提案(选辑)

世界各国有关艾滋病的立法和立法提案（选辑）１维护公共卫生安全方面鉴于艾滋病严重的社会危害性，各国政府都采取了积极措施予以遏止。一般都通过立法建立艾滋病的报告制度和强制血检制度。尽管各国宪法都普遍保护公民的人身自由权和隐私权，但根据“国家和公共利益至上...     

我区艾滋病筛查实验室存在问题及对策

从1994年开始我国艾滋病传播速度加快，疫情逐年大幅度上升。自此，我国艾滋病流行进入快速增长期。为加强对全国艾滋病检测工作的监督管理，规范艾滋病检测实验室的设置和验收，确保艾滋病检测工作质量，依据《中华人民共和国传染病防治法》，《艾滋病防治条例》和国家相关法律、法规的规定，2006年6月卫生部颁布了《全国艾滋病检测工作管理办法》（以下简称《办法》）。     

应用NUD*IST定性分析软件对AIDS相关法律的分析

目的 探索现行艾滋病(AIDS)相关法律存在的问题,为今后完善AIDS相关法律、法规提供参考。方法 根据不同的主题内容,利用NUD*IST 4．0定性软件,对现行的。AIDS相关法律、法规进行整理、编码、主题归类和分析。结果 现行的法律、法规在对艾滋病病毒(HIV)／AIDS患者的报告、检查、诊断治疗、随访、消毒、隔离和婚姻,对感染HIV的境外人员、羁押人员及流动人群的管理方面,以及AIDS的预防措施都存在一定的问题。结论 现行AIDS相关的法律、法规,尤其是《中华人民共和国传染病防治法》母法的部分条款已经不适应AIDS管理和防治的需要,亟待修改完善。     

Barriers to HIV testing and confidentiality: the concerns of HIV-positive and high-risk individuals

The authors report that individuals who are at highest risk of contracting HIV indicated the greatest concern about confidentiality and the greatest knowledge of local reporting laws. Although concern about confidentiality may not be cited as the most common reason to delay or defer testing, it is an important consideration for a minority of individuals--the very segment who are at highest risk of contracting HIV and are the most important targets of campaigns to encourage HIV testing. The particular concerns of this critical segment of the population at risk must be directly and carefully addressed and not lost in a general assessment of population-wide attitudes/concerns about HIV testing. Studies that examine individuals' concerns about HIV testing and privacy and do not stratify by level of HIV risk may obscure the important and heightened concerns of this most important subpopulation.     

Nonconsented human immunodeficiency virus testing among critically ill patients: intensivists' practices and the influence of state laws

BACKGROUND: Human immunodeficiency virus (HIV) testing can improve care for many critically ill patients, but state laws and institutional policies may impede such testing when patients cannot provide consent. METHODS: We electronically surveyed all US academic intensivists in 2006 to determine how state laws influence intensivists' decisions to perform nonconsented HIV testing and to assess intensivists' reliance on surrogate markers of HIV infection when unable to obtain HIV tests. We used multivariate logistic regression, clustered by state, to identify factors associated with intensivists' decisions to pursue nonconsented HIV testing. RESULTS: Of 1,026 responding intensivists, 765 (74.6%) had encountered decisionally incapacitated patients for whom HIV testing was wanted. Of these intensivists, 168 pursued testing without consent and 476 first obtained surrogate consent to testing. Intensivists who believed nonconsented HIV testing was ethical (odds ratio, 3.8; 95% confidence interval, 2.2-6.5) and those who believed their states allowed nonconsented testing when medically necessary (odds ratio, 2.3; 95% confidence interval, 1.6-3.4) were more likely to pursue nonconsented HIV tests; actual state laws were unrelated to testing practices. Of the intensivists, 72.7% had ordered tests for perceived surrogate markers of HIV infection in lieu of HIV tests; more than 90% believed these tests were sufficiently valid to base clinical decisions on. CONCLUSIONS: Most US intensivists have encountered decisionally incapacitated patients for whom HIV testing may improve care. Intensivists' decisions to pursue nonconsented testing are associated with their personal ethics and often erroneous perceptions of state laws, but not with the laws themselves. Uniform standards enabling nonconsented HIV testing may minimize inappropriate influences on intensivists' decisions and reduce intensivists' reliance on perceived surrogate markers of immunodeficiency.     

Why do patients refuse HIV testing in the emergency department? Perspectives from a qualitative study

ABSTRACT

Despite support for routine testing in all health care settings, including emergency departments (EDs), there are challenges to implementing ED-based HIV testing and high refusal rates. We conducted qualitative interviews to examine reasons for refusal with 30 testing refusers in the ED of a safety net hospital. Key themes included: routine testing is positive, importance of privacy and respectful approach, ED atmosphere and environment discourage testing acceptance, importance of HIV counseling, desire to see an MD before testing staff, and who should offer testing. Results provide useful information for programs and policies of routine ED-based HIV testing to encourage testing uptake.     

Names reporting fallout continues in states' battles

The Centers for Disease Control and Prevention (CDC) has issued guidelines recommending names-based HIV reporting, which has lead to political battles in a dozen States where confidentiality and names-reporting laws have been introduced. Some States have introduced laws that may further violate confidentiality with regard to HIV status, including partner notification laws. Names reporting continues to have support among HIV epidemiologists, who view it as an effective way to track the spread of HIV across the nation, but activists and clinicians continue to fear that it will dissuade many people from getting tested. In addition, minorities and immigrants may be especially resistant to testing if they know their names will be reported. A summary of activities in the States where names-based reporting and related issues are being debated is presented.     

Genetic susceptibility to malignant diseases--ethical issues. Minireview

Ethical problems connected with genetic testing with the intention of the measurement of the susceptibility or predisposition to malignant tumors are presented (respect for autonomy, beneficence, nonmaleficence, confidentiality, privacy, veracity and truth-telling, informed consent, right to know, right not to know, informational self-determination, etc.). Various aspects dealing with ethics of screening and research projects involving human subjects are discussed as well.     

Criminalization of HIV Exposure: A Review of Empirical Studies in the United States

This review of literature identifies and describes US empirical studies on the criminalization of HIV exposure, examines findings on key questions about these laws, highlights knowledge gaps, and sets a course for future research. Studies published between 1990 and 2014 were identified through key word searches of relevant electronic databases and discussions with experts. Twenty-five empirical studies were identified. Sixteen of these studies used quantitative methods with more than half of these being cross-sectional survey studies. Study samples included male and female HIV-positive persons, HIV-positive and -negative men who have sex with men, public health personnel, and medical providers. Research questions addressed awareness of and attitudes toward HIV exposure laws, potential influences of these laws on seropositive status disclosure for persons living with HIV, HIV testing for HIV-negative persons, safer sex practices for both groups, and associations between HIV exposure laws and HIV-related stigma. Surveys of the laws and studies of enforcement practices were also conducted. Attention should be shifted from examining attitudes about these laws to exploring their potential influence on public health practices and behaviors related to the HIV continuum of care. Studies examining enforcement and prosecution practices are also needed. Adapting a theoretical framework in future research may be useful in better understanding the influence of HIV exposure laws on HIV risk behaviors.     

MSM中HIV快速检测实际利用情况及需求调查

目的了解男男性行为人群（MSM）对艾滋病病毒（HIV）快速检测的实际利用情况,获取影响MSM接受HIV快速检测的相关需求。方法 2012年10-12月,在杭州市下城区、江干区和富阳市MSM活动场所、自愿咨询检测门诊招募MSM,开展问卷调查。结果在接受调查的501名MSM中,268人回答知道HIV快速检测,占53.5%,其中93.7%（251/268）接受过快速检测,74.3%（199/268）知道快速检测可以较快获得检测结果。在需要做HIV检测时,52.7%（264/501）选择快速检测。在接受快速检测同时,希望接受艾滋病/性病咨询、梅毒检测和丙型肝炎病毒检测的比例分别为71.5%、60.9%、48.9%。79.6%希望接受快速检测的场所为疾病预防控制中心,89.2%愿意动员性伴接受快速检测。影响调查对象接受快速检测的主要因素为获得检测结果的时间（54.7%）、检测结果的准确性（54.5%）、个人信息的保密性（45.7%）等。结论 MSM对检测场所、隐私以及其他检测咨询等有不同的服务需求。因此,要加强对快速检测及相关特点的宣传,在开展快速检测时,从MSM实际需求出发进行改进,促进更多的MSM接受快速检测,扩大检测覆盖面。     

Does HIV reporting by name deter testing? MESH Study Group

OBJECTIVE: Name-based HIV reporting is controversial in the United States because of concerns that it may deter high-risk persons from being tested. We sought to determine whether persons at risk of HIV infection knew their state's HIV reporting policy and whether they had delayed or avoided testing because of it. DESIGN: A cross-sectional anonymous survey. METHODS: We interviewed 2404 participants in one of three high-risk groups: men who have sex with men (MSM), heterosexuals attending a sexually transmitted disease (STD) clinic, and street-recruited injection drug users (IDU). Participants were asked standardized questions about their knowledge of reporting policies and reasons for having delayed or avoided testing. We recruited in eight US states: four with name-based reporting and four without; all offered anonymous testing at certain sites. RESULTS: Fewer than 25% correctly identified their state's HIV reporting policy. Over 50% stated they did not know whether their state used name-based reporting. Of the total, 480 participants (20%) had never been tested. Of these, 17% from states with name-based reporting selected concern about reporting as a reason for not testing compared with 14% from states without name-based reporting (P = 0.5). Comparing previously tested participants from states with name-based reporting to those from states without, concern about HIV reporting was given as a reason for delaying testing by 26% compared with 13% of IDU (P < 0.001), and for 26% compared with 19% of MSM (P = 0.06). CONCLUSION: Most participants did not know their state's HIV reporting policy. Name-based reporting policies were not associated with avoiding HIV testing because of worry about reporting, although they may have contributed to delays in testing among some IDU.