Concepedia

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

Quarraisha Abdool Karim, Salim S. Abdool Karim, H. M. Coovadia, Mervyn Susser

American Journal of Public Health · 1998 · 162 citations · 9 references

Open access

TL;DR

The study aimed to evaluate the quality of informed consent for HIV testing among first‑time antenatal clinic attendees in a South African referral hospital. Researchers randomly selected 56 first‑time antenatal attendees enrolled in a perinatal HIV study and administered questionnaires before and after counseling. Although participants already had high knowledge of HIV transmission and prevention, counseling did not significantly improve it, the acceptance rate for testing was high, yet 88 % felt compelled to participate, indicating that consent was informed but not truly voluntary.

Abstract

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.