The institutions are offered HIV testing routinely. The

The peer-reviewed article
selected for this assignment is “HIV
stigma and the experiences of young men with voluntary and routine HIV testing”
(Knight, 2016).

In summary, the issue at
stake here is as follows. Owing to the rising HIV epidemic, especially in young
men, public authorities have been push for and even incentivizing routine HIV
testing at the point of care. In clear, patients who present for care at
healthcare institutions are offered HIV testing routinely. The goal of this
“noble” approach is reportedly to increase awareness and hopefully reduce the
prevalence of the disease.

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The challenges with this
approach however arise when the testing practice is not done properly.
Challenges include the possibility of creating HIV-stigma, discrimination in
receiving care. Stigmatization and the perception of discrimination, especially
as it relates to AIDS, can lead exclusion out of the community (Thomas, 2006). Pre
and post test counseling are important safeguards in testing practice. It gives
the healthcare professional the opportunity to provide education about the
risks of transmission, treatment options, and change in behavior (Hicks and Rundell,
1996). It also helps avoid stigmatization, a phenomenon that has been reported in
association with HIV infection (Earnshaw and Chaudoir, 2009). People who
receive a positive HIV test result may perceive this as a fatality, a death
sentence. Such a perception may lead to isolation and depression (Takada et
al., 2014). Depression may lead to suicide.

The dilemma in this issue arises
from the noble intent to reduce the risk of HIV transmission by means of
routine testing. This represents a risk reduction dilemma. The challenge then
is to what extent should health promotion be allowed to cause health risks in
order to prevent the targeted harm?

In order to solve this
dilemma, it is important provide professionals that are assigned with HIV
testing with the tools that they need to avoid causing more harm. HIV testing
should not be an easy undertaking. More resources should be allocated to the
training of “testers”. Counseling both before and after the test is
paramount and this task should not be sacrificed at the expense of expediency. This
is an area where healthcare professionals, especially nurses, should be very vocal
about. Local political representatives should be engaged. Actions should be
encouraged, which aim at increasing alertness on the importance of counseling in
HIV testing. Counseling theories exist to assist the counselor in understanding
patients’ feelings and angst. That understanding will help the healthcare
professional better help the patient navigate from the initial result to the
treatment approaches. There are various theories available, but I think what
ultimately matters is the relationship that the healthcare provider builds with
the patient. For this particular issue, humanistic theories such as the client-centered
theory from Carl Rogers are best suited (Rogers and Carmichael, 2014). This
approach dictates that the counselor accepts and integrates the concept that the
patients are in control of their own destinies. With this approach, the
healthcare professional just needs to show actively listening skills as well a
genuine interest and compassion toward the patient’s condition.

This approach is also reflected in Provision 1 of
the 2015 version of the ANA code of ethics, which stipulates that the nurse
practices with compassion and respect for the inherent dignity, worth, and
personal attributes of every person, without prejudice. That provision includes
the right to self-determination, respect for human dignity, and the relationships
with patients. A patient-nurse relationship should be that of trust. By so
doing, the nurse can better promote health while respecting patients’ decisions.


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