Ethical and human rights dimensions in prenatal HIV/AIDS testing: Botswana in global perspective

Objectives: To evaluate the conflicts between the rights of society and those of mothers-to-be and the unborn, which raise difficult ethical and legal questions regarding decision-making, respect for autonomy, confidentiality, public health and individual rights in an ‘opt-out’ approach to HIV testing in antenatal care, which Botswana introduced in 2004. Methods: An empirical study with critical analysis of research studies since 2004, and documentary data/reports relating to opt-out HIV testing policy in prenatal cases in Botswana. Conclusions: The Government of Botswana’s capacity to deal effectively with HIV/AIDS is inherently connected with larger societal, legal, policy and contextual issues. These issues appear to be insufficiently appreciated in Botswana, even though their consideration is essential if the country is to align its practices with existing national laws, as well as international conventions to which it is a signatory.