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Canadian Journal of Public Health

, Volume 101, Issue 4, pp 300–302 | Cite as

HIV Counselling and Testing in Nova Scotia: The Provincial Strategy in the Context of an International Debate

  • Jacqueline C. GahaganEmail author
  • Janice L. Fuller
  • Valerie C. Delpech
  • Larry N. Baxter
  • E. Michelle Proctor-Simms
Commentary
  • 1 Downloads

Abstract

Nova Scotia, as a small province in Atlantic Canada, provides health care professionals and policy analysts with unique challenges for developing and implementing a strategy for accessible and acceptable HIV counselling and testing. Despite universal health care in Canada, barriers and challenges persist in relation to HIV counselling and testing programs and services in Nova Scotia. It is therefore necessary to examine the unique circumstances in the provision of programs and services in Nova Scotia prior to the possibility of adopting international HIV counselling and testing standards and guidelines being implemented in other jurisdictions. Nova Scotia’s provincial strategy on HIV/AIDS promotes a harm-reduction approach for different populations in various service settings, recognizing the diverse circumstances and experiences of people living in Nova Scotia. By contrast, the Centers for Disease Control (CDC) recommended strategy promotes opt-out testing and in some instances alters the requirement of informed consent. As the Public Health Agency of Canada (PHAC) revises the national HIV counselling and testing policies, it is imperative to address the unique characteristics of Nova Scotia’s provision of services, and how divergent strategies have the potential to address or compound the barriers to access that exist in this province’s communities.

Key words

HIV public health health policy public policy HIV testing 

Résumé

La Nouvelle-Écosse, une petite province du Canada atlantique, présente des défis particuliers pour les professionnels de la santé et les analystes des politiques sanitaires en ce qui a trait à l’élaboration et à la mise en œuvre d’une stratégie pour offrir des services accessibles et acceptables de counseling et de sérodiagnostic du VIH. Même si les soins de santé sont universels au Canada, les programmes et les services de counseling et de sérodiagnostic du VIH présentent encore des obstacles et des difficultés en Nouvelle-Écosse. Il est donc nécessaire d’examiner les circonstances particulières de l’offre de programmes et de services dans cette province avant d’envisager l’adoption des normes et des lignes directrices internationales de counseling et de sérodiagnostic du VIH en vigueur dans d’autres administrations. La stratégie provinciale de la Nouvelle-Écosse pour le VIH et le sida préconise une approche de réduction des préjudices pour différentes populations dans différents milieux de services, compte tenu des circonstances et du vécu des Néo-Écossais. La stratégie recommandée par les Centers for Disease Control (CDC) des États-Unis, par contre, préconise l’approche d’abstention pour les tests VIH et assouplit dans certains cas les exigences de consentement éclairé. Comme l’Agence de la santé publique du Canada (ASPC) est en train de réviser les politiques nationales de counseling et de sérodiagnostic du VIH, il faut absolument tenir compte des caractéristiques particulières de la prestation de services en Nouvelle-Écosse, et du fait que différentes stratégies peuvent réduire ou accentuer les obstacles à l’accès qui existent dans les localités de cette province.

Mots clés

VIH santé publique politique sanitaire politique publique sérodiagnostic du VIH 

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Copyright information

© The Canadian Public Health Association 2010

Authors and Affiliations

  • Jacqueline C. Gahagan
    • 1
    Email author
  • Janice L. Fuller
    • 1
  • Valerie C. Delpech
    • 2
  • Larry N. Baxter
    • 3
  • E. Michelle Proctor-Simms
    • 3
  1. 1.School of Health and Human PerformanceDalhousie UniversityHalifaxCanada
  2. 2.Health Protection AgencyLondonUK
  3. 3.Nova Scotia Advisory Commission on AIDSHalifaxCanada

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