The ethics of screening for early intervention in HIV disease.

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Abstract
The potential for early medical intervention to slow or prevent the development of AIDS in HIV-positive individuals has led to calls for widespread testing of asymptomatic at-risk persons. Levine and Bayer discuss the ethical aspects of these proposals, distinguishing among the justifications for screening and evaluating each independently. They present current clinical evidence for early intervention and explore its potential risks and benefits. Using the ethical principles of respect for persons, the harm principle, beneficience, and justice, they analyze the justifications for and the limits of screening infants, adolescents, and adults for HIV seropositivity. Levine and Bayer conclude that while there are clinical and ethical grounds for establishing voluntary screening programs, conditions of informed consent and confidentiality must be met, and protection from discrimination and provision of follow-up services for infected individuals are essential.