The Editor, Sir:

Recent debates concerning remarks of the Jamaica Employers' Federation executive director on employers' right to test employees for AIDS should also consider several key points. HIV testing in the workplace or even knowledge, attitudes and practice 'surveys' are not just 'surveys' or operational improvement programmes, but ought to be seen as 'research', because of the intent to contribute to general knowledge and study implications which go beyond the individual study participants.

Furthermore, employees ought to be considered as a 'vulnerable group' because of implications for health insurance, job promotion prospects, job security, job benefits, impact on family, and susceptibility to undue influence and coercion by employers, trade unions that may be anticipating increased benefits from study outcomes, as well as peer pressure. As such, employees ought to be guaranteed additional or special protection.

Because employers can claim to be the 'owners' of employees' records, effective confidentiality safeguards must be guaranteed and sanctions implemented when there is a breach. Rose and Pietri in the Journal of Occupational Medicine (2002,Vol 44) recommend that at minimum, when studies or medical monitoring includes the collection of biological samples, "all planned future uses of those samples, [personal] identifiers, and the use of the data obtained from the samples, must be fully explained and accepted by the participants before the study."

Seek ethical guidance

Companies/organisations should seek ethical guidance from the Ethics Committee of the Ministry of Health and/or collaborate with academics to access oversight by the University Ethics Committees. The Jamaica Business Council on HIV/AIDS is a good step in this regard. All stakeholders should ensure that workers' rights are protected in keeping with the highest ethical standards.

I am, etc.,

YOHANN WHITE

yohannwhite@yahoo.com

UWI Medical Student

Infectious Diseases Observership, University

of Miami Miller School of Medicine

Miami, Florida

Via Go-Jamaica