Religious Mandatory Premarital HIV Testing; Assessment of Perceptions on Ethical Concerns Among Healthcare Workers in Kwaebibirem

Objective: This cross-sectional survey describes healthcare workers’ (HCWs’) perceptions on religious mandatory premarital HIV testing- (RMPmHT) associated ethical concerns. Methodology: An online survey was completed with an e-questionnaire, circulated via WhatsApp, (a freeware, centralized instant messaging cross-platform). This involved 530 participants and data were descriptively analyzed using Epi info 3.5.1. Results: The findings illustrate that HCWs, mostly aged 30 or younger with a mean age of 30.4 (±7.2), were largely familiar with RMPmHT, (58.5%). Despite general acceptance, disclosing positive results to RO leadership was widely discouraged. HCWs considered RMPmHT non-intrusive, yet paradoxically believed it increased the risk of stigmatization. Despite an unclear ethical paradigm and state silence on RMPmHT, HCWs didn't see knowledge of a positive result as a 'right' for RO leadership. Policy frameworks for 'medico-legal' permission and result disclosure were seen as ambiguous. Concerns about fragile confidentiality structures persist, and the prohibition of marriages for HIV-positive or RMPmHT-dissenting couples was widely deprecated. Conclusion: RMPmHT, tenably, infringes upon the right to marry and found a family, bodily integrity, privacy, and information as negative results may subtly be a precondition for marriage. Advocacy for the need to situate RMPmHT in a clear ethical paradigm remains imperative. Policy frameworks guiding documentation of consent processes, HIV couple discordancy, counselling, information, disclosure, data management and linking RMPmHT services to public health institutions should be engendered.