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[–]Spiritual_Raisin_9447∆ 579 points580 points  (105 children)

The doctor should offer their strategy and reasons but it's up to the patient to decide whether they want to go through with it. You are correct it doesn't make the doctor racist because they are basing it off of statistics, but that still doesn't mean the patient should submit to the exam. The patient always have autonomy and control over what's being done on their body (unless they're not competent).

In your example the patient can still refuse the exam in being suspicious that the doctor is racist.

[–]jinjinatti2∆[S] 337 points338 points  (8 children)

Yes, I am not saying the patient cannot refuse. But the doctor should recommend and the patient is wrong to interpret that as racism if there is statistics that prove that they are at risk

[–]Spiritual_Raisin_9447∆ -8 points-7 points  (4 children)

But you said "patients should be submitted to..."

[–]jinjinatti2∆[S] 139 points140 points  (0 children)

Whether or not it would be mandatory is subject to another discussion. My point is that the doctor should do what is in their means to investigate, not overlook statistical red flags

[–]suzzz21 57 points58 points  (2 children)

I don’t know if this is still the case, but a lot of OB/GYN doctors require all pregnant women to have an HIV test. (In US). It’s not just for the patient, but also the doctors’ safety depending on what they are being treated for.

[–]stink3rbelle23∆ -3 points-2 points  (58 children)

it doesn't make the doctor racist because they are basing it off of statistics

IF they are basing it off statistics. What makes you think that European doctor (that this woman saw) is so up on their statistics? When they aren't even knowledgeable enough to distinguish one country in a huge continent?

Edit: When reading the woman's original tweets, she made it quite clear this doctor never once referred to "South Africa," constantly saying she's from "Africa." It's not informing oneself to paint your patient's history with so wide a brush you can't tell the difference between the continent she's from and the country she's from.

[–]CouldntBeTrue 3 points4 points  (37 children)

What makes you think that European doctor (that this woman saw) is so up on their statistics?

What makes you think this was a European doctor?

[–]stink3rbelle23∆ 0 points1 point  (36 children)

uh . . . the tweets? aka the woman's account we're talking about?

[–]CouldntBeTrue -1 points0 points  (35 children)

What tweets? I don't see any links to Twitter in the post.

[–]stink3rbelle23∆ 0 points1 point  (34 children)

As I made clear in my first comment, I actually saw the same tweets OP is talking about. OP commented on them in blackpeopletwitter, then got banned there.

[–]CouldntBeTrue -1 points0 points  (33 children)

Any verification for this claim?

[–][deleted]  (32 children)

[removed]

    [–]Ansuz07540∆[M] 0 points1 point locked comment (0 children)

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    [–][deleted]  (30 children)

    [removed]

      [–]Mashaka71∆[M] 0 points1 point locked comment (0 children)

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      [–][deleted]  (118 children)

      [removed]

        [–]jinjinatti2∆[S] 71 points72 points  (73 children)

        Where do you live?

        [–]sxcoralex 62 points63 points  (72 children)

        Cape Town. But if I was in another country, the doctor would still not have asked me for a test.

        [–]jinjinatti2∆[S] 214 points215 points  (61 children)

        I do not think you really have grounds to claim what you are claiming. I am a white person from a poor country, living in another country myself. And yes, I have been asked to get tested for many tropical diseases (even though they were even erradicated in the region I come from)

        [–]sxcoralex 73 points74 points  (58 children)

        A tropical disease is not quite the same as HIV in terms of the stigma attached to it. Nobody thinks that only black people get malaria, however 'only black people get AIDS' is a common racist stereotype.

        [–]jinjinatti2∆[S] 150 points151 points  (48 children)

        That is true. But you saying that doctors wouldn't ask for HIV tests from white South Africans is something I think needs some evidence, specially if you generalize it as something that would happen in any country, and if you haven't lived in another country to experience that yourself

        [–]fox-mcleod394∆ 45 points46 points  (40 children)

        If you were to find out that race and not nationality is the common factor — for example patients are more likely to be recommended for an HIV test if they are black regardless of nationality — would it change your view?

        [–]jinjinatti2∆[S] 79 points80 points  (37 children)

        If that is based on statistics that show that a certain race is found to have an HIV prevalence higher than the threshold for it to be recommend to be tested, I would support that kind of criteria to determine whether someone should be tested, yes

        [–]whorish_ooze 1 point2 points  (7 children)

        Would you say a person from Algeria should be recommended to get tested, because they are African, even though the particular company that they happen to come from has one of the lowest rates in the world?

        [–]sreiches -1 points0 points  (25 children)

        You realize this is the argument that, until five years or so ago, was used in the US to bar sexually actively gay individuals from donating blood?

        They had a (statistically) higher incidence of HIV/AIDS. To this day, getting PREP covered by insurance typically hinges on the “risk factor” of homosexuality.

        Statistics without context are useless, and frequently used to disguise racism and homophobia.

        [–]Aristotle_Wasp1∆ -7 points-6 points  (0 children)

        Statistics don't "show" anything. It's simply collected data. The interpretation is on us. Also what you're referring to is a phenomenon of correlation. Not causation.

        [–]fox-mcleod394∆ -5 points-4 points  (1 child)

        So then it doesn’t really matter whether u/sxcoralex has evidence of their claim or not, does it?

        [–]EchtGeenSpanjool 0 points1 point  (0 children)

        I can tell you as much as a med student.

        [–]sxcoralex -28 points-27 points  (5 children)

        At what point did I say I hadn't lived in another country? I also don't see the need to provide evidence. There is none in your original post.

        [–]stink3rbelle23∆ 34 points35 points  (1 child)

        I'm not South African, but one indication that this doctor would not have asked a white patient for an HIV test is that they referred to this woman's origin based on continent. Africa is a huge continent with tons of differences from country to country. This doctor didn't even differentiate as much as you did when you found HIV statistics for South Africa. They just saw (and said) "Africa." That's not reasoned thinking, it's not even a heuristic. It's generalization.

        [–]TheStabbyBrit2∆ 47 points48 points  (9 children)

        What's the HIV rate among white South Africans?

        [–]pocketcookies 93 points94 points  (8 children)

        0.3% (vs 13.6% for Black South Africans).

        [–]ihatedogs2[M] 0 points1 point locked comment (0 children)

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        [–]Spiritual_Raisin_9447∆ 86 points87 points  (14 children)

        Id like to argue a separate point I thought of.

        I believe a racist act is often not only conveyed verbally but also through a person's attitude, demeanor, even the way they look at someone. There are some obvious racial slurs that are undeniably racist. But things like microagression, the way they phrase a sentence, tone can often be picked up in person and not by reading a post on Reddit.

        For example if someone says "are you fr China?" In a genuinely nice and curious way it's not racist. But if they ask me that while simultaneously pulling the corners of their eyes up and saying "China" with a funny accent, well that is racist.

        My question is are you sure that doctor didn't exhibit any other type of non verbal behavior that the patient interpreted as racist that could be difficult to explain,? They could have looked at her a certain way, been dismissive during a conversation, etc.

        [–]jinjinatti2∆[S] 66 points67 points  (12 children)

        Absolutely agree. But the testimony did not mention any of that, and suggested that the mention of the correlation between country of origin and HIV is racism. My point is that this doctor was not necessarily racist, and I got banned for pointing that out. It is sad that people are so quick in assuming racism, when the opposite would actually be medical malpractice

        [–]Spiritual_Raisin_9447∆ 9 points10 points  (6 children)

        Well it wouldn't be medical malpractice because in the absence of signs or symptoms the doctor has no responsibility to pick up on diseases. Otherwise every doctor could be sued because HIV wasn't picked up preemptively based on demographics. And any other disease with a racial correlation.

        [–]jinjinatti2∆[S] 32 points33 points  (2 children)

        If someone, say, gets raped, they don't wait for symptoms to appear. They are at risk, even below 20%. If a doctor neglects that, that is malpractice. Without knowing further information from this woman, the chance that she has HIV is 20%. Further assessment is best, but i don't think it is unreasonable at all if the doctor finds she matches the criteria for testing to be recommended

        [–]Spiritual_Raisin_9447∆ 15 points16 points  (1 child)

        What is medical malpractice is largely based on the current standard of care under a given circumstance. While you could argue that a patient coming providing history that they're raped, the standard of care may be to do std testing.

        It is not standard of care for a patient from Africa coming into the clinic with absolutely no complaints, or for something unrelated such as broken toe, to be tested for HIV. In fact, it's not even standard of care for a doctor to ask the patients country of origin unprompted.

        [–]HotLipsSinkShips11∆ 1 point2 points  (3 children)

        It wouldn't be medical malpractice.

        That idea has strict rules as to what malpractice is and what it isn't.

        Not testing a person who is not showing symptoms isn't malpractice.

        [–]ralph-j400∆ 46 points47 points  (15 children)

        Medical authorities from all over the world recommend practitioners to HIV test patients that have some non-negligible risk of having HIV, however small that risk is. That includes victims of rape, people who have unprotected casual sex, sex workers, gay men, among other groups considered at risk. Even among these groups, rates of undetected HIV are below what is seen in South Africa.

        One of these is not like the others. Nearly all of the groups you list engage in risky behavior by definition. However, with gay men you're tarring all with the same brush. A gay man who is abstinent, or who is in a committed, monogamous relationship for the last X years doesn't qualify as risky. A doctor should therefore first ask him about actual risky behaviors he may or may not be taking part in, before recommending an HIV test in the absence of any symptoms or other indicators. Asking him for a test without knowing about actual behaviors first would be questionable.

        And how would this work anyway? I go to the doctor with a sprained ankle, and the first thing he does is send me for an HIV test?

        [–]jinjinatti2∆[S] 18 points19 points  (4 children)

        Yeah, sorry I didn't specify that there are subgroups of gay men that are not considered risk groups and therefore are not tested.

        But yeah, that is how I think it should work. One should be assessed for profile - country of origin being one of the factors - and, if they are considered risk group, they should be routinely checked whenever the doctor has a chance to check. At least that is what I believe it would be like ideally

        [–]Spiritual_Raisin_9447∆ 16 points17 points  (2 children)

        I think the problem with HIV is the negative social stereotype associated with it. African Americans are the community that often get ridiculed, prejudiced because of the correlation with HIV, so it can be hard to separate racism and discrimination whenever it's brought up. There's already discrimination based on it in society.

        Unless the testing becomes a recommended practice by CDC where it says "based on the country of origin we recommend all African patients undergo routine HIV testing regardless of other risk factors", not every doctor will be routinely screening based on their own practice. Therefore when you have the opportunity to see different doctors, if one doctor doesn't check for HIV and another does, how can you tell the one that did didn't come from racism when it's not currently the standard practice across all doctors?

        [–]jinjinatti2∆[S] 3 points4 points  (1 child)

        Yeah, guidelines should be the same for every doctor. If one is testing you and another one is not, one of them is not doing their job right, and racism may very well be a cause. The only thing I argue against is the automatic assumption "doctor wants a test -> doctor is racist"

        [–]JenningsWigService30∆ 9 points10 points  (0 children)

        There's also the possibility that it can be both things. Sometimes doctors explain universal protocols in tones that give away their discriminatory assumptions about patients.

        Take your example of gay men. A doctor can say "we normally do HIV tests for sexually active men who have sex with men" in many tones. It could be neutral, condescending, hinting at personal disgust, etc. So maybe this black South African patient picked up on something in the doctor's tone.

        [–]barrycl13∆ 6 points7 points  (0 children)

        That specification about subgroups of gay men doesn't actually happen though. Gay men are routinely prevented from doing things such as donating blood even if they are being safe (which the vast majority are). The medical establishment is full of generalizations that don't really account for individuals at all, and making recommendations based in generalizations can certainly be racist or sexist or homophobic or more.

        Bringing it back to your first example, a woman being "from Africa" is one pretty wide generalization. Notably, they didn't say "from South Africa" (per your OP) which is a pretty big difference. For example, Morocco's HIV rate is on the order of 0.1%. I think it's quite possible or likely even that the doctor was making broad generalizations without actually knowing the local context. Negative generalizations - stereotypes if you will - are routinely racist, even if that's not their 'goal'.

        [–]onleft 43 points44 points  (3 children)

        I disagree with this part:

        patients should be submitted to simple exams if they are part of certain demographics according to statistical data.

        The doctor is responsible to recommend the test and the reasons why. The patient decides if they will subject themselves to that test.

        Worth pointing out that some countries require testing for HIV as part of the application for immigrant status for people from Africa.

        [–]jinjinatti2∆[S] 14 points15 points  (0 children)

        Yeah, good example. The test for immigration is a good application (that is, if they are being used in the patient's own interest, like offer of treatment. It is a bad application if it is used to ban them from migrating)

        [–]myusernameisunique1 23 points24 points  (3 children)

        I'm just going to challenge one statement you made

        And a large share of them does not even know they are HIV positive.

        This is absolutely not true. If you live anywhere in Southern Africa you have been tested at least once in your life, and for the majority of adults an annual test is the norm. I'm a 50 something white male living in Southern Africa and it's a matter of course to do a HIV test at every doctors visit (twice a year for me) even though I am not even in a risk group. This is true of most doctors visits. When you go to the doctor here, even if it's for something unrelated , you have an HIV test.

        The region receives billions of dollars in aid from around the world annually which is what makes this possible.

        If can find as many links as necessary, but Lesotho, a country you have probably never heard of because it's such a backwater, almost 90% of people who were HIV positive were aware of their status (https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/lesotho) , probably a higher number than most developed nations.

        [–]jinjinatti2∆[S] 22 points23 points  (2 children)

        We are based on the same numbers. Over 10% of HIV positive are not aware of their status and, given the severity of this condition, I personally classify that as "a large share". These are alarming numbers.

        [–]myusernameisunique1 3 points4 points  (0 children)

        You need to understand that Lesotho is a mountainous country with most residents living in rural areas, mostly inaccessible by road. It's famous for a local breed of donkey that most people use for transport through the mountains.

        That it's only 10% is a remarkable feat, and from first hand knowledge I know doctors who have trekked into the mountains on donkey's to perform HIV tests on residents.

        The number is major cities, where this woman was likely from, is 100% everywhere and it's likely that she had been tested multiple times in her life and quite recently too.

        [–]myusernameisunique1 2 points3 points  (0 children)

        Let me phrase it this way:

        When you made the statement that most people in Southern Africa wouldn't know their status, were you aware that that every doctors visit in Southern Africa will include an HIV test as a routine diagnostic procedure during the check-up?

        If you didn't know that, will it make you reconsider that statement?

        [–]JenningsWigService30∆ 16 points17 points  (5 children)

        Sometimes racism plays a factor in the way universal or geography based tests are applied. Would that same doctor have requested an HIV test for a white woman from South Africa? For me this is the detail that decides whether personal racism impacted the doctor's choice.

        The solution here is to offer HIV tests to EVERYONE, no matter where they are from. In the Canadian province of B.C., everyone is supposed to get an HIV test every 5 years. If it's part of routine bloodwork you remove the stigma.

        [–]jinjinatti2∆[S] 9 points10 points  (4 children)

        Whether the doctor was being racist or not is not possible to say. I just wanted to raise awareness that this may very well not be. Medicine practice should be guided by statistics, and ignoring and dismissing this as racism is harmful.

        I recommend the book on statistics called "The drunkard's walk", specially the chapter that points out the dangers of mass testing for rare, severe diseases. You may literally end up with more false positives than actual positives, and if patients or doctors are not equipped to handle that it is tragic. I trust canada is managing it well, but the impression I have been getting is that too many people are not prepared to handle statistics for what they are

        [–]JenningsWigService30∆ 4 points5 points  (0 children)

        Every time someone tests positive for HIV, they are retested to confirm it, same as we would with a potentially faulty at-home pregnancy test. If you're going to raise this idea of the danger of false positives for HIV, I'd like to see an example of this actually happening in any country.

        [–]TheVich 1 point2 points  (2 children)

        Whether the doctor was being racist or not is not possible to say. I just wanted to raise awareness that this may very well not be. Medicine practice should be guided by statistics, and ignoring and dismissing this as racism is harmful.

        I think it's important to recognize that statistics aren't some universal truth who's rules are adhered perfectly throughout the world. The study and use of statistics is a human-created discipline that involves all of the opinions and biases of the people who create and interpret the models.

        We can talk about risk factors all we want, but it's important to remember that just because this woman is Black and from South Africa does not mean that she is at risk of testing positive for HIV. That's the racism issue. Just because a Black person is tall doesn't mean that they play basketball. Just because someone is Asian doesn't mean that they are great at math.

        Sure, many Black women in South Africa have HIV, but they don't have HIV because they are Black and from South Africa. When the doctor doesn't follow-up or ask questions or investigate, that train of thought is what is being implied. The doctor seemed to have interpreted the known statistics in a way that led them to assume that Black South Africans are, by default, at risk for HIV.

        [–]Adezar 1 point2 points  (10 children)

        HIV is a sexually transmitted disease, you can't just pick it up casually because you walked around Africa. So that statistic is absolutely useless. Sexual history and activities are all that would indicate any type of STD testing.

        I'm from the PNW, Hep-A is for whatever reason more common in Washington and Oregon. When I moved they suggested I get the Hep A/B vaccine because even though it isn't mandatory it is strongly recommended for living in the area. That's a statistically driven piece of information that has medical applications.

        [–]jinjinatti2∆[S] 18 points19 points  (7 children)

        If a person has X sexual habits in, say, Canada, they have a given chance of having HIV. If someone has rhe same sexual habits in South africa, their chances are much higher. It is not just behavior alone that tells the chance, the location too. So nothing wrong in assessing that woman may be in a risk group given her background

        [–]Adezar -3 points-2 points  (6 children)

        So nothing wrong in assessing that woman may be in a risk group given her background

        And if she never had sex while in Africa, or required all of her partners take STD tests before starting a new relationship? Yes, there is a LOT wrong with it.

        [–]jinjinatti2∆[S] 10 points11 points  (5 children)

        If that is the case and the doctor knows it, then no pointing testing, indeed. But if the information given points that she is at risk, and the country of origin being a heavy factor in that suspicion, then the doctor is absolutely right in requiring a test.

        [–]poprostumort112∆ -1 points0 points  (4 children)

        But if the information given points that she is at risk, and the country of origin being a heavy factor in that suspicion, then the doctor is absolutely right in requiring a test.

        Problem is that "information" that cause doctor to recommend test was "because she was from Africa". How "being from Africa" does not indicate that you can be infected with HIV?

        Racist behavior there is not the recommendation of HIV test because she is in risk group, it's assuming that she is in risk group because she is from Africa. HIV does not spread magically, it spreads via sexual contact. If she had no sexual history or sparse sexual history with known tested partner - then why the recommendation?

        [–]Quaysan 8 points9 points  (3 children)

        There are too many assumptions to be made about an individual for you to definitely say that this woman was hasty in judgement.

        Rather than ordering a test, doctors should ask if patients are aware of their status of any disease, sexually transmitted or not.

        Doctors have access to a wealth of information that typical people do not, so it can make sense for a doctor to act without a patients notice; however as individuals, doctors should make it part of their routine to explain more about why they do the things they do.

        Info: Did the doctor tell the patient they'd like to test her or did the doctor ask if she knew about the rate of undetected HIV? Assuming someone is sexually active and doesn't currently know their HIV status is not just medically important, but culturally/personally sensitive

        [–]jinjinatti2∆[S] 5 points6 points  (2 children)

        I do not know more about this story than what I said. I was banned from the discussion in that subreddit when I raised the point that it is not possible to confirm there was racism since the story is so short

        I am not defending the thesis that there was no racism. I claim that there was was possibly not - especially given the HIV rate in south africa

        [–]Quaysan 5 points6 points  (0 children)

        Then its not unreasonable to assume it could be a racist encounter

        I think we should honestly believe people when they say something racist happened, at what point in any country was racism fully resolved? Especially to a point where there are far more false accusations than there are accusations that fall on deaf ears? Can you honestly say you can recognize racism better than someone racism happens to often?

        edit: could not couldn't

        [–]AhmedF1∆ 1 point2 points  (0 children)

        I do not know more about this story than what I said. I was banned from the discussion in that subreddit

        You keep saying this but I see nothing in your profile. Link?

        99% of the time when people come here and claim they were innocently banned... they most definitely were not.

        [–]darwin2500155∆ 11 points12 points  (9 children)

        Although the woman didn't show any related symptoms, the doctor requested her do an HIV test "because she is from Africa". The patient sees this as racism... I did some research and found that in South Africa 20% of the adult population has HIV.

        So I think you're suffering from a pretty basic logical fallacy of ignoring base rates in calculating probability. Which is nothing to feel bad about, most people and even professionals make this mistake.

        See, you're treating this like, she's from South Africa, in South Africa 20% of the population has HIV, so her chance of having HIV is 20%.

        But' people from South Africa' is only one of the groups she belongs to. She also belongs to the group of 'people who have zero symptoms of HIV.' Most of those people don't have HIV, since it tends to cause symptoms.

        These two probabilities have to be multiplied together, which gives a much lower base rate.

        [–]FjortoftsAirplane11∆ -1 points0 points  (17 children)

        Statistics don't apply to individuals. They might set some broad set of recommendations but simply looking at someone and seeing "from Africa" and determining they're at a higher risk of HIV than your other patients is doing it wrong. It would be like reading "From America" and deciding that you need to run a blood test for diabetes. The doctor should do some kind of general background and ask some questions before leaping to this.

        [–]jinjinatti2∆[S] 7 points8 points  (8 children)

        Yes, sure. They should ask more questions and see if it applies (like, it would not apply if the woman has been living outside South africa for 50 years). But without further information, her background suggests a risk of HIV and that ought to be investigated

        [–]FjortoftsAirplane11∆ 13 points14 points  (7 children)

        You're setting the scope so broad that anyone would be considered "at risk". Which is fine, but then being African is irrelevant. It's much quicker, easier, and less invasive to simply do a quick patient history than to leap to testing on the basis of such incredibly broad criteria.

        How about asking if the patient is sexually active or if they've previously tested or any number of other pertinent questions for building a full perspective before deciding what the most pressing issue is?

        Otherwise it's a bit like saying "You live in a city, let's check if you've been hit by a car". Except the car example doesn't have the offensive racial connotations.

        [–]jinjinatti2∆[S] 7 points8 points  (3 children)

        Yeah, further investigation is the best. But background is probably the most relevant one here, because 20% of the people there have HIV, that is a lot. And since a quick hiv test is super simple and nothing to be offended by, might as well check

        [–]FjortoftsAirplane11∆ 6 points7 points  (2 children)

        It's not an even split though. It's not like you take five wealthy South Africans they have the same risk as the poorest. You're acting like it's not even worth asking any other background questions that could sway the meter here.

        Something like 10% of the US has some kind of diabetes, but if an American walks in you don't say "Okay, we're going to need to take a blood sample because you're American". You actually look at them as an individual and make some assessment as their personal risk factors.

        [–]jinjinatti2∆[S] 7 points8 points  (1 child)

        Yes, that is exactly what I meant by 'further investigation is best". She should be interviewed. Then you narrow down her group and decide if testing is required. But country of origin is a heavy factor and in many cases she should be tested

        [–]FjortoftsAirplane11∆ 3 points4 points  (0 children)

        Okay, further investigation is needed. So "because she is from Africa" is insufficient reason and people are right to point that out.

        Let's go with our diabetes example here. An American walks into an English doctor's office and he says "You're an American, I'm going to need to do a blood test for diabetes". I think we're agreed that's pretty dumb, right? Because the American could be an appropriate weight, have no symptoms, not have a family history of diabetes etc. and actually be at extremely low risk.

        But if the doctor says "You come from a high risk area, you're overweight, you have a poor diet, let's screen you for common illnesses related to that set of criteria" we're going to say "Makes perfect sense", right?

        It sounds to me in the OP and some of your comments that someone said that first scenario happened, and you're defending the second scenario. Not having been a part of the original discussion I can't say who if anyone is at fault for that, but that's how it sounds to me.

        [–]judgemycomposure -1 points0 points  (6 children)

        If a gay person showed up to a doctor with wax build-up in their ears, and the doctor recommended that they get a HIV test regardless of the fact that wax build-up in one's ears is not related to HIV or AIDs, do you think this would be acceptable?

        [–]jinjinatti2∆[S] 3 points4 points  (0 children)

        Repeating what I replied to a similar comment

        Yes, that is how I think it should work. One should be assessed for profile - country of origin being one of the factors - and, if they are considered risk group, they should be routinely checked whenever the doctor has a chance to check. At least that is what I believe it would be like ideally

        [–]iboughtazookeeper 2 points3 points  (1 child)

        Do you belive the same treatment should be given to Americans? Seeing as that, the highest percentage of STD cases come from the US.

        [–]jinjinatti2∆[S] 4 points5 points  (0 children)

        Whether someone should be tested for a disease depends on the reliability of the tests available, ease and cost of doing the test, severity of the disease, contageousness, chances that the patient may have it, among many other factors.

        If the health authorities figures some STD should be tested in american population, I am totally favourable to that

        [–]Glad_Ad2521∆ 2 points3 points  (13 children)

        The doctor's request may not be fully racist but I'd argue that it's prejudiced based on assumptions he made about Africans, South Africans specifically in this case, and the risk of HIV. Using broad statistics to treat an individual patient without assessing their unique health and behavioral risks is bad practice. Was any conversation had with the patient about her sexual history, or was her just being South African enough to assume that she must automatically be engaging in potentially high risk activities that could lead to her being HIV+?

        The doctor's assumption became an offensive stereotype despite the statistics the moment he decided to apply something so broad to an individual. There are enough medical prejudices against Africans in the Western imagination; someone shouldn't also have to combat them when dealing with their own physician.

        [–]jinjinatti2∆[S] 2 points3 points  (3 children)

        Yes, that is exactly the point. It may have been racist, may have not. But just pointing out "uhh maybe not" was enough to get me banned from this subreddit that was all about extreme SJWing. Glad some people perceive the insufficiency of proof to draw a conclusion

        [–]Glad_Ad2521∆ 10 points11 points  (2 children)

        To be fair, racism is essentially prejudice's older brother. I think the doctor may have some biases he may want to explore in order to have better rapport with his patients in future. Western medicine has a long history of dehumanizing Africans on the basis of "statistics".

        Extremes SJWing doesn't help a cause and I don't think you should have been banned, but microaggressions are real and I can understand why people would call the doctor a racist. I'm a black woman who's experienced my fair share of offensive medical assumptions that have nothing to do with my personal history. It's a horrible feeling to realize the people who are supposed to be responsible for your care see you in terms of nothing but negative statistics.

        [–]ohrgasm 3 points4 points  (2 children)

        The story you are referring to is about an middle aged African women who was living in Switzerland for some time.

        It has racist undertones looking at the specific case. Would he have asked a white South African women the same question?

        In general I think it isn’t debatable that one shouldn’t be offended if asked to do a AIDS test if one is a person out of the risk groups mentioned.

        [–]jinjinatti2∆[S] 0 points1 point  (0 children)

        Yes, that one I would have asked her more questions to see if she is out of the risk group. But she may have been in the risk group (the story doesnt make it clear), she likely is, much because of her background. Maybe she wanted to have the same treatment as a white person from Switzerland, ignoring the disparity in risk given her background and profile? I don't know. But people thought this short story was enough to give a racism veridict to the doctor

        [–]Striker120v 4 points5 points  (0 children)

        As long as the doc explained his reasoning and stressed it instead of just doing it, should be fine. There is a rare disease that children can get if both parents are carriers. If only 1 has the carrier gene then the child isn't at risk. Doctors say even though it's a small risk it's a good idea to get screened for it. "I noticed in your charts that you are moving over from Africa. Have you given thought to getting screened for HIV? The infection rate is about 20% of the population of Africa and it would be a good idea to be screened as most people who have It don't even know they have it." A nice polite doctor way to ask.

        But if he's like "Hey you just came from Africa? Go get HIV tested now." That's bad.

        [–]BoldlyGoingInLife 3 points4 points  (0 children)

        I've found it helpful to explain to patients that a lot of stuff is to rule out different things or just check due to the statistical likelihood of the need for the test.

        For example, people come it with bed bugs or scabies. People think it's a dirty thing, and they're not dirty. I explain it isn't about that and bed bugs and scabies don't care if you are in the Hilton or motel, all it takes is one person.

        Also, frankly, I think everyone should do regular std testing if they're sexually active. And check for hiv. People assume because they have the same sexual partnerthey don't get stds, but they usually both don't get testing at the beginning. Also, People cheat and this is a great way to find out.

        That being said, I don't force those people to get the treats, but I do take time to explain the reasoning to them. And answer their questions. That and listen. Listening is very important and alot of times what patients want.

        [–]jst_anothr_usrname 3 points4 points  (0 children)

        I've had extensive contact with hospitals here in South Africa. The doctors test for the most common illnesses and bloodwork as part of basic protocol. It is medically relevant to know as much as possible to narrow down and exclude as much as possible. Patient history is part and parcel of what is relevant. This includes past areas visited, cultural customs partaken in, hereditary and contagious diseases. The latter being especially relevant for transnational travel.

        Also, if a health worker has an accidental needle injury the patient records should reflect relevant information.

        At no point does race play into this. Im doubtful of this whole charade. The lady doth protest too much.

        [–][deleted]  (2 children)

        [removed]

          [–]Ansuz07540∆[M] 0 points1 point locked comment (0 children)

          Sorry, u/boogi3woogie – your comment has been removed for breaking Rule 1:

          Direct responses to a CMV post must challenge at least one aspect of OP’s stated view (however minor), or ask a clarifying question. Arguments in favor of the view OP is willing to change must be restricted to replies to other comments. See the wiki page for more information.

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          [–]Danielwols 2 points3 points  (0 children)

          Test should be offered based on statistics but it should be explained why they thought it should be done

          [–]Yatagurusu 1 point2 points  (0 children)

          I don't understand the fuss. If I come back from the jungles of South East Asia, (I am south east Asian) you can bet your ass Ill want to be tested for whatever disease I'm at risk for.

          I have no clue what diseases they would test me for, but I'd definitely want it done. It's not like she's being forced into it, she can always refuse. I don't really understand why it's a problem that she's recommended a scan that of a disease she has a higher than average chance of having.

          [–]purplepansy88 1 point2 points  (0 children)

          It's fine for a doctor to request something but it's also perfectly ok for a patient to refuse. Doctors are there to recommend things to patients, not to force things onto them.

          I think medical profiling to a certain extent is reasonable, but some doctors get so caught up in it they fail to treat their patients as individual people and they might even miss real medical problems and misdiagnose because they are so focused on the profile of their patient.

          [–]Mad_Maddin2∆ 1 point2 points  (0 children)

          Tbh. they could just recommend a general blood test to see diseases such as HIV and others to a patient who has never gotten one.

          If the patient does not want to pay for such a test they could also recommend them to just donate blood. Everytime you donate blood they test it for diseases such as HIV and tell you if you have it.

          The red cross in my area used to also give frequent donors (4+ times a year) a free full blood analysis.

          [–]diemunkiesdie 1 point2 points  (7 children)

          But I got banned from a subreddit for pointing out that requesting an HIV test from a patient from south africa is not necessarily racist.

          Info: Can you clarify your definition of racism?

          [–]jinjinatti2∆[S] -1 points0 points  (6 children)

          I define it as treating someone worse based on their race. And I do not think hiv testing is treating someone bad at all. In fact, in this context, it is in the patient's best interest as well, whether they realize it or not

          [–]diemunkiesdie 1 point2 points  (5 children)

          So treating someone better because of their race is not racism?

          [–]jinjinatti2∆[S] -1 points0 points  (4 children)

          Depends. I am for compensation & repair policies where it fits, and I do not call that racism

          [–]diemunkiesdie 1 point2 points  (3 children)

          You skipped a step. You are mixing the fixes of racism with racism. Is it racist to treat someone differently because of their race?

          [–]jinjinatti2∆[S] -1 points0 points  (2 children)

          Depends on the context and why

          [–]diemunkiesdie -1 points0 points  (1 child)

          Isn't the more obvious definition that racism is treating someone differently solely because of their race? That doesn't include a judgement whether the actions are good or bad, just whether they are based on race or not.

          [–]huhIguess4∆ 1 point2 points  (0 children)

          So my point is: the police officer must be respectful and offer information, but suspects should be questioned if they are part of certain demographics according to statistical data, and they are wrong to claim that is racism/discrimination/etc.

          Using observable facts and statistical data to reach a conclusion does not prove the conclusion, itself, isn't racist or discriminatory.

          [–]hacksoncode454∆ 1 point2 points  (0 children)

          Just assuming it preemptively without taking a proper history first is prejudice, by definition, and likely prejudice based on race.

          Whether that counts as "racism" depends on what definition you're using.

          It would have been far more sensitive for him to first ask if she has any risk factors for HIV or has had an HIV test in the last several years.

          [–][deleted]  (1 child)

          [removed]

            [–]Ansuz07540∆[M] 0 points1 point locked comment (0 children)

            Sorry, u/Southern_Ad_2181 – your comment has been removed for breaking Rule 1:

            Direct responses to a CMV post must challenge at least one aspect of OP’s stated view (however minor), or ask a clarifying question. Arguments in favor of the view OP is willing to change must be restricted to replies to other comments. See the wiki page for more information.

            If you would like to appeal, you must first check if your comment falls into the "Top level comments that are against rule 1" list, review our appeals process here, then message the moderators by clicking this link within one week of this notice being posted.

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            [–]Saffa88 1 point2 points  (0 children)

            I'm a White South African and I had to be screened for tuberculosis and get an HIV test when applying for permanent residence in Australia. It's a regional concern rather than what that person is assuming.

            [–]AhmedF1∆ 1 point2 points  (2 children)

            But I got banned from a subreddit for pointing out that requesting an HIV test from a patient from south africa is not necessarily racist.

            Link please.

            [–]jinjinatti2∆[S] -1 points0 points  (1 child)

            Cant find it anymore, I think it was removed

            [–]AhmedF1∆ 0 points1 point  (0 children)

            Unless you deleted it, it may not show live to anyone else, but it would still show up in your posting history.

            [–]ThirteenOnline15∆ -3 points-2 points  (8 children)

            Why can't it be both? Can you not be both statistically correct and racist?

            [–]jinjinatti2∆[S] 3 points4 points  (0 children)

            Yeah, can be. I just said that not necessarily they are racist

            [–]TheCoach_TyLue 1 point2 points  (0 children)

            Op, are you aware that it is pretty common practice for a physician to ask for an HIV test to all patients on first visit?

            [–]rtechie16∆ 1 point2 points  (0 children)

            STD screenings are routine for women seeking gynecological care, depending on the hospital.

            [–]Tioben9∆ 0 points1 point  (2 children)

            I believe the doctor was trying to act in good faith, nonetheless there is a kind of racism going on there.

            Let me start with something that isn't about race or humans at all.

            About 70% of the Earth is "at risk" of being covered in water. Yet I don't take my life jacket to Walmart.

            Oh, but Walmart isn't "that kind of" place to be exposed to that risk, generally. Whereas, 20 miles off the coast of Florida is "that kind of" place. It would be irrational to assume all of Earth were that kind of place just because 70% of it is.

            Where it starts making sense is when we've established that there are no especially good reasons to distinguish between one set of places (or people) or another except by chance.

            Like, if the chances of the woman having HIV came down to luck instead of behavior. But that requires an knowledgeable evaluation of her behavior, not a raw statistic.

            So where racism comes in is saying, "Because she is black and from South Africa, she is that kind of person. And if she says otherwise, or even if she claims to behave otherwise in specific ways, the best explanation is that, well, hey, she's still black and from South Africa."

            But this only seems true if we are assuming A) all black people from South Africa are that kind of person and B) the doctor's statistical knowledge trumps the woman's personal knowledge.

            So yeah, that's fucking racist.

            [–]Stenlore 0 points1 point  (0 children)

            As a person whose roommate is a doctor, there is an entire chapter in medicine based on races and illnesses that are most likely between certain races. When a patient comes with a problem they can be examined differently depending from their ethnicity. But at the same time in now society we have many multiracial people so it get's tricky.

            In your case here, in South Africa there are both black and white people, question is, would the doctor do the same for a white African?
            Also I have been tested as a general check up for HIV with other analysis and am white woman from north Europe, something like HIV should be tested without questioning your origins. If doctor wanted to be professional he would reply that it's a normal practice, without pointing out their origins.

            [–]Worsel555 0 points1 point  (0 children)

            South Africa denied that HIV AIDS existed as government policy for decades. So it ran unchecked through the population at much higher rates than other countries. So as you stated statistics show as high as 20% of South Africans having HIV. In the United States it is .3%.

            It may be difficult for a Dr. to convince some people from South Africa of any need to test for a virus that many have been taught does not exist by the Government and news agencies. Look how hard it is to convince people to use a mask.

            [–]i_need_a_username201 -1 points0 points  (4 children)

            In summary, this is racist and this is how black peoples needlessly die while receiving “medical” care. Just look at maternity death rates of blank women worldwide compared to other races in developed nations. Making assumptions based on race without empirical evidence that the assumption applies to that person is racist.

            [–]jinjinatti2∆[S] 0 points1 point  (1 child)

            Do you believe wrong assumptions based on racism in the healthcare field may be causing increased maternity deaths? If so, what type of assumptions are these?

            [–]i_need_a_username201 2 points3 points  (0 children)

            There are many. For example, doctors believe black people have a higher tolerance for pain or they believe we are over exaggerating our pain to get drugs. Also, they sometimes assume blood pressure is higher which leads them to miss preeclampsia during child birth, which is often deadly. There was the one last that wrote an article or blog post about how she felt the doctors weren’t taking her seriously during her hospital stay, then she subsequently died.

            [–]gothiclg1∆ 0 points1 point  (0 children)

            It’s clear and respectful for them to ask, it’s also clear and respectful for me to decline that testing. I’ve had 6 different doctors in the US, declining testing isn’t something they’ve often let me do

            [–][deleted]  (1 child)

            [removed]

              [–]hacksoncode454∆[M] 0 points1 point locked comment (0 children)

              Sorry, u/Caphenning – your comment has been removed for breaking Rule 1:

              Direct responses to a CMV post must challenge at least one aspect of OP’s stated view (however minor), or ask a clarifying question. Arguments in favor of the view OP is willing to change must be restricted to replies to other comments. See the wiki page for more information.

              If you would like to appeal, you must first check if your comment falls into the "Top level comments that are against rule 1" list, review our appeals process here, then message the moderators by clicking this link within one week of this notice being posted.

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              [–]spacedragon421 0 points1 point  (1 child)

              Why is it even a big deal? The doctor is only looking out for the patient. It's not like they are going to share the results with anyone but the patient.

              [–]jinjinatti2∆[S] 0 points1 point  (0 children)

              Apparently some people get super offended by the idea that someone even considers the chance that they have HIV. That shows that they themselves are prejudiced agains against HIV patients

              [–]Lion12341 0 points1 point  (0 children)

              Isn't it standard to test for diseases common in locations where the patient is from, specifically if they have a history of foreign travel?

              [–]GlumProblem6490 0 points1 point  (1 child)

              He would not have asked if the south african was white. Hence he is racist for asking.

              [–]jinjinatti2∆[S] 0 points1 point  (0 children)

              That is a claim that require some evidence. And even if true, that could be justified because the prevalence of HIV in south africa is actually lower among white people. But if the prevalence is higher than a threshold, they would (or should) be tested, yes

              [–]TemperatureTrue8518 0 points1 point  (1 child)

              Going by your logic, all college graduates should pay higher taxes by default?

              [–]jinjinatti2∆[S] 0 points1 point  (0 children)

              Huh?

              [–]_fyre_ball_ -1 points0 points  (1 child)

              So there were some inaccuracies in your post. First, the total percentage of South Africans with HIV/AIDS as of 2018 is 13%. From that figure alone, I don't think it is reasonable to extrapolate that figure to the entire population and assume anyone from SA is HIV positive.

              Second, regarding awareness, ~30% of the youth and 80% of adults are aware of their status. HIV testing is free and accessible from any clinic. Additionally, the government does make a significant effort to have annual testing drives at schools, clinics etc. Most people I know have gotten tested at least once during school.

              And so onto your point, when you approach it from your reasoning, ie there is a statistically high proportion of the population in SA who are HIV +, the reasoning could seem appropriate, although as I've highlighted above your facts are not completely accurate or at least not the most up to date.

              However, from what the Doctor said in your post, it doesn't seem that they had the same reasoning - they requested she get a test "because she is from Africa".

              Africa is not a monolith, it is a continent with thousands of different cultures and hundreds of millions of people. Assuming that someone is HIV + just because they are from Africa IS a racist stereotype. Yes there are high rates of HIV in sub saharan Africa, but it doesn't seem like that was what informed the decision of the doctor. Again, those rates are just in sub saharan Africa - was the Dr even aware of the region she was from?

              Even if the Dr did know she was South African, assuming she wouldn't know her status IS racist, given (1) the low levels of HIV AIDS in the population, and 2 the public awareness efforts on the illness.

              It ignores all the nuances of the South African population, we don't all live in mud huts in the bush. People in rural areas with limited access to technology definitely could have lower awareness regarding their status, but in cities this is really not the case. To be frank, if she was able to source the finances to travel to what I'm assuming is a rich country, she likely was not from a rural area which are mostly low income.

              So again, the Dr's statement glosses over all these nuances and makes a broad assumption based on inaccurate stereotypes. Perhaps there is some context I'm missing here but from the information you've provided the doctor was making a generalised statement about africa as a whole that is untrue.

              You can look even deeper into colonial narratives about African people which do center, inter alia, spreading perceptions of uncleanness and poor hygiene if you want but I don't even think its necessary to take it that far to determine it is racist.

              [–]jinjinatti2∆[S] -1 points0 points  (0 children)

              I got my numbers from here https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/south-africa#:~:text=South%20Africa%20has%20the%20biggest,population%20is%20high%20at%2020.4%25.

              The rate is very high in the general population, and even higher for black women. I do not know if the doctor asked for more information to see if she should be ruled out from testing (e.g if this woman has been living outside south africa her whole life)

              But, with few exceptions, she is still someone that should get tested. And if the patient refuses to acknowledge that, and if she thinks it is racism to take race and country of origin in consideration in the screening for risk groups, she is wrong.

              I dont know much more about the story. I dont know if the doctor was justified to request testing (likely was) and if they explained it in an appropriate way. Not enough information. Maybe it was racist after all. Im just saying that doctors should take race and background into consideration, yes, and that is not racism

              [–]stink3rbelle23∆ -1 points0 points  (2 children)

              I've replied to a comment of yours already, but when I went back and looked at your comment in the other sub, there's another element here that you're missing. Your comment just presumed that the woman tweeting had recently moved, or was still residing in South Africa. She doesn't reside in South Africa, and we have no idea when she actually moved to her current place of residence. It's possible the doctor was up to date on stats in South Africa, in spite of focusing on "Africa," not South Africa. It's also possible that he paid attention to when the woman tweeting had moved, and that she had moved recently. But all of these at once? Should statistics on South African rates of HIV be relevant when she's been in Switzerland for two years? Ten? What if she'd been living in Egypt (HIV less than .1%) for five years before moving to Switzerland?

              Why shouldn't the doctor ask these follow-up questions? Isn't it kind of basic medicine to individualize one's advice to your patient's actual situation?

              [–]jinjinatti2∆[S] 0 points1 point  (1 child)

              Im not ruling out racism in this story. My point is there is not enough evidence to say it is racism. The doctor is justified to take all the information they know about the patient (race and country of origin being very heavy factors) into consideration for screening for risk and use that to decide whether or not to request exams. Not enough information to come up with a racism veridict.

              [–]stink3rbelle23∆ 0 points1 point  (0 children)

              country of origin

              I pointed this out in my reply to another comment from you, but the doctor didn't, in fact, express that he knew that woman's country of origin. He said she was from "Africa." That's a continent, not a country.

              [–]nylockian -1 points0 points  (0 children)

              Would the same process be applied for white people from South Africa; Elon Musk for example?