Re: Karnataka to enact law to make pre-marital HIV test mandatory

[Guest guest]

Dear Forum,

We have had debates in this forum about the same issue. In a country where

corruption is so rampant, do you think it will be difficult to produce a piece

of paper saying one is negative or whatever? And it is very dangerous to make a

sweeping statement about all young positive men that they 'deliberately infect

others'. We have made considerable damage by stigmatising several groups of

people already and we do not want to be adding to that list.

Why don't we work on strengthening our own testing facilities instead of

legitimising mandatory testing? What one does not understand is the double-

speak- on one hand we talk about 'voluntary counselling & testing' as the best

strategy and in the same breath we want to mandatorily test several groups of

people.

Apart from giving a false sense of security, pre- marital screening does little

else

Akhila Panchamukhi

E-mail: akhila_punch@...

[Guest guest]

Hello to the forum,

Ref: Message dated 29 Jan 2004 posted by Dr. Sharad M. Tanga which mentioned

that " " In a letter to the Chief Minister, S.M. Krishna, recently, Sharad M.

Tanga, member of the National AIDS Control Organisation, member of the Karnataka

AIDS Prevention Society, and noted surgeon, highlighted the need for the law " "

One of the things that I have to do when I travel is to store emails that I

don't have time to read while I am moving around India.

One of the stored emails that has just reached the top of the in-box is one

dated 30th Jan 2004 from Kanataka regarding a law for pre-marital testing for

HIV. The message then goes on to say that some YOUNG people have become married

without revealing their status yet there is no statistics to suggest how many

even knew their status. Since it can take seven years before the existence

of the virus gives rise to symptoms that might raise concerns it is reasonable

to assume that some infected youths, either girls or boys might well be infected

and not be aware of it.

That is hardly unlawful behaviour.

Which brings me to the point of the rest of the article which suggests that

there is a whole cadre of infected YOUNG people who take pleasure in spreading

the disease. I have only met two people who refused to insist that their clients

take precautions when having sex even though they knew their status and both

were substance abusers with mental health problems.

This is not a regular practice and it will not be fixed by testing marriage

partners The biggest problem in India is the lost opportunities for

counselling and prevention education between the pre test counselling session

and the post test delivery of the result. It is the best time to educate for

behaviour change and it just doesn't happen. VCT's are only surveillance and

census bureaux where the +ves are counted. Not much more happens in a systematic

way.

I wrote an essay about this problem in India entitled " I'm Sorry, The Test Came

Back Positive " . It is available for anyone who wants to read it. It should be in

this archive of AIDS Treatment as essay No 4.

If the government is to guarantee that couples intending to marry are disease

free they need to ensure that the rules take account of the behaviour of the

virus otherwise a positive person who just happens to get a negative test before

the marriage is going to still infect.

We have a program for couples to use if they want to ensure safety especially if

they intend to have a family and don't want to infect each other or their

children but one test before the marriage will not achieve that.

For a couple to be sure they would both need to present for a test together and

share the results. Then they would be still required to use protection and

refrain from any other sexual risk practices with anyone else for a full thirty

days when both would need to be tested again. If the behaviour was to be trusted

between them both and both tests came back negative then there is a reasonable

chance that both are uninfected and provided they are faithful

without question then the certificate could be issued. Any other testing

protocol will be useless and liable to give a false sense of security.

I spend quite a lot of time explaining our TALK TEST TEST TRUST program to

prospective partners who want to commmit and practice sex without protection. It

works if both partners follow the rules but it can't be regulated by laws.

Deliberate unprotected sex engaged in by people who know their status is a crime

and it should have a category in the crimes act and people who offend should be

punished. It would seem that deliberate infection is a punishment inflicted

summarily by offended men whose wives are dowry delinquents, but this practice

should also be illegal and anyone who uses that as a punishment should be dealth

with the same way as someone who shoots a gun with the intention of killing

someone.

We now need to be teaching very practicle lessons around the theme of sexual

health and safety showing young people what constitutes risk behaviour and what

alternatives there are for the life enhancing experiences of good erotic

behaviour.

So what's the latest on the Karnataka Law Making front?

Geoffrey

E-mil: <gheaviside@...>

[Guest guest]

Dear all

I would just like to add to what Mr. Heaviside has said.

In a country like India where corruption and fake certificates are as common as

poverty and unemployment, is there any guarantee that individuals (or their

families) who want to get married won't go for quick fix solutions of procuring

false HIV negative certificates instead of going through the trouble (according

to many) of getting oneself tested.

Most parents and families are too proud of their childrens and their own moral

values, to belive that their children can be at risk to HIV or may be infected.

With regard to the bride's family (especially from lower and lower middle class

families) would they be ever able to ask a prospective grooms family to tell

them the HIV status of their groom

And law can't do much about it unless the bride's family complains (as often

seen in cases of dowry related problems) and that may hamper the chances of the

girl finding a groom.

And in addition prospective couples would have to go through confirmatory tests

which will take so may months (those who cannot afford PCR tests) and hence will

postpone the marriage date which is problematic for may families

Inspite of all this would there be any guarantee that either of the couple would

be faithful after marrige (after being tested HIV negative) or that they won't

practice high risk activities.

The law makers will have to keep all this in mind in order to implement a proper

law and to me it seems a very tough job

instead more effort needs to be given behind sustainted awareness generation,

concern building and empowerment of the weaker sections

But off course there should be laws which can be implemented easily in order to

discourage and punish people who intentionaly infect other

Lets hope we can work out this fine balance

Regards

Anupam Hazra

E-mail: anupamhazra23@...>

[Guest guest]

Dear forum,

At the risk of sounding naively idealistic, I feel that making a law that

specifically addresses HIV and marriage is a huge step against fighting the

stigma associated with HIV. I understand the practical difficulties within many

Indian traditions that can interfere with the implementation with this law, but

at least it may be inplemented in a few cases. For the rest of the people, at

least HIV has become an issue. This law would be a big step in making people

realize that HIV is not a disease of " others " but rather one that knows no

boundaries and can affect our own brothers, sisters, friends, and family.

On the other extreme, the law may be completely disregarded and be one that is

fully ignored. Even such a senario, I think, will not minimize the issue of

HIV. The point is that the government is recognizing the gravitiy of the

epidemic in India. Just because a law cannot be properly implemented in all the

present circumstances, does not mean that it should not be passed.

Sincerely,

Rohini Khatri

E-mail:<rohinikh@...>