AP AIDS Bill bridging the views

[Guest guest]

Dear Forum Members,

I agree with Mr Mohanty that Mandatory Premarital HIV screening is not only the

solution ofcourse. I is better to approach a more rational way he has mentioned.

But among few points (from a to d), he has mentioned, I find similarity among

them.They are the same point explained one step forward.

We know HIV screening is a snap short view, looking into point prevelance. But

if you ask an epidemiologist, he will say,in common practice, we use 'point

prevelance' to be the prevelance indicator for disease burden.Period prevelance

is difficult to get.

So it is not that HIV screening has no importance to find out the existing

problem.Why do we think that all grooms or brides will come only in the " window

period " ? Probability is there that they may also come when test result will be

positive.Also there is possibility of false positive and false negative, you

have to consider as HIV ELISA most commonly used test is highly sensitive but

less specific. Where as Western Blot is highly specific and less sensitive. So

when somebody is negative, you cannot confirm that he is negative in HIV (cause

is due to both sensitivity, specificity of the test and window period as well)

Anyway, pre marital testing has also necessity too. Think about an innocent

bride who has no concern about HIV can be infected by one HIV positive groom. It

has also been found HIV positive groom( who knew his status) got married with

negative bride and spread the infection. How can you reduce (not prevent !)that

possibility ? The revesrse can also be true of transmission.

Cannot we buildup a bridge between two views ! Say, if our objective is to

enhance/motivate brides and grooms to go under premarital HIV testing ! Does it

make more sense ? Consider , voluntary participation for testing can be

sustainable view for target achievement. Once it is widely practiced, it becomes

the rule.

Question is whether rule comes first or motivation brings the rule !

IT IS OPEN FOR DISCUSION.

Dr Arup

E-mail: <arup_dr@...>