Ref: HIV test Before Marriage. (Arguments For & Against)

[Guest guest]

Dear FORUM,

Ref: HIV test Before Marriage. (Arguments For & against).Posting

from the following seven commentators are combined (Moderator)

1) Winnie Singh

2) Arti Samajpati

3) Krishner

4) Rajaratnam Abel

5) Sreeram Varadadesikan

6) Geoff Heaviside

7) Akhila Panchamukhi

1) Winnie Singh

Dear Forum,

I am in total agreement with Dr.Sarman Singh when he says there

should be HIV test before marriage. In today's society when

premarital sex has become a norm

than an exception, it is worthwhile for parents to counsel their

children for getting HIV test done before marriage. It is in my

opinion more important and relevant today to get HIV test done than

the janampatris and horsocopes to be matched. And it is not the case

that its only the boys who should be tested but also the girls

because even they are sexually active before marriage. It is time we

as a society come out of the closet and accept realities for what

they are. I am organising an event in Shillong on World AIDS Day

where I have had this one session put against a lot of opinion.

I am a mother of two marriageable daughters and I am strongly

advocating testing before marriage. In solidarity with combating

HIV/AIDS

Regards,

Winnie Singh

Maitrii

E-mail: singh_winnie@...

_______________________

2) Arti Samajpati

I totally endorse to the concept of HIV test Before Marriage.

Please let us not make this a social and human right issue, unless

we could provide the HIV positive people a stigma free environment.

Here we are talking about the psychological and physical concerns of

the people, who could be affected by HIV infection due to careless

attitude of some people.

As we all know, honesty is not a quality for which Indians are

esteemed and in marriage this factor could play a very crucial

role. In a love marriage it is two individuals, who choose their

life partners, but in arranged marriage it is all about negotiation.

Then why not discuss this very vital health issue during that time?

And it might sound very unfashionable that I find these upholder of

human rights usually fight for misplaced priorities.

Arati Samajpati

Director, Parivartan

E-mail: <parivartan@...>

_______________________________

3) Krishner

In my humble opinion ( IMHO) , Premarital HIV Testing cannot be

mandatory if it were, then it would be a form of coercion certainly

not 'voluntary'. It would definitely infringe the rights of an

individual. There are very serious issues around disclosure in

an 'arranged marriage' situation that have to be addressed.

One may even argue that in north India, and perhaps also in other

parts marriage itself is really a 'non-voluntary' thing with 80

percent of the brides and grooms pushed around the fire by their

families.

Premarital HIV testing no doubt could be desirable if the couple

concerned wish to do some concrete planning of their lives together.

Premarital HIV testing in itself is no guarantee that in `arranged'

and often forced marriage extramarital heterosexual and homosexual

liaisons will not occur that risk behaviour will be kept away that

the risk of infected blood transfusion will be any less

The argument that the testing is desirable because it will

somehow 'protect' the 'innocent' bride from HIV/AIDS is also

preposterous I would say it's a typically myopic middle-class

argument on the one hand there are a lot of women activists who are

screaming themselves hoarse that one in five girls in this country

[more so in the villages] are victims of sexual abuse and on the

other hand, there are ample independent surveys on sexuality and

psycho-sexual behaviours in rural India in recent times which

indicate that voluntary pre-marital sex is as much a part of the

adolescent girls' life as it is a part of the boys'.

This talk of pre-marital HIV/AIDS testing sounds very much like

trying to re-introduce the chastity belt it's cumbersome, woman-

unfriendly, and rusty.

IMHO, the argument for compulsory HIV/AIDS pre-marital testing is as

asinine as the so-called 'ban' on foetal sex-determination it's

really a self-defeating exercise.

What's needed is an upgrade on how the middle class in this country

looks at issues around sex and sexuality, and reproduction and

health. First accept that sexual behaviour exists. then accept that

it is by and large enjoyable.

Also accept the fact that all people - adolescents, young, and old

have sexual rights irrespective of their 'marital' status, then work

on how to make sexual behaviours as risk-free as possible. [and yes,

one of the methods is definitely don't do it unless you're married

or over 65!]

All that mandatory Pre-marital HIV/AIDS testing will achieve is more

paper work, more government control over private individuals and

more opportunities for corruption to spread.

Krishner

ACT, Patna/Delhi

E-mail: aasra@...

______________________

4) Rajaratnam Abel <rajaratnamabel@...> wrote:

I would like to support Dr. Sarman Singh's view on this issue. It

needs to be handled in a professional manner rather than from a

purely in a rights approach. Most girls

anyway do not have right to choose their husbands. This only

protects them.

Last November I facilitated a group of students from Kerala who were

attending the National Youth Parliament at Delhi. While discussing

with the students what legislation they would like to bring to the

youth parliament, the first topic suggested was precisely this

issue. All girls were near unanimous in demanding HIV test before

marriage as they were more vulnerable than boys. Therefore both

sides have rights which need to be dispassionately discussed.

Yours sincerely,

Abel.

E-mail: <rajaratnamabel@...>

________________________

5) Sreeram Varadadesikan

It was interesting to note a couple of people advocating for pre-

marital testing for HIV. I wish to say the following:

1. Lawyer's Collective's letter to The Chief Minister of Karnataka

(posted in this forum) is self-explanatory vis-a-vis the legal and

Constitutional rights implications on making such tests " mandatory "

2. What should be encouraged is voluntarism in any tests.

3. How many parents will be willing to take their sons / daughters

for a HIV test?

4. People may simply go to another State (say, from Karnataka to AP

or Tamil Nadu) and get married.

5. How many marriages in India are " Registered " so that we can keep

track of implementing such a legislation (if at all it is enacted)?

6. What about the window period? Do we then get to PCR tests?

7. Can all these people who wish for pre-marital tests guarantee

post-marital behaviors?

8. Is HIV thru the sexual route linked with marriage or unsafe sex

practices?

9. Will legislating pre-marital tests only make laboratories rich

thru issue of " negative " certificates?

The Dowry (Prevention) Act of 45 years is still a piece of

legislation on paper. We have to break Social acceptance of certain

evils before putting a legislation.

Should we strive for greater awareness on HIV and dangers of risk

behaviors, or still keep hacking at the " branches " of mandatory

tests - pre-marital?

Can we wake up to reality, or busy ourselves promoting " un-

implementable " and ineffective legislations?

Should we not wait for the legislation on HIV/AIDS (draft said to

be in the stage of being tabled for discussion in Parliament) ?

Sincerely Yours

S.V. Sreeram

Sreeram Varadadesikan setlurs01@...

____________________

6) Geoff Heaviside

This issue of pre-marital testing is of course a perennial but I did

want to unpack the idea a bit and also suggest that even those who

live in a marriage like relationship or in fact have regular sex

with one partner, that the concept of testing is also important but

it is important for both partners, not just the man.

One test of course just before tying the knot will only determine

whether you have been positive for over a month.

Unless the risk exposures (unprotected sex or needle sharing) are

known as regards both partners in the previous month leading up to

the test then the test if it is positive will be useful, but if it

is negative it will be inconclusive.

Any decision based on an inconclusive test result is not useful or

reassuring.

Couples of any kind who are proposing to be having unprotected sex

with their partner need to understand the nature of the window

period for anti-body formation which of course is what the test

looks for. No antibodies means the test is negative but if an

exposure has occurred anytime within the 30 day lead up to the test

then infection could be present but antibody formation not yet in

place. Triathletes usually form antibodies quite quickly because

their immunity is poised and ready to deal

with any viral infection that might occur. TB patients or people

with large scale dental decay on the other hand have a very pre-

occupied immune system which might not have time to deal with the

HIV virus due to the daily demands on the immune function and that

is why we suggest that the best time to get an accurate result is to

delay the test until 30 days after a risk exposure.

What communities don't always understand is what constitutes a risk

exposure. That should be a very high priority for Indian citizens.

It includes unprotected anal and vaginal intercourse, multiple

partner sex, sharing injecting equipment and high risks associated

with the use of blood product from the Indian Blood Banks.

This is not a formidable list to learn about. It does require

commitment to behaviour change and for those who find that their

sexual needs are not fulfilled in their spousal relationship should

ensure that they use protection any time that they are not having

sex with their spousal partner.

No where is this fact more necessary that for the 100 million same

sex attracted Indians, many of whom were encouraged to marry

heterosexually.

MSM sexuality, partner swapping, migrant spouses living away from

their families for a variety of reasons, transport workers, peace

keepers. expatriate workers etc need to be constantly checking their

status before resuming their spousal sex lives, and that checking

needs to include both spouses, not just the man.

A good start would be to regulate the sex work industry and

encourage those who need to use the services of a sex worker to only

do so in licensed premises. Licensed premises would only be licensed

if they adhere to the regulations related to the age and willingness

of those who consciously choose to work in that industry. These

workers need protection. Underage sex workers can be eliminated from

licensed premises which should go a long way to controlling the so

called trafficking of minors. It won't stop minors selling their

bodies of course because most of them who are free to choose, are

doing it for survival, but even these young people can be trained to

behave safely when they work when we feel comfortable enough to

start talking about sexuality and safety.

India is a long way from even considering these necessary changes to

societal functioning and of course there are many who would not want

to introduce controls because of the impact that it would have on

their unlicenced profiteering. These people are not young people I

might add.

By all means lets encourage people to learn the skills of viral

protection. It seems pointless to wait until they are seeking to

marry because the infection rate starts at 14 years of age.

That is my contribution to the debate on pre-marital testing.

Geoffrey

E-mail: gheaviside@...

____________________

7) Akhila Panchamukhi

I am not sure i understand this issue- are you advocating for

mandatory pre- marital testing? If not, then all HIV testing is

anyway voluntary, so why this emphasis on pre -marital testing?

What are we expecting pre- marital testing to achieve?

Is it something couples undergo consensually after counselling and

mutual discussion? If this is the case, then there are VCTCs anyway

where consenting

couples can go to test. Also, what if one of them tests positive?

What kind of support systems are we putting in place to support

them?

Or

Is it something like a certificate that one demands at the time of

marriage? If this is the case, then how does one deal with window

period?

Also in a country where one can buy practically anything through

bribes, it should not be difficult to produce a HIV negative

certificate. In fact this will open up another business avenue.

And more seriously, pre- marital testing will send a wrong message

and create a false sense of security that if one tests negative

once, then one stays negative for the rest of one's life,

irrespective of one's behavior.

The exclusive focus on pre- marital testing is misplaced because

there continues to be no incentive for people to test- why should a

person test if he is going to be stigmatised and discriminated

against?

In fact more work to reduce stigma around HIV/AIDS/ STI would go a

long way in helping people to come forward to test.

Frequently, pre- marital testing is touted as a tool to protect

women. But in a country where there is a huge premium on marriage

for women, where women are anyway considered a burden, to be got rid

of, where women go through worse things only to get married, do you

think that anyone would call off a marriage because of HIV?

Recently we read in this forum of how women were willing to marry

positive men because these men had relatively stable jobs and the

women needed someone who could provide for their children. Two

square meals mean a lot more in our country than being HIV- free.

I urge the forum to give this issue some thought because several

state governments are considering it as a serious option and we do

not want to spend our scare resources on something that is not

only ineffective but truly dangerous.

Akhila Panchamukhi

E-mail: <akhila_punch@...>