Re: Maharashtra set for mandatory HIV testing

[Guest guest]

Dear FORUM,

It is indeed sad to note this. I just do not understand how premarital HIV

testing is of any use! The partner who's HIV - ve can be in window period too.

Further more, even if one is HIV -ve due to no infection before marriage, what

about his behavior after that?

Such compulsion of testing is going to break the binding of faith between the

partners. Instead faithfulness assured in the relationships is more important.

There are going to be millions of loopholes in mandatory premarital HIV testing.

I do not think this will solve the problem.

Dr. Nishikant Shrotri

E-MAIL: nishikant@...

[Guest guest]

Dear FORUM,

Perhaps the more important issues to examine are:-

-HIV prevention

-stigma and discrimination

-availability of reliable testing services

-Is it just testing, or does one also have to disclose the result

(and thereby intrude privacy)

-power of the state to enforce such a policy

power of women to demand a test of their prospective husbands, and

does the absence of this power creates a need for intervention by the

state

-possibility of the policy causing harassment at the hands of

officials

-Cost, feasability and time it will take to achieve the desired

result though effective awareness creation and education

Guidelines to inform policy would be based on these considerations

Best regards,

Ranjan

E-MAIL: <ranjandwivedi@...>

[Guest guest]

Dear Friends,

Mandatory pre-marital testing is at best a myopic policy that attempts

to offer a quick-fix solution that unfortunately cannot work when we

are talking about a complicated issue such as HIV/AIDS.

Here are some of the reasons ( apart from some already mentioned) why

we should be sceptical about this idea of mandatory testing:-

1. Mandatory testing of HIV before marriage does not really serve the

purpose of preventing the spread of HIV/AIDS as it does not consider

extra-marital relations and pre-marital relations (that can happen

after testing!) Majority of the Indian women get HIV infected from

their husbands who have sexual relations outside marriage when they

migrate/travel for work.

2. Mandatory testing is going to be a very costly public health

strategy that is going to require the mobilisation of huge resources.

Where will the funds come from this? Instead the govt. can divert

these resources for advocacy and IEC so that people VOLUNTARILY decide

to get tested.

3. I think this issue is comparable to that of forced sterilisation

that Sanjay Gandhi had undertaken in the 1970s. Clearly any compulsion

of this sort can open a racket of false certificates as there will

always be people who seek the easy way out.

4. HIV testing is not simplistic diagnostic testing. Being a

life-altering test there are specific protocols such as pre and post

test counselling that must be adhered to. And anyone familiar with

these protocols will know that " informed consent " is a key part of

testing procedure. Doesn't manadatory testing violate this aspect?

5. Further this would have the consequence of people simply going of

Maharashtra to marry where such tests might not be required! So the

worrying question is are we more concerned of reducing the HIV " cases "

in Maharashtra rather than India or even Asia as a whole?

6. It must be noted that mandatory testing can reach those people who

get their marriages registered legally; which entails that those who

do not get their marriage certificates might not get the HIV test.

Unfortunately it is these people who are more likely to be vulnerable

to HIV/AIDS as they lack the awareness or inclination for the need for

such " unnecessary paper work " .

7. Another cost related aspect is that HIV tests need to be confirmed

thrice across a period of time with the issue of three different

techniques. ( due to the concept of 'window period') Is the govt going

the bear the costs of three tests per person? Currently only about 15%

of those eligible for ART are receiving it. What does the Govt. want

to really know by getting people's HIV test done? Instead they should

focus of enhancing access to services for existing PLHAs.

8. Although the govt. is providing the assurance that the HIV test

results will not be misused in the job market etc. the question arises

- How are they going to do this? There is no specific legal

stipulation for this.

There are ample experiences about the ineffectiveness if mandatory

testing from Germany, Japan, USA and Malaysia.

Instead the govt. could introduce MANDATORY HIV COUNSELLING so that people are

appropriately counselled about this issue and they volunteer to take the test

themselves.

After all, the people should also be responsible for their own health !

Aditi Chowdhary

Research Officer,

AIDS Research & Control Centre

e-mail: <arcongov@...>