I was recently asked to write a speech on whether pre-marital HIV testing should be made mandatory. Although I have been working in the HIV/AIDS field for about a year, and I am a little familiar with this subject, I hadn’t given it the serious thought that it merits.
My first instinct was a big resounding YES! Of course, it should be made mandatory. No one should be put at risk for HIV/AIDS infection. After all, even though now infected persons can lead full and healthy lives for many years, it is a dangerous disease that not only an individual has to live with for his/her entire life, but also dumps emotional and financial burden on his/her family.
Plus one is always at a high risk of transferring the Virus to someone else – a partner or to a baby. Also I have come across enough stories and incidents where a young woman would be married to an individual like you and me, and would find out during her pregnancy to find herself infected, with her in-laws either in the know of her husband’s HIV status or with the full blame of the infection placed squarely on the poor girl’s shoulders. I also know that it can happen the other way around, with the young woman infecting the man that she marries.
Yes, definitely a premarital HIV test is necessary.
However, as I studied this in more detail, I came across some arguments against what seems like a completely logical position to take on this subject.
Firstly, the UN guidelines state that NO ONE (not the central government, not the state government, not the doctor, not the nurse, not the counsellor, not the brother, sister, father, mother, wife, child – NO ONE) can force an individual to test for HIV/AIDS. Okay. So you can’t do mandatory testing. However, you can advise patients to get the test done as part of routine medical care as suggested by the UN. And most importantly, once an individual or couple does get tested, there should be mandatory counselling to ensure that they are made aware of HIV/AIDS, its risks and prevention methods. Also, if this test is made so routine, there will be heightened awareness of HIV and it will no longer be something that happens only to people we don’t know.
Secondly, even if an individual does get tested and the result is a negative, there is no guarantee that the person does not have the Virus. It usually takes up to 3 months for the HIV antibodies to show up in a person’s blood, and in some cases, up to 6 months. That’s scary, eh? What is one to do if the groom contracts the Virus during a really rambunctious bachelor party the night before his wedding?
Recently, an intern with my organization (Lets call him A.H.) stopped on the road to help an accident victim. The victim was an auto rickshaw driver, who was bleeding profusely and was stuck under his vehicle. A.H. got off the vehicle he was travelling in, and helped get the injured driver out from under the auto rickshaw, and in the process, cut his hand. He didn’t think much of the cut on his hand at that moment. However, later, his room-mate (also an intern with us) cleaned the wound on A.H.’s hand and wondered if he was at risk of contracting any blood-borne diseases, especially HIV/AIDS. That was a scary moment! I can see that thought crossing his mind – the thought of having to live with HIV/AIDS for the rest of his life – just because of a good deed that he did. The next morning we called the doctor who basically told us that there was NOTHING that we could do at that moment, and had to wait at least 3 weeks or more for the Virus strain to show in a blood sample, and then too it would not mean that A.H. could be certain that he is HIV negative. To be absolutely certain, A.H. would have to get tested again six months after the incident. Imagine being on tenterhooks for six months to know whether your life has been altered permanently.
Fortunately, today we have very advanced tests that can give very accurate results within 3 weeks of an infection. Prohibiting factors with the PCR test are that this test is very expensive and not easily available. Therefore, logistically and financially speaking, most young Indians would need to wait 3 months to know their HIV status.
Other arguments why HIV tests should not be made mandatory include Stigma and Discrimination. How would an individual, who happens to be HIV positive, even think of leading a normal life in a society where external image is all that matters? In response to this, I would say that why not keep the HIV status confidential? We keep salaries confidential. We keep our private lives confidential. Then why not our HIV status, with the caveat that the spouse or the spouse to be must be informed.
So what it all boils down to is - premarital HIV test allows for a RIGHT to a safe happy life that a couple can choose to take. However, our own pre-conceived notions about the disease, our family’s discomfort and our society’s mental block may stop many of us from taking up this right. But at times, something as insignificant as our pre-conceived notions can end up being a matter of life and death.
And therefore I believe it’s simply question of one’s right. What about you?
[...] Singh talks about pre-marital HIV/AIDS testing and the surrounding issues. No one should be put at risk for HIV/AIDS infection. After all, even though now infected persons [...]
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