Should pre-marital HIV testing be made compulsory?

Debate

‘No. Test is no guarantee that the infection cannot happen after marriage’

Recently the National Aids Control Organisation (NACO) estimated 4.58 million people are infected with HIV in India. This is a 15 per cent increase from the government’s own figures of last year. Whether we believe these numbers or not, no one can deny that we are in the throes of an epidemic.

What makes HIV so different is that it makes us question our entire moral fibre and it is also forcing us to lookwith suspicion at the institution of marriage, considered to be sacrosanct.

We know that most people who are being infected are in the age group of 18-49. Increasingly we are seeing young wives testing positive. They claim to be monogamous and that the infection is via the husband. So an easy solution is why not advocate mandatory testing before marriage. On the face of it, the suggestion may look as the perfect solution, but let’s look at what this could actually mean.

The commonly used test for detecting the virus, ELISA, only detects antibodies. This means that for up to three months after infection the test is not able to pick up antibodies. A person who is HIV positive will show a negative result inspite of being positive. So, imagine this scenario. A couple gets married after being tested for HIV. The woman gets pregnant and a test is conducted (as is increasingly done today). She tests positive. Therefore, who is blamed for spreading the infection? All that the pre-marital test will do is give a false sense of security to both the state and the couple.

Add to this the fact that there is a possibility of false positive results. This would lead to tremendous victimisation given the stigma and discrimination against those living with HIV have to face. Therefore, in effect someone who is not positive may never be able to marry. Also, do not forget that a test is no guarantee that the infection cannot happen after marriage. Because many of us know, marriage does not necessarily mean fidelity.

Taking all this into account, let us not forget the public health rationale against any mandatory HIV testing. Twenty-five years into the epidemic, we know that this would drive the disease underground. Given the present climate of discrimination and fear that exists, it would be difficult to do. We also have a clear government policy against mandatory testing. What about issues of consent and confidentiality?

In a country where you can buy any kind of certificate - from an MBBS degree to that of fake stamp papers - what holds from preventing yet another racket of issuing false certificates from not taking a stronghold.

We may not know everything about the virus - but there are something we can be very sure of. What is needed is empowerment of women to protect themselves from the infection, an effective condom policy and information on HIV that is open and honest and widely disseminated. Let us also learn from history and other people’s experiences. More than 30 states in the US considered HIV pre-marital testing and rejected the idea. Lastly, as a citizen of this country and a woman, the last thing I want is the government in my bedroom- if today they have the right to legislate on this issue, then what will to stop them from deciding whom we should have sex with and when.

The author is executive director, The Naz Foundation (India) Trust, New Delhi

‘Yes, what’s privacy for you may be death for me’

Ones HIV status is a private matter. An individual’s right to privacy must be respected but not at the cost of a human life. What’s privacy for you may be death for me. Therefore, I think it is an excellent idea to make pre-marital HIV testing compulsory. This will surely help check the spread of Aids virus. Let’s not talk about the US and Europe where people are affluent and government is active enough to control the disease.

The Aids bomb in India is ticking and if something is not done right away the situation will be worse than Africa. Already experts are worried that if the present trends are allowed to go unchecked, the country could have 35 million people with HIV/Aids by 2015.

An HIV infected spouse can endanger many lives. Humans are linked to each other in more ways than one. Incest, adultery, tendency to have multiple partners are some of them. A human chain linked that way shall see many casualties because one of the constituents was positive. The best way to avoid this chain reaction is to ask for an HIV test before an individual enters the domain of marriage. It will also reduce the cost that society incurs on the treatment of diseases like Aids.

Arguing against pre-marital HIV testing is arguing against cure. I am arguing for prevention. It is perfectly legitimate on the part of a person to know that his/her spouse is going to live a normal healthy life. While searching for prospective grooms/brides people enquire about everything, including job, income, family background, convent, non-convent education, English-speaking skills, complexion, height and so on. So, why not include HIV status in this list?

In many Indian marriages, both the parties exchange janam kundlis before even thinking of the match. The idea is to study the janam kundli to know if there is compatibility between the girl and the boy. I think we should rather leave this topic to astrologers and parents but those arguing against pre-marital HIV testing would have us believe that there is compatibility between an HIV positive and HIV negative without the option of pre-marital testing in place. This is insane.

In any marriage, doctors should play the role of astrologers. Just like a janam kundli, doctors can prepare an HIV kundli.

We are not living in the Sati-Savitri age. An individual must know whether his/her partner is HIV positive. And it is then his/her responsibility and decision whether he/she chooses to marry or reject the same person. If the wife has viral fever then she can ask her husband to stay away so that he doesn’t contract it. The same thing applies to HIV.

The writer is a student of mass communication at Jamia Millia Islamia, New Delhi