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India: Should Pre-Marital HIV Testing Be Mandatory?

In an attempt to lower HIV rates, the Indian state of Maharashtra introduced a controversial proposal earlier this year, which would make it compulsory for couples to undergo an HIV test before getting married. Similar bills have been proposed in other Indian states, such as Karnataka, Goa, and Andhra Pradesh.

The proposed bill adds fuel to an ongoing debate in India about whether mandatory pre-marital HIV testing is an effective prevention strategy. HIV rates in India skyrocketed in the 1990’s and today it's estimated that around 2.5 million Indians are living with HIV. Despite these numbers, the National AIDS Control Organization (NACO) encourages voluntary HIV testing, rather than compulsory testing.

blog.bioethics.net points out that such a policy will create a number of new issues for India to address.

“Will the mandatory testing policy create a new stigmatized underclass? How would the policy protect women in India, when many of them end up being infected after marriage by unfaithful spouses? Will HIV positive persons start gravitating towards other HIV positive persons as their only likely marriage partners (a form of what is known as ‘serosorting’)?”

Bobby Ramakant of Citizen News Service argues that this kind of policy infringes on a person's right to privacy and doesn't address the stigma and discrimination that follow an HIV diagnosis. The policy may also be counter-productive, since an HIV test alone won't necessarily lead to the behavioral changes needed to lower HIV transmission rates.

“The paramount progress we have made in terms of NOT thinking about prevention and treatment in isolation is at risk to be lost with Indian states promoting HIV prevention strategies completely ignoring the treatment, care and support provisions for people living with HIV.”

Queer India goes a step further, calling the idea absurd.

“A crazy idea doesn’t take time to take root in a climate of fear and ignorance, a climate where even talking about safer sex is shameful.”

Reason for Liberty also opposes mandatory testing, but says that voluntary testing can be beneficial, especially since HIV has now made its way into India's middle class. Voluntary pre-martial HIV testing may be one of the solutions, along with legalizing prostitution and talking more openly about sex, to help lower HIV rates in India.

“Despite all shaggy faiths and belief system, it is highly improbable to shut eyes and accept that Indian middle class is safe. In reality I feel that the middle class is more vulnerable to HIV then others. When middle class people can stress on horoscope matching [for a marriage match], why cannot they accept pre-marital HIV testing?”

Mahima, however, supports compulsory testing and says that the real question is what is the implication of such a test?

“The authority that has these results in its hand, in this case the state government, can one trust it enough to be sure this won’t be the beginning of a HIV-cleansing (if you will). But if we are being hypothetical, then why not consider that the mere existence of this test might encourage younger people- even married couples – (if its made compulsory every couple of years) to behave responsibly. Because ultimately, for the most part this is a behavioral disease and with adequate precaution, can be totally avoided.”

Sakshi summarizes both sides of the debate. Though her initial response to the question of mandatory HIV testing was yes, she now sits on the fence.

“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?”

Photo of Maharashtra Painting of Bride by yashrg on Flickr.

7 comments

  • There are many occidental countries who recommand HIV test before wedding but of course making it a State’s business may be too drastic but I understand the urgence of the situation.
    Great Post Juhie we can’t wait to hear more from the new Rising Voices grantees

  • Irrespective of the issue of making something “mandatory’, it is obviously Libertarian, Libertarian n0t against Governmental Dogmatism, but against “SOCIAL DOGMATISM”.

    I am libertarian; I oppose governmental regulations in most cases. Yet, Government becomes an advertising plank alone.
    There’s an idea, that marriage should be incorporated along with a HIV testing, it may be regulatory by government or by Individuals, I don’t care, But it is much more important than any JanmPatri or horoscope.

    Now take it to the Insurance.

    USA state government opposes Insurance companies to discriminate over AIDS and other illnesses.

    I say Companies should be free to discriminate.
    I say Genetic and health discrimination is proper logical and reasonable.

  • Hey there!
    As you have mentioned my blog article here, i should clarify certain points.
    I didn’t write that article on behalf of any governmental mandatory order. It was my personal idea of demanding HIV test and other genetic tests rather than demanding for horoscope.
    I never supported or stated that government should enforce it as compulsory, it should be asked/demanded by girls and boys by themselves for their own and if they demand it, it is appreciable.
    2nd thing is, I have written a similar article again on almost similar lines which clarifies the point I mentioned in my previous post in better way.
    Here is it Indian Insurance system and Free Market!
    thanks!

  • one last comment for this piece of writing of yours.

    I am sorry but according to me you misinterpreted my article completely and my friends who have read your artiles by now are blaming me that even though I am libertarian, why the hell i supported any mandatory law of government?

    So I must make it proper and clear, that In the same article, i commented as “Me”
    and my comment was
    #
    Me Says:
    February 5th, 2008 at 12:53 am e

    @benji
    It is not at all necessary to commit a mistake for getting HIV infection.
    One may get that infection just because the dentist he visited was not sincere enough and used undistilled and infected tools.
    One may get infected because of a barbers mistake, or may be because of a doctor’s, nurse, wardboy’s, hospitals mistakes!
    To have a HIV test before making any sexual relation is quite genuine.
    and I never talked of law, I talked of genuinity of HIV test and why it is necessary.
    Any compulsory law is obviously not OK.
    Yet, any rational step is genuine.

    I was never in support of any mandatory compulsory law.

    I am sorry for knocking in your article again and again, but I need to make it clear

  • […] e di lavorare con lei per ampliare i nostri spazi riservati ai citizen media dedicati alla salute. Nel suo primo articolo [in lingua inglese], Juhie esamina le reazioni dei blogger dell’India su un progetto di legge […]

  • UnpretentiousDiva, thanks for your input. My post has been updated to reflect your clarification. Thanks, Juhie

  • jessica

    wel.. this is the most topic of conversation lately.. me being an aspiring lawyer would like to tell one thing to all.. what is more important- a life with sum1 which wil end god knows wen or a safe and secure life with a safe environment. if the govt is talkin bout makin the test compulsory den your right to privacy will also be ensured. the hospital where u will get your test is not by any chance going to leak your result. always remember we Indians need a drastic step to shake us up and confront reality. Accept the fact that the statistics are not made up and that something needs to be done. what better than MANDATORY before marriage!!! think.. if u r safe so are ur children!! do not think u r not goin to be a victim and that dis disease is alien to u. it can happen to anyone at any time.. so i say YES the test shud be made mandatory.

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