17 August 2006

HIV testing should not scar anyone

The drive to expand HIV testing in the developing world must not bruise human rights or see people treated like "cattle," activists including Irish ex-president Mary Robinson say.

The drive to expand HIV testing in the developing world must not bruise human rights or see people treated like "cattle," activists including Irish ex-president Mary Robinson said Wednesday.

A dramatic increase in testing is seen as vital to checking the deadly march of the disease, as only 10 percent of those living with HIV in the world are aware of their status.

But medical authorities must also offer comprehensive counselling or risk exposing patients to stigma, despair and discrimination, the activists warned at the 16th International Aids Conference in Toronto.

'Opt-in' vs. 'opt-out'
Some Aids workers fret that the drive to widen testing could see more nations adopt what is known as an "opt-out" policy.

Such schemes allow people to be tested for HIV unless they specifically say they do not want to be tested.

"I see the counselling before testing, the real choice about testing, the 'opt-in' position ... as being about dignity, as about rights," said Robinson, former UN High Commissioner for Human Rights.

"Otherwise you are treating people almost like cattle," she said.

Empowering doctors to test patients
Kevin De Cock, director of the World Health Organisation (WHO) department of HIV/Aids, told AFP this week that empowering doctors to test patients could help control the spread of the disease which has killed 25 million people.

He said the WHO could not accept that patients were flocking to health centres across the world, but were not being tested for HIV or Aids.

But several conference delegates warned that an aggressive push for testing must take into account the devastating impact of an HIV diagnosis, and ensure that patients can get counselling and access to drugs if the test result is positive.

"Women really don't know what is ahead, if they sense that they may be in fact infected," said Robinson. "It's terribly fearful. They know there may be awful consequences, they need to sit down and be listened to, and they need time."

Discrimination still a major issue
Grace Sedio, an Aids activist from Botswana, herself HIV-positive, agreed it was important for people to know if they were infected, but warned that discrimination still stalked the developing world.

"We still have issues, we still have people who are being stigmatised, we still have people who are being discriminated against ... it took a lot of time for me to accept my status."

Beri Hull, global advocacy director of the International Community of Women Living with Aids, said that though HIV testing was the gateway to treatment, it could spark unintended consequences.

"People need to be completely prepared and ready to accept an HIV diagnosis ... it is also the gateway to stigma and discrimination."

The monitoring group Human Rights Watch last week accused India, Saudi Arabia and other countries of breaching liberties by embracing policies of coercive testing.

It said "an increasing number" of countries were either proposing or applying HIV test programmes that were mandatory or discriminatory and often failed to ensure confidentiality.

Finger pointed at India
Human Rights Watch pointed the finger at India, where it said the state government of Goa had proposed mandatory premarital testing for HIV, while in Punjab state, the government had proposed testing all people seeking or holding a driver's license.

"Testing is mandatory in Saudi Arabia for foreign workers, who are then confined to locked hospital rooms and deported if found to be HIV-positive," Human Rights Watch charged.

Among abuses in other countries in the past few years, the Chinese city of Guiyang had proposed testing all workers in the tourism sector and beauty parlours; Botswana had planned to test all students applying for scholarships; and Malawi and Sierra Leone had proposed testing all journalists, it added. – (AFP, August 2006)

Read more:
XVI International Aids Conference
HIV/Aids Centre


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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