The Ma­ha­rash­tra gov­ern­ment’s pro­posal is aimed at shield­ing women but it could end up adding to their vul­ner­a­bil­ity

Tehelka - - PROS&CONS -

HE MA­HA­RASH­TRA gov­ern­ment is con­sid­er­ing a pro­posal to make HIV test manda­tory be­fore mar­riage. The pro­posal is seem­ingly an at­tempt to pro­tect women from con­tract­ing HIV from their hus­bands. How­ever, ev­i­dence shows that such test­ing is in­ef­fec­tive in pre­vent­ing trans­mis­sion.

The pro­posal is not new. It has been con­sid­ered in Ker­ala (2011), Jhark­hand (2010), Goa (2006), Andhra Pradesh (2002) and in Ma­ha­rash­tra it­self in 2008. Each time, the pro­posal was aban­doned or re­jected for man­i­fold rea­sons.

First and fore­most, the Na­tional HIV/AIDS Con­trol Pro­gramme, im­ple­mented by the health min­istry’s Na­tional AIDS Con­trol Or­gan­i­sa­tion ( NACO), is founded on a rights-based ap­proach. It is based on the un­der­stand­ing that the epi­demic can be ad­dressed only by re­spect­ing the rights of peo­ple liv­ing with HIV and those vul­ner­a­ble. Three fun­da­men­tal as­pects of this ap­proach are in­formed con­sent, con­fi­den­tial­ity and non- dis­crim­i­na­tion. When rights are vi­o­lated, peo­ple lose con­fi­dence in the pub­lic health sys­tem, caus­ing the epi­demic to go un­der­ground.

Manda­tory test­ing is an­ti­thet­i­cal to the rights-based ap­proach. It over­rides an in­di­vid­ual’s right to make de­ci­sions about their body and thereby vi­o­lates their right to in­formed con­sent. There is also a se­ri­ous risk of the HIV sta­tus of a per­son be­com­ing pub­lic, vi­o­lat­ing their right to con­fi­den­tial­ity. A large num­ber of marriages in In­dia are ar­ranged with the par­tic­i­pa­tion of the prospec­tive spouses’ fam­i­lies. If a per­son tests pos­i­tive, the re­sults would be shared with ev­ery­one in­volved, thus mak­ing it pub­lic, with grave reper-


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