Should HIV testing be mandatory?

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I always listen to the Morning Grill a morning phone-in discussion on FM channel 92.80 where various interesting topical issues are debated.

Saturday Dialogue with Ropafadzo Mapimhidze

On Thursday this week, the topic was about whether or not HIV testing should be mandatory.

But isn’t it amazing to note that the people, who sometimes come up with such suggestions, are actually not aware of their HIV status?

President Robert Mugabe recently suggested Sadc to adopt forced HIV and Aids testing to curb the endemic, when he addressed heads of states and government at the 33rd Sadc summit in Lilongwe.

The President argued that although there is need to respect rights of individuals, everyone should be subjected to examinations because those who volunteer are not the ones who are infected.

It is not a secret that we have all been affected and some infected with HIV that causes Aids.

Although it is no longer a death sentence, infection rates in Zimbabwe are still worrisome.

However, wilful infection of HIV still remains very difficult to ascertain as most couples engage in sexual contact before they have had an HIV test taken.

Unless one partner can prove through medical records that show that he/she had several tests in the past, prosecution is very difficult.

Prosecution is generally possible when it involves minors who have been raped by adults and then test HIV positive.
The “virgin myth” is still being practiced by some people who are told by traditional healers to have sexual contact with virgins for healing.

This has resulted in many young girls and even babies being raped in Zimbabwe.

It is perhaps against this background that the President called for a mandatory testing of men and women for HIV.
But is it not true that we now have healthy looking teenagers and toddlers that are living with HIV?

This development also makes the whole issue even more complicated. Not all virgins are free from HIV.

In Greece, a recent move by the Health minister to reinstate a controversial measure that allows police to stop people who they suspect are HIV-positive, and force them to be tested, has received with outrage from international human rights organisations.

Adonis Georgiadis’ decision to reinstate this policy unfairly targets sex workers, drug users and undocumented migrants for testing.

The measure also urges landlords to evict tenants with HIV, as a public health threat.

This is clearly violating basic human rights and human dignity under the guise of protecting the community from contagious diseases.

In April 2012, the measure was used for the forced testing of hundreds of women in that country.

A report on Internet alleges that 17 women were found to be carrying the virus resulting in their photographs and personal information being spread across media outlets.

Police characterised the women as “prostitutes”, despite the fact that no evidence was ever provided to back up the accusations.

These “prostitutes” were arrested for allegedly having unprotected sex with customers.

After the women were detained for months, the regulation was repealed and they were sent home.

But how is this law enforceable in Zimbabwe or the Sadc region since many people are not even aware of their HIV status?

This is one piece of legislation, found in the Sexual Offences Act, which is silent on the issue of wilful transmission.

For as long as both parties have not been tested before engaging in a sexual relationship, how do courts prove that a person transmitted HIV to the other?

Those that have been diagnosed and possibly taking medication can obviously be prosecuted for the wilful spread of HIV.
But for as long as there are no medical records to show that neither party has been to a doctor or hospital for HIV treatment, how do you prove that someone wilfully transmitted HIV?

These are pertinent questions that have resulted in utterances by the President to force people undergo HIV testing.

The present situation, where HIV tests are said to be a private matter involving the patient alone without the spouse or their various partners, has created a lot of problems.
There are some men and women who are taking ARVS in private at work, and continue infecting their partners at home.

A woman was recently shocked to find three containers in her husband’s drawers at work, after she came to collect his personal effects a few days after he had collapsed and died.

When she inquired with the hospital where her late husband used to get the drugs from, she was told that he had been on their list at the Opportunistic Infections section list for nearly three years.

“She was so shocked and fainted. After counselling, she was tested and told that she had to start drugs after it was discovered that her CD4 count cells had plunged down to nearly 100.

“This happened about five years ago and the woman is now as fit as a fiddle. But she had lost about two new born babies during her marriage,” said a counsellor at one of the local non-governmental organisations in Harare.

The question still remains that how do you prove reckless and intentional transmission of HIV in Zimbabwe?