Should there be mandatory testing for HIV prior to marriage in India?
The National AIDS Prevention and Control Policy of the government of India states that testing for HIV infection should be voluntary in nature. But from time to time various state governments and the central government have announced their intent of introducing mandatory premarital testing. Though this intent has not yet been translated into action, we present our case against the adoption of such a policy by discussing various social and medical issues. These include the limited population that such a policy would target given the early age of marriage in India; issues related to its implementation considering the low marriage registration rates in India; potential of stigma and discrimination associated with it; issues with defining boundaries and the role of the state; limitations related to the HIV test itself in context of the policy, including the window period and the positive predictive value of the test; its limited impact in population groups at a high risk for HIV infection; its limited role in changing unsafe behaviours; its limited potential to enhance the empowerment of women; its conflict with existing human rights; and the adverse experience of other countries with a similar policy.
Malhotra
Rahul
R
rmalhotra@post.harvard.edu
Malhotra
Chetna
C
Sharma
Nandini
N
D015492:AIDS Serodiagnosis / Q000941:ethics / Q000379:methods; D001294:Attitude to Health; D034462:Dissent and Disputes; D054242:Emigrants and Immigrants; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D006291:Health Policy; D006801:Humans; D007194:India / Q000453:epidemiology; D018580:Mandatory Testing / Q000941:ethics / Q000379:methods; D008393:Marriage; D008889:Military Personnel; D009313:National Health Programs / Q000941:ethics / Q000458:organization & administration; D011287:Prejudice; D011291:Premarital Examinations / Q000941:ethics / Q000379:methods; D015980:Public Health Practice / Q000941:ethics; D012042:Registries; D012307:Risk Factors; D013240:Stereotyping