Should HIV test be made compulsory before marriage?
HIV/AIDS is fast becoming an endemic in India. In spite and despite the not so broadminded kind of lifestyles led by most Indians when compared to the liberal West, we are surging towards becoming the most highly HIV affected people in the world. Surely, we Indians aren’t that bad? So, how is it that so many are being affected by the invincible HIV? Is it careless sexual habits or is it lack of care in hospitals? Is it lack of awareness among people or a carefree careless nature that prompts so many of our fellow Indians getting affected and even transmitting it to others? What is it that can prevent this from happening further? Can compulsory HIV Testing be a way of controlling this epidemic? Or will it be an infringement of personal privacy?
How vital is the HIV test for couples?
When such a test is suggested there are many who wouldn’t mind going for it especially when it is a couple who are going to get married. After all, it is going to safeguard their future isn’t it? Wouldn’t it be more relieving to know that your would-be spouse is HIV/AIDS free and that you are in no danger of getting affected by this deadly incurable disease? If that is the case, then why don’t we have more of voluntary testing? Why do people hesitate to safeguard their respective futures? Valid question but there is an equally valid answer. India is more of a socially prone society and anything that any Tom, Gopi or Unaid does, not to leave out Julie, Mili and Gazala is not an individual matter. What they do or don’t is influenced by society’s thoughts, deeds and decreed. So, if a person does come out with a positive test, he or she is ostracized for doing good (i.e. testing). Leave alone treatment, the HIV positive person is left in the lurch to lead and die a horrible life and death, never to see love, never to care or be cared for. If this is going to be the probable consequence of a HIV test then, pray tell me who would go in for it?
With the advancement of society and lifestyles more and more people are feeling free enough to indulge in pre-marital sex. So, if there have been multiple affairs before the marriage then, why would the person (male or female) want to do a test? And if the other party is really desperate to get married, why would they even ask for such a test?
Even if the test would be made mandatory before marriage what guarantee is that either spouse might not indulge in careless sex with third parties after marriage and in turn get infected? A test before marriage, forced or not does not prevent a possible infection later in the married life if the people concerned are not responsible enough or do not love their families enough. There is also a possibility that the ELISA test commonly used to detect the HIV/AIDS virus could turn up negative when a person is tested but change into positive after a few months. This is because the three month period also known as the window period does not detect the antibodies. So, who is to blame if the couple does the test, gets a negative result but either both or one of them becomes HIV positive later?
What about those who decide that they don’t want to get married at all but still have an active sexual life? How does this policy help them from getting infected and infecting others? Does undergoing a HIV test make a person more responsible? Will compulsory testing for HIV/AIDS not create a new breed of HIV positive people who have been forcibly cast away from society? Will this not create an entirely different kind of epidemic because of the lack of emotional and social support? Isn’t making people aware of the risks of a careless sexual life more effective in controlling HIV/AIDS? No wonder, such plans of compulsory testing though suggested in states like Goa and Maharashtra have not been implemented. Why! Even in the sex-first marriage- later culture of the United States, this policy failed miserably when it was adopted leading the authorities to drop the plan.
So, what would you suggest friends? Is a HIV test before marriage an effective form of prevention? Should all couples wanting to get married do it? Would they be morally insensitive if they leave their fiancés or lovers if either of them tested positive?
Well, a marriage is usually meant to last thru thick and thin, illness and health... so can we discard a person because of an illness? What if it is acquired later? Of course hiding about the illness and getting married is criminal too. No easy answers. But I doubt if testing before marriage is the solution.
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Thanks Irene. I agree. A problem of these proportions cannot have easy solutions. There have been cases of people having discarded their spouses (mostly women being thrown out) for no fault of theirs for having contracted the HIV/AIDS virus.
With a society like ours, forcing a test upon couples becomes very difficult.
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'morally insensitive'- i don't think so.
What you do after you get the results is the couple's choice.
but compulsory testing before marriage is a good idea i think
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True Nadi. What a couple decides to do after the tests turn positive is their personal decision but the problem is it doesn't stop with that. There is humiliation, discrimination and a lot more to be faced by either couple.
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Shail, As usual, you’ve come up with another relevant question…and as usual, there is no single answer to it. While I may feel (probably because of my age and values) that it is essential, others may not Morally, yes, the test should become mandatory…but then morally people should refrain from pre-marital or extra-marital sex…but who can stop it!!?
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Thanks Mita. Yes, values play a great role in issues like these. Pre marital and extra marital sex boils down to all this doesn't it? Again that becomes a personal choice. But if a person's life can be safeguarded by such a test why not?
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Shail, another difficult topic for discussion. I feel with time everything is moving so fast...lifestyle is advancing in leaps and bounds. When such an infection can pose a great threat and risk to each other (the couple) can go for the test out of their personal choice.
Gouri
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Thanks Gouri for your comments. Many feel the need for such testing although how true either spouse will be after marriage we don't know. Again, we need to be careful while receiving blood in hospitals.
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Shail,
these are signs of the times. In arranged marriages, when they check thousands of things like whether the girl/boy is having what job, what salary, what physical problem, what is the net worth, etc, I think an HIV test can also be included! But in the case of a love marriage, I think it should be done with mutual consent and understanding - and it is here, that the options become difficult, if it turns out that one of them is positive. Again, one has to remember that one can get infected by a mere blade in a saloon, and that the way a person is infected, speaks largely of the person. There is an orphanage home in Salem that has HIV infected children - all of them having the deadly virus from their parents, and who have the virus for no fault of theirs - which could have been avoided by such testing as described in your article. When one sees these children, who have been GIVEN the virus by their own parents, one tends to feel sad, and it is in this respect that the test becomes very important, and it is in this context that the law needs to look into seriously and perhaps advocate avoiding pregnancy. There are some HIV couples who go in for begetting children fully aware of the children getting the infection - but I think it is morally wrong to inflict this disease on an UNBORN child, (without consent)- so it is better for such couples to go in for adoption. But as someone earlier said, there are no easy answers.....
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Hi Om. Look forward to your comments every time. Yes, I agree. It is morally wrong to infect an unborn child with the deadly HIV virus. That is almost like attempt to murder. We all need to be careful. And if HIV testing before marriage can to some extent control the virus then why not?
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OM, Nice to see your comment here. The govt and NGOs must target the specific groups such as lorry drivers etc and insist on their testing at regular intervals and prior to marriage. Our ppl will listen only if something is told by film stars. Hence a multimedia campaign by film stars may create some awareness on this topic.
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Hi Shail,
Enjoyed reading your article, as usual. Absolutely, I think every couple planning to get married must go ahead and have an HIV test done. This is a matter of life and death. I would like to share one fact that even though my husband and I have not been with anyone both of us have had blood donated blood and have had injections so before having a child both of us got tested for HIV. First of all, people need to be educated. An HIV infected person does not always get it due to sexual intercourse. I think getting tested is a smart thing to do.
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hi Brinda. Glad you enjoyed reading the article. Yes, education and awareness are the things necessary before any rule can be brought about compulsory HIV testing. The more aware the people get the lesser the danger of getting infected.
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Just one more cross we burden our children with.Testing we all agree is a must but how many of our youngsters/children who've married -like Brinda-have gone and got themselves tested? not even 1% I'm sure!Like Mita says we need to make it mandatory.I agree.But after that,if positive, Will they not get married? Even in arranged marriages it'll be difficult to insist.So stalemate.But we are at least talking now.
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Thanks Sreelata. Yeah, I know. Already our children have enough pressures. But, then, this is not only about them, it is about two responsible people who will in the future become responsible for someone else. Testing is fine. What comes after is the problem.
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Thanks for raising a very relevant issue... there's no easy answer to it. But I think the answer lies in caring for your ownself... if a person has had an irresponsible lifestyle, he or she should feel the need and perceive that they are at risk to even go and get tested...i think first each one of us has to learn to be responsible for ourselves...rest should follow...although HIV testing is mandatory for pregnant women, sex workers and men who have sex with men... most general people do not feel the need because of "it can never happen to me attitude"...the only answer is raise awarness, talk to people openly and accept those who have HIV as you would acceot any other human being...
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Thanks Prerna. So nice to see you here again. Yes, the responsibility lies on each individual. He or she needs to take the test, lead a careful sex life and be wary of blood tests and yes, like Om mentioned even the blade in the saloon. Only if there is awareness accompanied with responsibility can something constructive be brought about for this problem.
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Good topic, Shail.I feel this test should be done before marriage and then the couple has the choice to marry or not and to have children or not. I have visited and written about the freedom foundation in Secunderabad that houses and looks after about 40 HIV+ children who have been orphaned or abandoned by relatives.Seeing these bright and courageous children moved me deeply.
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Thanks Beyniaz. If only all people thought so. India is still a country run by the society instead of the individuals themselves. So, if the society feels it is absurd and stupid, the individuals follow suit. People forget that all those people who get infected with HIV are normal human beings and have done no wrong to suffer this way. The least we can do is not humiliate them by keeping them away.
As far as the tests before marriage is concerned, it is the least that a couple can do to safeguard their future, their coming children's future and that of society on the whole.
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This is a very deep subject, Shail. It would be highly desirable if couples underwent such tests. Maybe if there was more awareness about AIDS,the consequences might not be so tragic.
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Thanks Padma. I agree with you. What we need is awareness and responsibility. The administration and people themselves outside the system like you and me can make a difference.
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Dear Shail, In many Orthodox Communities even if the girl's parents ask 4 such a test for the couple, people usually misunderstand & spread rumors about the girl's family, being very Hi-Fi & thus prevent other people to approach the Girl's family 4 mairriage. Usually asking such question to do HIV test, they feel that they are insulted & their Son's character is doubted.
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True dear Simran. It happens a lot in our Indian society and therein lies the main problem. The fear of being discriminated, the fear of being humiliated, the probable loss of respect influences people a lot when they think of doing these tests. But awareness must be enforced. Even though a compulsory test could infringe on the personal rights of a person, maybe, this could be one of the significant ways in controlling the HIV/AIDS epidemic. Don't you think so?
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Its a difficult question but yes, testing could protect others. Its important to be responsible and stay truthful in a relationship from beginning to end.
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Yes Lesley. Responsibility, trust and being true to oneself is of extreme importance here. Testing for HIV could bring in more awareness and yes, also protect.
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I also agree with you that it testing is absolutely necessary prior to marriage. But in our society it will take a long time before it becomes a norm. We are more concerned with matching of horoscopes, matching of salary slips etc.
Let us hope that things will change soon...
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Thanks Hari. Yes, I agree. Our society is more obsessed with other trivial matters than things like awareness of HIV/AIDS and its control.
Hoping like you for things to change.
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Shail, The answer is a big yes. Yes it must be done taking the window period into consideration. sometime back there was genetic counselling for prevention of genetic disorders like downs syndrome etc. Research is going on in the field of genetics and in the future geneticists would be able to splice a gene , remove unwanted character or diseased genes and introduce wanted or healthy genes. this being the direction of medical science testing , treating and counselling hiv patients and their family members will go a long way in controlling the disease.
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Thanks Jai for stopping by. It definitely helps when a person expresses his/her opinion from the medical point of view.
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