Saturday, September 20, 2008

Compulsory HIV-testing for couples before marriage

There are presently eight states (Kelantan, Johor, Selangor, Terengganu, Perak, Kedah, Pahang and Perlis) in Malaysia which have made HIV-testing compulsory for Muslim couples before marriage. Negeri Sembilan is aiming to follow suit in the coming year. Although many argue that compulsory HIV test is a violation of human rights, it is deemed to be a necessary evil in order to reduce HIV infections. The staggering rise of HIV infections every year in Malaysia is alarming and it is no longer wise or safe to treat the subject as a taboo.

While many countries in Africa have carried out similar move in making HIV-testing compulsory for couples prior to marriage, many western countries are treating it as a voluntary measure. While couples are encouraged and given an option to carry out HIV testing before engaging in sexual intercourse, it is up to each individual to do it.

It is unnecessary for me to dive on the subject as to why it is important for us to contain the epidemic. There are already many existing reading materials on this deadly disease. Today, I’m interested in two issues concerning compulsory HIV-testing for couples in Malaysia.

Firstly, the human rights versus public interest argument. As a supporter of human rights, I can appreciate the implications brought by this, mainly invasion of privacy as well as discrimination and stereotype faced by people living with HIV. However, I strongly believe that the two can be reconciled.

While HIV-testing can be deemed as a strong or perhaps necessary preventive measure, it is also important to ensure that appropriate and ethical steps are taken to ensure that such human rights violations are not compromised. For instance, the medical profession must uphold the principle of confidentiality if they want to gain the confidence and trust of patients. Once this trust is broken, rest assured that many people will understandably shy away from taking the test.

Secondly, while the test may be compulsory, it should not be necessary for the couple who have undergone the test to reveal the results to the authorities. It is sufficient for the couple to share the information between themselves only. At the end of the day, the test is aimed at providing the couple the possibility of an informed decision prior to the marriage. While we are on the discussion of rights, let us not forget the right of a partner to know whether the other is HIV-positive or not. Ergo, if strong steps are taken to protect the rights of the couple, compulsory testing can serve as a benefit rather than a burden.

Thirdly, I am rather disturbed by the fact that only Muslims are applicable to this measure. Does it mean that there are no HIV-infected non-Muslims? If the government truly intends to reduce the rate of HIV-infection, it doesn’t make sense to exclude the rest of the population, as small as it may be. I’m sure there are non-Muslims who engage in sexual intercourse with Muslims. In fact, it makes me uncomfortable to use the term “Muslims” and “non-Muslims” because it provides a sense of segregation, especially during such a fragile and sensitive time.

In matters such as public health, it should concern everyone unless the disease is gene-specific which deems it unnecessary for everyone to do it. Unfortunately, AIDS does not discriminate and hence, any preventive measures taken, should not as well.

Written on 2 December 2006

*Posted on on 11 December under the title “Compulsory HIV Testing Can Be A Benefit Not Burden”.

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