my take on compulsory HIV testing

This week’s BBC Have Your Say focuses on the recent UN position that health clinics in countries with HIV epidemics should test all patients for HIV unless they specifically request not to be tested.

Supporters of the policy say that the vast majority of those infected with HIV/AIDS are unaware of their status and that testing could go far in preventing the spread of the disease.

Opponents say compulsory testing violates the human rights of patients, condemning them to a life of discrimination, and is especially problematic in areas where few can avoid life-extending anti-retroviral drugs (ARVs):

Why should it be compulsory when Africans can not afford the cost of the cure? Let me die in peace instead of being stigmatized to death.
Jonathan Enders, Monrovia

Ostracization of the HIV-positive is an enormous problem in sub-Saharan Africa, largely due to the misunderstanding about how the virus is spread. I would argue, however, that the best way to reduce this isn’t to avoid testing but to push for public health education that includes wide-spread sensitization efforts. The same goes for access to ARVs — this month Brazil issued a compulsory license to locally produce efavrienz, an ARV patented by Merck. The license, which overrides patent laws, will save Brazil an estimated $240 million in the next five years and will help the government provide better care for its HIV-positive citizens. Rather than encourage ignorance about HIV status, other countries should seek out similar ways to lower the cost of these drugs.

I fear I’m somewhat of a Utilitarian on this issue: everything for the greater good. I wouldn’t wish discrimination on anyone, but I don’t think it’s fair for a person to avoid testing just because she doesn’t want to know her status. The avoidance of stigma isn’t worth the lives of her partners and children.