HIV testing before marriage

[Guest guest]

Re: [] Digest Number 148. I think Dr Vinay Kulkarni(PRAYAS) is right.

" There are issues of testing facilities, counselling, confidentiality,

corruption and follow up.The best way now and may be for ever would be

to work towards a situation where people discuss sexuality before

marriage and then mutually volunteer to get the test done " .

I would go further than he did though in pointing to the naivete of the

proposal.

The problem with it is the one time focus on a one time right, as if following

proof

of either positivity or negativity at engagement, the HIV status of one partner

or

the other will not change.

At the minimum, the proof would have to follow the " test, tell, test, trust "

formula for unprotected sex between monogamous couples ie. at least two tests

three months apart. However, the weakness lies in the last element " trust " .

I don't know if there are statistics on the number of people where one partner

is positive at marriage, and then transmits the virus to his or her spouse, but

my guess from other data is that the rate of post-matrimonial infection of the

first partner is pretty high (as in the number of those infected post-matrimony

at some point, vs those infected before). And we know that certain groups such

as truckers have a fairly high risk rate, no matter which side of the

matrimonial knot they are on.

Dr Kulkarni's point about discussion and open-ness is the only real key, but

must be applied across the whole sexual life of any couple. And perhaps, given

the gendered structure of trust (trusting female moving in restricted circles,

males moving around with greater freedom and less accountability etc), perhaps

trust is the most delicate of all the issues. In reality, the only real approach

to such a

proposition would be not to test, tell, test (still a three month, double test

process) pre-nuptually, but prior to planned conception.

In other words, safe sex should be practised by heterosexuals except for the

specific purposes of reproduction. Even within marriage.

Quentin

E-mail: vicente@...