Call to frame rules on HIV testing

[Guest guest]

Call to follow rules on HIV testing

C. Maya: Government should frame legislations: activists

• NACO guidelines say testing should be done only on a voluntary

basis, • State Governments can adopt legislative measures

Thiruvananthapuram: The Government should frame rules and

legislations to ensure that private clinics and hospitals in the

State comply with the national guidelines for HIV testing, human

rights activists have demanded.

As per the guidelines on HIV testing framed by the National AIDS

Control Organisation (NACO), testing should be done only on a

voluntary basis, with appropriate pre-test and post-test

counselling.

Accordingly, no individual should be made to undergo mandatory HIV

testing. HIV testing should not be done on a person without his/her

informed consent, the guidelines state.

Breaching rules

However, this rule is observed more in the breach by private

hospitals and clinics, where most patients are screened routinely

for HIV/AIDS, without the knowledge or consent of the patients.

Most patients come to know that they were tested for HIV only when

they saw a report `HIV negative,' among their other blood test

reports.

It is an entirely different matter altogether if the patient happens

to be HIV positive: he/she is either `referred' quietly to the

Medical College or some Government hospital without further ado or

told bluntly that he/she is HIV-positive and that the hospital had

its own `limitations' in treating him/her, points out Sandhya

Sivakami, the State coordinator of Human Rights Law Network (HRLN)

The HRLN has, along with an NGO working among HIV-positive people,

National Network of Positive People (NNP+), filed a petition before

the State Human Rights Commission that the State Government be asked

to take necessary measures to ensure that the national guidelines

for HIV testing were not flouted by private hospitals.

HRLN has specifically referred to the manner in which pregnant women

who go to private hospitals for ante-natal visits are secretly

tested for HIV without their consent or pre-test counselling.

Creating confusion

" Most women are unaware of the fact that they cannot be tested for

HIV without their consent and take it for granted that it is part of

the routine blood tests. Things are fine as long as the women are

not HIV-positive. But those who are found to be HIV-positive are

referred to the Medical College without any treatment or

explanation.

This creates a lot of confusion, stress and trauma for the

individual concerned, " points out Ms. Sandhya.

Counselling

Pre-test counselling should be provided to help a woman understand

the risks of an HIV infection, to learn about the precautions for

prevention of an infection or for checking the spread of an HIV

infection. If the test result turns out to be positive, this

counselling will help the woman cope with the immediate trauma,

psychological stress and social fears.

The State Government has made available an extensive network of

Voluntary Counselling and Testing Centres, where there are

facilities for providing counselling before and after testing. Any

individual willing to check his/her HIV status can get him/herself

tested there and all records are maintained confidentially.

NACO guidelines also say that respective State Governments can adopt

legislative measures to ensure that private hospitals and clinics

adhere to the national HIV testing policy and guidelines

But there has been this argument among the medical fraternity that

these guidelines should be amended for the safety of doctors and

paramedical staff, who face risks in the clinical management of

those with HIV infection. Most patients are thus tested secretly for

HIV, prior to surgery while pregnant women are tested during ante-

natal check-ups.

" We are aware of the fact that some private hospitals are doing

routine HIV testing without giving counselling or taking the consent

of patients. It is for the Government to adopt legislative measures

to ensure that this happens. We have written to the State Health

Services that all cases of HIV testing should necessarily be

referred to our VCTCs, " an official at the Kerala State AIDS Control

Society, said.

Routine screening

At the Gynaecology and Obstetrics wing of medical colleges, all

pregnant women are screened routinely for HIV as part of the

Prevention of Parent-to-Child Transmission of HIV programme of NACO.

However, this is done only after group counselling and after

obtaining the informed consent of pregnant women.

" We are not saying that pregnant women should not be screened for

HIV, but only that they should be informed about it and properly

counselled before testing.

All hospitals should have the support system for this or at the

least, the women can be referred to the network of 40 VCTCs in the

State, " points out Ashok K. Nair of NNP+.

http://www.hindu.com/2006/09/13/stories/2006091315550400.htm