Re: Sujatha Rao: The women with India's toughest job

[Guest guest]

Dear FORUM,

Ms.Sujatha Rao (DG NACO)called the move for mandatory

testing 'stupid' after it was mooted at the meeting with business

leaders in Mumbai.

In that proposition by Holbrooke, he also mentioned people with TB

as candidates for mandatory testing. Let me corect that impression:

TB patients are not per se at higher risk for carrying HIV

infections, it is the other way around. TB also kills people living

with HIV when they do not receive the treatment that they ought to.

By pushing for testing every person with TB for HIV, we run the risk

of stigmatising the patient with an identity that may be a

disincentive to TB treatment seeking behavior.

For arguments sake, even if the person with TB were HIV positive,

the benefits to continuation of TB treatment with no knowledge of

HIV status outweighs the reality of losing the patient in the

process of referrals between programs.

Reinforcement of positive messages for voluntary testing, assurance

of confidentiality of test results, and the presence of efficient

referrals for sputum microscopy if required and support for directly

observed treatment for TB within the context of the care and support

centers for HIV will go a long way to reduce significantly deaths

among people living with HIV from the 500,000 that Ms Rao states as

our current number of deaths due to HIV in India (refer same

report of the meeting in Mumbai).

Pushing for mandatory testing, for candidates for marriage or for

those joining the army, seems to be the shortcut that people

discover around the arduous task of education and behavior change

for prevention, without heed to outcomes from the testing.

Shortcuts like these will get us quicker to the problem that we

still need to figure a solution for: what do we tell the premarital

boy and girl or the prospective jawan to the army to do with her or

his positive status?

Dr Bobby

E-mail: <bj@...>