Put an end to indignity
Anand Grover
October 14, 2012First Published: 21:17 IST(14/10/2012)
Marred by disruptions and adjournments by the Opposition, the monsoon
session of Parliament was a complete washout with minimal business being
conducted. While the government took decades to table the much-hyped
Lokpal Bill in Parliament, one wonders when important legislation like
the HIV/Aids Bill, which aims to protect the rights of people living
with the disease, will see the light of day.
From being forced out of schools to the denial of jobs to involuntary
disclosure of HIV status, there's no end to discrimination that people
living with HIV/Aids face. Not just this, their family members are also
subjected to hostility, prejudice and stigma. Groups at risk of HIV like
sex workers, men who have sex with men (MSM) and injecting drug users
(IDUs) face rights violations in different spheres of their lives.
However, only a few of these cases get reported.
With no specific anti-discrimination law to protect the rights of people
living with and affected by HIV/Aids, there is limited legal redressal
against rights violations faced by them. Unlike India, which is one of
the earliest countries that started the process of drafting the HIV/Aids
Bill, many, including 20 African nations, have passed laws on the
disease. Earlier this year, the East African Assembly passed the HIV
& Aids Prevention and Management Bill, 2012.
Among the Asian countries, the Philippines, Kazakhstan and Vietnam have specific HIV/Aids legislations.
Countries like South Africa, Australia, the US and Britain protect the
rights of HIV positive people through anti-discrimination laws. The
Disability Discrimination Act, 1992, in Australia covers not only HIV
positive people but also those who are associated with HIV and those who
are believed to have HIV. The Equality Act, 2010, of Britain protects
HIV positive people from any kind of discrimination in both the public
and private sectors.
In our country, after a series of consultations with all the
stakeholders like people living with or at risk of HIV/Aids, doctors,
lawyers, women's groups, children's rights groups and government
officials, a draft Bill to that effect was finalised by the health
ministry in July 2006. But till date it has not been tabled in
Parliament.
The Bill seeks to protect people living with or at risk of HIV/Aids from
discrimination, provides for informed consent for HIV testing,
treatment and research, protects the confidentiality of HIV-related
information including HIV testing and provides for complete and free HIV
treatment for everyone in need of it.
It was first sent to the law ministry in August 2007. However, it took
almost three years to clear the Bill and finally sent it back to the
health ministry in March 2010. After that, in 2011, once again the
health ministry sent the Bill to the law ministry. Even now, the Bill is
pending with the law ministry and has not been sent to the Cabinet. For
the last six years, people living with HIV/Aids and civil society
organisations working in this field have been advocating the passing of
this Bill.
Although the estimates of people with HIV/Aids have come down in our
country, rights violation continues unabated. It's time the government
displays some urgency on the issue and tables the Bill at the earliest
so that people with HIV/Aids can lead a life of dignity.
Anand Grover is a senior advocate and director, Lawyers Collective, New Delhi
The views expressed by the author are personal
http://www.hindustantimes.com/News-Feed/ColumnsOthers/Put-an-end-to-indignity/Article1-944578.aspx
Friday, October 19, 2012
Pre-marital HIV testing is a shortcut to nowhere
Anand Grover & Mihir Samson Director & Advocacy Officer, Lawyers Collective
(The Maharashtra government's proposal is aimed at shielding women but it could end up adding to their vulnerability)
THE MAHARASHTRA government is considering a proposal to make HIV test mandatory before marriage. The proposal is seemingly an attempt to protect women from contracting HIV from their husbands. However, evidence shows that such testing is ineffective in preventing transmission.
The proposal is not new. It has been considered in Kerala (2011), Jharkhand (2010), Goa (2006), Andhra Pradesh (2002) and in Maharashtra itself in 2008. Each time, the proposal was abandoned or rejected for manifold reasons.
First and foremost, the National HIV/AIDS Control Programme, implemented by the health ministry's National AIDS Control Organisation (NACO), is founded on a rights-based approach. It is based on the understanding that the epidemic can be addressed only by respecting the rights of people living with HIV and those vulnerable.
Three fundamental aspects of this approach are informed consent, confidentiality and non-discrimination. When rights are violated, people lose confidence in the public health system, causing the epidemic to go underground.
Mandatory testing is antithetical to the rights-based approach. It overrides an individual's right to make decisions about their body and thereby violates their right to informed consent. There is also a serious risk of the HIV status of a person becoming public, violating their right to confidentiality. A large number of marriages in India are arranged with the participation of the prospective spouses' families. If a person tests positive, the results would be shared with everyone involved, thus making it public, with grave repercussions. There is also a risk of false positive results.
Persons who may not have contracted HIV may test positive, which could have a serious negative impact on their future.
Mandatory testing is also ineffective in preventing HIV transmission. It is based on a fundamentally flawed assumption that an HIV test prior to marriage guarantees protection from HIV subsequently as well.
It does not address the fact that HIV can be contracted during marriage, by either spouse, through extra-marital sex, blood transfusion or sharing needles. In fact, the test would lure spouses into a false sense of security of being protected from HIV.
This could increase complacency regarding health risks associated with sex and increase risky sexual activity. It would also reduce the ability of women to negotiate safe sex.
The public health system currently uses the antibody test to detect HIV. However, the limitation of the test is that there is a window period, of up to three months, during which antibodies remain below detection levels. During this period, an HIV positive person would test negative for HIV. As a result, HIV transmission would not be prevented when a person is tested during the window period.
Experience shows that mandatory pre-marital testing is easily subverted. When it was implemented in Illinois, US, people travelled to other states to get married. The law was later repealed. In Louisiana and Utah, similar laws were found to be wasteful and ineffective and eventually removed. In India, it is also possible that instituting such a policy could open a racket of obtaining false certificates.
It's possible that instituting such a policy could open a racket of obtaining false certificates
That women are more vulnerable to HIV than men is well-established. Part of this is biological, but a large part of this vulnerability can be traced to the socio-economic and cultural disadvantages that women face. Most women have little or no control over decisions about sex, including condom use.
It would be far better if NACO introduced the HIV/AIDS Bill in Parliament immediately. The Bill espouses the rights-based approach in general. It contains a number of specific provisions, seeking to ensure that women have access to information regarding, and able to take decisions relating to sex. These include the provision of sexuality education to adolescents and couple counselling before marriage. NACO must champion the cause of the Bill and put to bed all debate about policies such as mandatory pre-marital testing, which are contrary to the rights-based approach and deleterious to public health.
(The views expressed in this column are the writers' own)
letters@tehelka.com
http://www.tehelka.com/story_main54.asp?filename=Op201012Proscons.asp
Anand Grover & Mihir Samson Director & Advocacy Officer, Lawyers Collective
(The Maharashtra government's proposal is aimed at shielding women but it could end up adding to their vulnerability)
THE MAHARASHTRA government is considering a proposal to make HIV test mandatory before marriage. The proposal is seemingly an attempt to protect women from contracting HIV from their husbands. However, evidence shows that such testing is ineffective in preventing transmission.
The proposal is not new. It has been considered in Kerala (2011), Jharkhand (2010), Goa (2006), Andhra Pradesh (2002) and in Maharashtra itself in 2008. Each time, the proposal was abandoned or rejected for manifold reasons.
First and foremost, the National HIV/AIDS Control Programme, implemented by the health ministry's National AIDS Control Organisation (NACO), is founded on a rights-based approach. It is based on the understanding that the epidemic can be addressed only by respecting the rights of people living with HIV and those vulnerable.
Three fundamental aspects of this approach are informed consent, confidentiality and non-discrimination. When rights are violated, people lose confidence in the public health system, causing the epidemic to go underground.
Mandatory testing is antithetical to the rights-based approach. It overrides an individual's right to make decisions about their body and thereby violates their right to informed consent. There is also a serious risk of the HIV status of a person becoming public, violating their right to confidentiality. A large number of marriages in India are arranged with the participation of the prospective spouses' families. If a person tests positive, the results would be shared with everyone involved, thus making it public, with grave repercussions. There is also a risk of false positive results.
Persons who may not have contracted HIV may test positive, which could have a serious negative impact on their future.
Mandatory testing is also ineffective in preventing HIV transmission. It is based on a fundamentally flawed assumption that an HIV test prior to marriage guarantees protection from HIV subsequently as well.
It does not address the fact that HIV can be contracted during marriage, by either spouse, through extra-marital sex, blood transfusion or sharing needles. In fact, the test would lure spouses into a false sense of security of being protected from HIV.
This could increase complacency regarding health risks associated with sex and increase risky sexual activity. It would also reduce the ability of women to negotiate safe sex.
The public health system currently uses the antibody test to detect HIV. However, the limitation of the test is that there is a window period, of up to three months, during which antibodies remain below detection levels. During this period, an HIV positive person would test negative for HIV. As a result, HIV transmission would not be prevented when a person is tested during the window period.
Experience shows that mandatory pre-marital testing is easily subverted. When it was implemented in Illinois, US, people travelled to other states to get married. The law was later repealed. In Louisiana and Utah, similar laws were found to be wasteful and ineffective and eventually removed. In India, it is also possible that instituting such a policy could open a racket of obtaining false certificates.
It's possible that instituting such a policy could open a racket of obtaining false certificates
That women are more vulnerable to HIV than men is well-established. Part of this is biological, but a large part of this vulnerability can be traced to the socio-economic and cultural disadvantages that women face. Most women have little or no control over decisions about sex, including condom use.
It would be far better if NACO introduced the HIV/AIDS Bill in Parliament immediately. The Bill espouses the rights-based approach in general. It contains a number of specific provisions, seeking to ensure that women have access to information regarding, and able to take decisions relating to sex. These include the provision of sexuality education to adolescents and couple counselling before marriage. NACO must champion the cause of the Bill and put to bed all debate about policies such as mandatory pre-marital testing, which are contrary to the rights-based approach and deleterious to public health.
(The views expressed in this column are the writers' own)
letters@tehelka.com
http://www.tehelka.com/story_main54.asp?filename=Op201012Proscons.asp
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