A South African doctor’s recent call for compulsory HIV testing triggered a lively debate on Wednesday at the South African Aids Conference in Durban.
”It’s dangerous to go this route,” said Heidi van Rooyen of the Human Sciences Research Council (HSRC).
”Should we go back and undo 20 years of work with the possibility that it will fuel stigma and discrimination?”
The call for mandatory HIV testing was made earlier in the week by researcher Francois Venter of the Reproductive Health and HIV Research Unit in Johannesburg.
He argued that the level of denial was so intense that most of his patients only discovered their infection on their deathbed.
A colleague of Venter at Witwatersrand University, ethics professor Thad Metz, remarked: ”We shouldn’t manipulate people for their own good, Francois.”
Pholokgolo Ramothwala, who was tested for HIV/Aids by his doctor in 1999, said he might support mandatory HIV testing if efforts failed to halve new infections by 2011.
Ian Grubb of the World Health Organisation in Geneva, Switzerland, supported voluntary HIV-Aids counselling and testing.
But he noted that in all of sub-Saharan Africa fewer than a dozen people out of every 100 know their Aids status.
”Twenty-five years on, HIV remains a hidden disease,” Grubb said.
Venter, for his part, told the conference: ”Our staff are dying of HIV/Aids because they don’t want to test. It’s not a disease of ignorance, it is a disease of denial.”
He queried the view that the voluntary system worked fine, asking if the next Aids conference would see a doubling of the percentage of South Africans who had been tested.
The number of South Africans tested for HIV-Aids, after a quarter of a century of knowledge about the disease, currently stood at about two for every 100 people.
”Fluffy language takes away the reality that people die of this disease. We have a culture of death,” Venter said.
He asked members of the audience to indicate whether insurance companies had compelled them to take an HIV/Aids test. Many hands went up.
”Lie number one is that it’s voluntary in this country. For the rich, you get forced. I’ve had 12 tests — 11 for insurance.”
Venter said the second lie was assuming that desperately ill patients were volunteering to find out what was killing them.
Another lie was the myth that testing had to wait until people were somehow ready for the results.
This could be likened to refusing to test a woman for pregnancy until the baby was coming out, Venter said. — Sapa