South Africa, burdened with one of the world’s worst AIDS crises, should institute mandatory HIV tests through employers, banks and medical insurance programmes, a senior AIDS doctor said on Thursday.
“I don’t think ignorance is a human right,” Dr. Francois Venter, head of the South African HIV Clinicians Society, told a news briefing.
Mandatory screening for HIV is a controversial topic in South Africa, with proponents saying it is the best way to stop the epidemic’s spread by alerting infected people of the need to get treatment and act responsibly.
Critics of such proposals charge they would violate human rights and could leave HIV-positive people open to social stigmatisation if their status becomes widely known.
Venter said most people in South Africa - where an estimated one out of five are infected with HIV - do not know their status, a dangerous ignorance that is responsible for at least 500,000 new HIV infections each year.
“Five hundred thousand is a hell of a lot of people,” he said. “It scares me. ... I keep saying to policy makers, ‘When are you going to start screaming?’”
Venter said mandatory annual HIV tests could be a requirement for medical insurance programmes and that all employers should insist on proof of an HIV test - but not the result - before offering a candidate a job.
“We shouldn’t care whether you are positive or negative, but we should care that you know what your status is and you are acting responsibly,” Venter told Reuters.
“People could be required to show proof of a HIV test to open a bank account, apply for a government grant, or deal in any way with bureaucracy. You are not allowed to drive a car without a license, and this should be seen in exactly the same light.”
South Africa’s official AIDS policies urge people to get tested, but on a purely voluntary basis. Venter said this was insufficient, and that HIV tests should be as easily accessible as pregnancy tests for the broader population.
Venter emphasised that HIV tests should only be conducted in situations where people have access to counseling which can offer suggestions for treatment and tips on safe sex and other ways of acting responsibly.
But he said that to allow people to remain ignorant of their HIV status in a country like South Africa was ethically unacceptable.
“The problem with HIV is that it is eventually going to come out into the open when you get very sick. I would rather people get the news when they are healthy and can do something about it,” he said.
Revision date: July 6, 2011
Last revised: by Janet A. Staessen, MD, PhD