Premarital HIV Testing in India

The government of the western Indian state of Goa seems to be planning to make HIV testing a mandatory requirement for couples planning to get married. Couples would be tested to find out their HIV status, and then – depending on the results – decide whether or not to go through with the ceremony. This proposal raises obviously a number of concerns such as the social fate of Indian women who are found to be HIV positive and rejected by their fiancés. Will the mandatory testing policy create a new stigmatized underclass? How would the policy protect women in India, when many of them end up being infected after marriage by unfaithful spouses? Will HIV positive persons start gravitating towards other HIV positive persons as their only likely marriage partners (a form of what is known as ‘serosorting’)? Is HIV testing compatible with the Indian tradition of arranged marriages, where the main criterion is not the sexual behavior of the bride or groom-to-be, but whether he or she ‘comes from a good family’? A nice short radio item about the changes to Indian marriage culture brought by the HIV/AIDS epidemic is available here.

Before writing off the policy as unethically draconian, one should realize that India has the second highest number of persons living with HIV/AIDS after South Africa, and that America also had a flirt with mandatory premarital testing. Back in 1988, Illinois passed a law requiring premarital HIV testing as condition of obtaining a marriage license. This had an interesting effect: the number of marriages in Illinois dropped 14% while the marriage rates rose in the neighboring states. When the law was repealed, the number of marriages in Illinois returned to its pre-1988 level. Perhaps the governors of Goa should take note.

posted Mar 23, 2006 | link | jump to the comments (9)

comments

It's posts like this that prove why I I can't go a day without checking out this blog...Anyway, I agree with your implied view that this isn't a backward act of the third world, but something thing actually moves us forward in the fight against AIDS. It's much more important to test now and lower future occurrences of AIDS so that mandatory testing will ultimately become unnecessary, than to propagate the problem by letting millions live in dangerous secrecy-and ignorance-about their condition...Are there any other nations with mandatory HIV testing, and why isn't the US one of them?

- by djcharisma13 on Mar 23, 2006 at 1:45 PM | link

I think the lowered marriages in Illinois gives you something to think about. If you have an inclination that you have such an awful disease I would think that you would want to be tested. Especially if you could be potentially passing it on to someone you love. I guess with the arranged marriages in India that wouldn't be a problem but I still think that being proactive about this devastating disease is better than doing nothing. In a country that has a very high rate of infection such as this I think that something very well should be done. I just am not sure what would happen to the poor souls who then are stigmatized by it. Maybe for alot of people the idea of not getting married at all might be a better option. Then again I am living in an age where in america divorce affects 50% of marriages, and living together is the next best option.

- by Amy on Mar 24, 2006 at 3:55 PM | link

I like the idea of people getting tested for HIV in India and everywhere else in the world. Although positive results would be devasting for an upcoming marriage, treatment and preventative measures could begin immediately for the individual. Mandatory testing may encourage people to think more about the consequences before then engage in unsafe sex or other risky behaviors. I would hope that the results would be confidential but it would be hard to explain why a marriage was called-off all of a sudden after testing. I believe in India that it probably would create a sub-class for HIV individuals. Maybe a positive thing about the sub-class would be that couples would marry inside this class, keep the virus confined, and still have a partner.

- by charlotte on Mar 24, 2006 at 7:39 PM | link

Sorry, but I'm old enough to remember when mandatory syphillis tests were required to get married...they were mainly to protect the (presumably chaste) woman and their children from getting syphillis from a husband who had caught it from prostitutes...
The bad news is that it didn't work then (see the movie Out of Africa) and now, with many children born out of wedlock, and premarital sex being the rule, testing for HIV in the US would be like closing the barn door after the horse has left.
However, in India, where virginal brides are still common, HIV testing makes sense

- by Nancy Reyes on Mar 25, 2006 at 6:23 AM | link

I'm not sure I agree with premarital testing of HIV as the answer although I give them credit for trying to come up with a way to stop the spread of the disease. Maybe have mandatory age testing, why wait until someone wants to get married HIV can take a while to show up positive in your system so having the test done once before marriage may show negative and two years after marriage then be positive. If they would mandate tests to be done every so many years it may decrease the spread and make the people more informed. And since this is a world wide disease it should be carried out throughout the world.

- by Desiree on Mar 26, 2006 at 3:16 PM | link

I think that mandatory testing is not an answer, but maybe a chance for someone who was never tested to get it done. Even if the 5 out of every 10,000 test came up positive, that is 5 more cases of HIV if not more that could be prevented. Most people do not think of themselves as being at risk for the disease if they do not have risky behaviors. When entering into a sacred relationship such as marriage, everyone would think they know their mate. The fact is everyone has a past. I think that it may be a good idea, if just for the fact that some people will get tested who otherwise might not.

- by Erika on Mar 27, 2006 at 11:32 PM | link

I don't know that mandatory HIV testing is going to solve the problem in India or even begin to irradicate this disease. If the marriage is forbidden because of an HIV positive woman, then what? Will this be public knowlege? Will she never have sexual relations because her face will be on posters everywhere? Will she never have to fear rape? The study in Illinois is definitely interesting a a big surprise to me. Maybe the testing isn't such a bad idea to protect individuals, but why wait to do it before marriage? It may be a very good start to control this epidemic.

- by Mary Jayne on Mar 28, 2006 at 3:58 PM | link

I am not sure if mandatory testing is the right answer but not a bad idea, I would like to know if the person I was marrying had HIV but if everyone got the testing right before marriage it would be devasting to find this out at this time, maybe when a man or woman was of marrying age they should be tested then? Are they educating the people about wasys to prevent AIDs? That would be a good start. I think if this was done, it would create a new stigmatied underclass. I didn't know about Illinosis requiring this, very interesting. I know some ob/gyn doctors encourage pregnant women to have testing done but I think it is too late, it should be done when a woman is thinking about becoming pregnant. It would be very interesting to hear the rest of the story and see what happens.

- by Esther Long on Apr 3, 2006 at 3:24 PM | link

I hardley think that mandatory HIV testing prior to marriage is going to solve the problem or for that matter even diminish it. I think there is way to much premarital sexual relations today; so how do you know that this couple that is about to embark on marriage hasn't already been involved sexually, and what is that going to change when they are just about ready to get married.

- by aimee on Apr 4, 2006 at 7:10 PM | link