August 17, 2006
While several high-profile speakers at the 16th International AIDS Conference have called for routine opt-out HIV testing in hard-hit countries, this could produce unintended negative consequences especially for women, said Mary Robinson, former president of Ireland and a supporter of the International Community of Women Living with HIV/AIDS.
Women who test HIV-positive may be blamed for bringing the virus into the family, "even when their husband may very well have infected them, just because the woman was tested first," said Robinson. "I've heard this again and again: 'She's the one in the family, so it must be her. She's to blame, out she goes,'" Robinson said. In addition, women who disclose their positive status are often subjected to verbal abuse and "sometimes terrible violence."
In Botswana, which offers routine opt-out HIV testing, many women do not realize they can refuse to be tested or are too intimidated by health providers who tell them they should comply, said Grace Sedio. "HIV prevalence is high in Botswana and when you're offered routine testing, you think in the back of you mind, 'This is the right thing for me to do,' not necessarily being ready or that you want to do that," said Sedio, who is HIV-positive.
What is missing from HIV testing, said Sedio, is counseling about what a positive result entails such as the potential for stigma and discrimination from family, friends and neighbors when they find out.
Opt-in testing, Robinson argued, is about dignity and human rights. "Otherwise, you're treating people almost like cattle," she said. "You know, 'Let's test them unless they positively protest.'"