Positively negative

Time of article published Mar 7, 2012

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The ANC has revived an old proposal to make HIV/AIDS a notifiable disease. This means that doctors would be obliged to report all cases of HIV to the health department (numbers rather than names) and that the partners of HIV- positive people would be told.

At face value, these seem to be perfectly reasonable measures. Tracking new HIV cases would assist government to record the progression of HIV and – even more importantly – it could protect people who are exposed to HIV.

But in a country where people have been killed for being HIV positive, policy makers should proceed with extreme caution before declaring HIV notifiable.

HIV is not an ordinary communicable disease that you can contract if your neighbour sneezes on you. HIV is primarily transmitted through sex and because of this, it comes with a big stigma. Many people still think that only sex workers and promiscuous people get HIV.

Women with HIV are at particular risk of physical violence from their partners should their HIV status be reported to them.

Unfortunately, women usually get to know their HIV status before their male partners, because HIV tests during pregnancy are virtually compulsory.

But if a man wants an HIV test, he has to be proactive and find one at a health facility.

The woman is thus usually seen as the culprit who first brought HIV into the house, even if her partner infected her, simply because she had the first test.

Should HIV become notifiable and people know that their partners will be told if they test HIV positive, this is likely to deter rather than encourage HIV testing. Yet an HIV test is the door to treatment, care and support if the person is positive – and to safer sex if the person is negative.

In a world where there is gender equity and no discrimination against people with HIV, making HIV notifiable would make sound policy sense.

But in the current conditions, such a move is likely to drive HIV underground.

It would make much better sense to concentrate on measures to normalise HIV, particularly testing for men, rather than a policy that has potentially disastrous side-effects.

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