Wednesday, April 7, 2010

Malawi and Uganda Consider HIV Status Bill

This link describes a bill being considered in Malawi, but Uganda is actually considering passing the same law.

If passed, the law would make it illegal for a person who knows they are HIV-positive to infect another individual.  The article above mostly focuses on the problems this would pose to sex industry workers - and there's certainly a healthy industry in Uganda who could complain of the same. 

A few months ago, however, a friend pointed out to me an even bigger problem with such a law. (She was referring in our case to Uganda, not Malawi.)  Making it illegal to knowingly pass on HIV essentially makes it dangerous to know that you have HIV.  Not knowing is safer - if you pass it on, you can't get convicted, because you had no idea!  This provides a disincentive for testing, which is the only true way to know if you are HIV-positive.  

Imagine, for instance, that two married people living in a village are HIV-positive.  The woman (lets call her Isa), suspects that her husband (Nsoni) has AIDs, and has passed on HIV to herself.  Isa figures that Nsoni probably contracted HIV in the years after their marriage - perhaps through mere cheating, or perhaps through another wife.  Isa wants to test herself for HIV.  After all, she's still having children by Nsoni, and if she's HIV-positive she wants to take the proper precautions to avoid mother-to-child transmission.  However, to the best of Isa's knowledge, Nsoni has never been tested himself.  So this mean that if she tests herself, she'll be the first one to know that she is HIV positive.  This would allow Nsoni, in the coming years, to prosecute her for knowingly passing along HIV to him - never mind that he's almost certainly the one who had it first, because now it can't be proved either way.  But it would be clear that Isa was the only first one who knew about it (for sure), and especially if she didn't volunteer the results of the test to Nsoni right away, she might be liable under the law. 

I don't claim to be an expert on this sort of HIV related policy, but this was the story that my friend explained to me, in our conversation months ago.  And I think its a worrying one. 

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