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Published by the government of Zimbabwe

Zimbabwe: Promote HIV Testing Among Couples

8 October 2007

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editorial

Harare — Far  too few adult Zimbabweans are willing to learn their HIV status, even when they are about to be married or enter a long-term relationship, a time one would have thought that both members of a couple would like to have such knowledge.

The New Start Centres have previously noted that there is a tendency for one member of a couple to slink in, have a test and then, only if they are HIV negative, bring in their partner. Women parliamentarians meeting recently in Nyanga condemned those in marriage or long-term relationships who are secretly tested and decline to tell their partners how the test came out.

The Minister of Health and Child Welfare, Dr David Parirenyatwa, added his voice over the weekend, also appealing to couples to be tested together and give each other the results. Presumably, without actually saying so, the women parliamentarians were concerned about the cases where the secret test was positive. There seems to be no medical damage done when the test is negative and the partner is not told although clearly the marriage might well be under severe strain in non-medical areas. At the heart of the debate in Nyanga was the question of whether confidentiality could be breached and a spouse having an absolute right to learn the result of any HIV test taken by their husband or wife.

In theory the idea is good, but in practice we are likely to see a drop in the numbers going for voluntary testing since there are people with some moral responsibility who have committed adultery but are only prepared to face the consequences one step at a time.

There are only two good reasons for a secret test by a spouse. The first is that they suspect their spouse has been fooling around and they are desperate to know if they have been harmed medically by this. A negative test can reassure them. Passing on the data may impose a greater strain on the marriage than it can bear; unwarranted suspicions can destroy a marriage.

The second reason has far more moral implications. A spouse has committed adultery and wants to know if they were infected as a result. Again, if the test is negative there is no medical risk; he or she has, in that respect at least, "got away" with it. The moral dimension is a personal problem without medical risks. One can only hope that the adulterous partner in this case will have learned her or his lesson and be more ready to live up to their marriage vows in future even if they cannot be persuaded to come clean now. If the test is positive, then the adulterous spouse faces a second choice, and in these circumstances must be willing to protect their husband or wife from harm and open up, even knowing that the marriage could well end in divorce as a result.

So, on practical grounds, it appears that ending the confidentiality rule of HIV tests so far as spouses are concerned will almost certainly see less testing, not more.

Spouses should continue to be encouraged to go for testing together, but if a single spouse turns up for a test the result should continue to be kept confidential, along with special counseling on the responsibilities the spouse seeking a secret test faces if the result is positive. It is necessary for as many people as possible to learn their HIV status and it must be assumed that those who do come for testing are at least willing to face up to the consequences should they be found positive.

There is a different position where a couple is about to be married. Here we think more marriage officers, who are usually ministers of religion, should be as persuasive as possible in getting the couple to go together for testing, so they can make an informed choice about whether to continue with the marriage.

And if both test negative they at least know - and know absolutely - that they are able medically to start with a clean state.

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