East African Business Week (Kampala)
Ben Moses Ilakut
10 August 2008
In 1998 a young Bolivian girl called Gracia Violeta Luiroga was raped by unknown men. Her feeling of sexuality and womanhood was shattered; little did she know that the worst was yet to come.
In 2002, her elder sister without asking for her consent took her for an HIV test. This was done without any pre-test counseling. After the test, Gracia's sister, again without seeking her consent or considering what the impact would be, took her to receive the results. The result was devastating.
She was HIV positive.
Gracia was not prepared for this. "I had never thought I could ever be positive. All I knew was that AIDS was a disease for men who have sex with men," she says. "I decided to end my life and walked towards a bridge that people often went to commit suicide. When my sister noticed what I was about to do, she arrived just in time and stopped me," she says.
From then on Gracia hated her sister, refused to accept her own status, until three months later she decided to have another test. This time, she went through pre and post voluntary counseling and testing (VCT) and was confirmed positive.
"Although it was hard to get the confirmation, I felt much better than how I felt when my sister ambushed me," she told Panoscope.
Patricia, now a healthy PLWA and career woman was on Tuesday one of the speakers at a controversial session on: "Scaling up Testing and Counseling: A Human Rights and Public Health Imperative" during AIDS 2008 In Mexico.
The session that brought together experts from the public health background and human rights activists demanded for the removal of all mandatory policies that compel immigrants to take an HIV test without consent, leaking of client information to employers, detention and deportation in the case of immigrants, because of their HIV status.
Anyone who is in a situation of being tested without consent could even go into more risky behavior," said Gracia to underscore the risks associated with compulsory testing. "It is worse for immigrants because unlike my situation where my sister did it because she loved me and because she was ignorant of the impact , the immigrants are forced to test be governments, by the police-total strangers and after which they are deported to their countries without any arrangement for treatment, care and support."
Speaking on behalf of the UNAIDS Reference Group on Human Rights, a body that advises UNAIDS on issues concerning HIV and human rights, Mr Ralph Jurgens, a member of the group asked UNAIDS and WHO to ensure that HIV prevention, care and support services and access to ART become available as part of the national plan to achieve increased VCT and ART.
"Even as vastly increased funding for HIV has become available, those most vulnerable to HIV and its impact continue to receive the least access to HIV prevention, care and treatment. In many countries there are many abuses around the manner in which HIV testing and counseling is conducted. We are concerned that if issues raised in our advice are not implemented, there will be further abuses, rather than increased benefits for human rights and public health," Jurgens said.
WHO and UNAIDS already have recommended that decisions on how best to implement provider initiated HIV testing and counseling should depend upon an assessment of the situation of the country.
Where there are high levels of stigma and discrimination and low capacity of health care providers to implement provider initiated HIV testing and counseling under the conditions of informed consent, confidentiality, counseling, the WHO /UNAIDS guidelines urge, adequate resources must be devoted to addressing these issues prior to implementation.
Ms Amara Quesada, the Programme officer Action for Health Initiatives, in the Philippines said imposing mandatory testing on immigrant's means denying them pre and post VCT, and when found to be HIV positive they are sent away. "Deporting immigrants will not reduce HIV, instead the immigrants will go underground, conceal their identity and become a risk to others," she said.
Nduku Kilonzo, the Director of Liverpool VCT, Care and Treatment in Nairobi, Kenya said there is need to introduce family based VCT to encourage coupled supported VCT.
"The word couple should be programmed to apply to any people in any relationship involving sex, including unmarried youth," said Kilonzo.
"It is the high time we begun supporting discourse involving partners.
We should start to move away from individualism in testing."
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