March 23, 2006

Premarital HIV Testing in India

The government of the western Indian state of Goa seems to be planning to make HIV testing a mandatory requirement for couples planning to get married. Couples would be tested to find out their HIV status, and then – depending on the results – decide whether or not to go through with the ceremony. This proposal raises obviously a number of concerns such as the social fate of Indian women who are found to be HIV positive and rejected by their fiancés. Will the mandatory testing policy create a new stigmatized underclass? How would the policy protect women in India, when many of them end up being infected after marriage by unfaithful spouses? Will HIV positive persons start gravitating towards other HIV positive persons as their only likely marriage partners (a form of what is known as ‘serosorting’)? Is HIV testing compatible with the Indian tradition of arranged marriages, where the main criterion is not the sexual behavior of the bride or groom-to-be, but whether he or she ‘comes from a good family’? A nice short radio item about the changes to Indian marriage culture brought by the HIV/AIDS epidemic is available here.

Before writing off the policy as unethically draconian, one should realize that India has the second highest number of persons living with HIV/AIDS after South Africa, and that America also had a flirt with mandatory premarital testing. Back in 1988, Illinois passed a law requiring premarital HIV testing as condition of obtaining a marriage license. This had an interesting effect: the number of marriages in Illinois dropped 14% while the marriage rates rose in the neighboring states. When the law was repealed, the number of marriages in Illinois returned to its pre-1988 level. Perhaps the governors of Goa should take note.

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