Mandatory AIDS Testing
AIDS has become a worldwide epidemic that has struck every identifiable group. However, persons who are considered to be in a high-risk group of contracting HIV, the disease believed to cause AIDS, are still stigmatized by the media and other professionals as being diseased and abnormal. It is quite surprising still that this type of stereotype still exists now in our gender-bending society. No longer do only gays, prostitutes, bisexual men, intravenous drug users contract HIV, the heterosexual community is also facing the epidemic at phenomenon increases. It is estimated that heterosexual transmission accounts for 75% of all AIDS cases in the world.(Video, CBC In Review) And still individuals persist that AIDS is a gay disease and that if one is not gay, one is immune from it. No one is immune to from AIDS. Until a vaccine and cure is discovered for AIDS, the numbers will increase and people will keep dying. Therefore it is of vital importance to educate people about AIDS and to promote safer sex. The key word now is prevention. Among many proposed policies to help prevent AIDS infection, one of the most controversial is mandatory AIDS testing. Mandatory AIDS testing is theoretically very effective, however, when it is applied, it is not practical at all because one is dealing with human nature, the odd nature of the virus itself, and also all of the stigmas that are attached to AIDS. Therefore, not only will mandatory AIDS testing not prevent HIV infection, it will indirectly increase HIV infection because of the adverse effect it will have on voluntary testers.
One of the major flaws of mandatory AIDS testing is that "it provides people with a false sense of security."(Greig, p68) When one goes for AIDS testing or more accurately an HIV antibody test which is also know as the ELISA test (Kolodny, p42), one tests for the presence of HIV antibodies not for the virus itself. Our bodies manufacture antibodies to fight against foreign infections, therefore the presence of HIV antibodies indicates that the person is infected with HIV and is considered a carrier and may infect others. However, if the person is infected recently enough, these antibodies might not show up in the test because it can take the body as long as six months to develop these antibodies. This period of time is known as the window period. So a person whose test returns with a negative HIV status may be in fact a carrier and not know it because the antibodies have not shown up yet. Misguided, this individual believing to be HIV negative, may participate in high risk activities for contracting HIV and infect others as well.
Mandatory Aids testing also involves sub-policy known as contact tracing or partner notification. The intent of this policy is to have an individual who is HIV positive disclose his sexual history and all partners as well. Then the public health office will contact these partners and have them tested and educated. This policy fails to recognize that it is dealing with a very sensitive, and private issue and people might not want to disclose their sexual history. Also how will this information be verified? It will be of no surprise that certain individuals may lie and identify someone who they had no sexual contact with just to put that person through the hassle. Not only is this policy an infringement on privacy, it is not effective because there is no cure for AIDS. In the past, contact tracing was also implemented for other STD's(sexual transmitted diseases) such as syphilis, gonorrhea, herpes simplex where there is treatment for the diseases. (Greig, p71) For AIDS, there is no cure or vaccines, therefore, people living with AIDS(PWA) are not treated but in fact being re-educated again.
With all the hassle and insecurity of the mandatory AIDS testing policy, people will become reluctant to test. Also because the results of the tests will be kept on file and the results are accessible by some selected individuals and groups, people will become even more hesitant to test voluntarily first let alone be mandatory. The consequences of public disclosure or even select disclosure are very damaging to a person who has just learned of his HIV positive status. Some of the negative consequences are alienation from community and family, loss of accommodation, denial of disability and life insurance, travel restrictions and also the prospect of "blackmailing". (IPC, HIV/AIDS, p17) The notion that mandatory AIDS testing and its implications deter people from voluntary testing is evident from the possible discrimination that one might face undergoing the procedures of the policy.
As of today, there is no mandatory AIDS testing programs being implemented for persons of "high-risk groups". One cannot help but feel the society as a whole believes when one is dealing with an issue like AIDS, which is so sensitive and private, the rights and the comfort of the individuals stricken with this horrid disease should come first. As a result, anonymous testing has been made available to provide people with discretion and protection from discrimination. Although not many cities provide this sort of services, just the fact that it is available is a relief for those who suspect that they might be infected with HIV. This type of service encourages testing and is the right tool to help prevent HIV infection.
Some of the question asked may be very difficult or even impossible to answer, but a strong debate can be put up for both sides. Can Aids testing control the spread of AIDS, for the individuals who seem to believe that it can, many argument go in it's favor. By promoting HIV testing "it enables those who have tested positive to seek early treatment. By learning of their infection, people with HIV can avoid unsafe practices that could infect others."(Bender, p.114) By doing this it will prevent those who are infected from spreading the virus to those who are not accidentally. A lot of the time when this virus is being passed it is done unknowingly. If this system were to be in place, it would be the end of people passing the virus off unknowingly. Leaving us with the few that have been found knowingly passing the disease. There have be some cases where a person who has been tested and knows that they have the virus, but continues to engage in an unsafe sexual manner. Therefore passing the virus off to other uninfected people. How should we deal with these individuals? Should there be a criminal punishment? How can we protect ourselves from these individuals? With this system it may crack down on this problem, and the a criminal punishment may follow.
When testing not everyone must be tested only those who are in the high-risk groups, consisting of homosexuals, IV drug users and those who have partners that are infected with the HIV virus. This testing would inform people of possible HIV infection and enables them to seek early treatment. It also does a very important job in telling the person if he/she if a carrier of the virus. With this information hopefully the spread will drop in accidental cases this meaning a smaller number of AIDS cases. This isn't it only purpose it also helps the blood donor clinics such as the Red Cross in determining who has the virus and who doesn't. It would mean there would be a safer system in blood donating overall. It ensures the public that everyone who is giving blood is HIV/AIDS free. It is possible for one bad unit of blood to contaminate 10 000 - 30 000 other units of blood. That would be a huge catastrophe for the Red Cross. Lastly it gives individuals engaging in any sexual activities that added piece of mind that the person they are sleeping with does not have the AIDS virus.
A case of a man who was infected with the HIV virus was found trying to donate blood at Red Cross located in Ottawa.(G&M, June 5/'95) Mr. Thornton in the fall of 1987 donated blood after being tested positive twice for HIV and not revealing that he was homosexual. A high risk group that the Red Cross won't except blood from. He had been warned not to donate blood, but did so any ways believing it would relieve his chances of developing AIDS if he got rid of some blood. One of his friend quoted him saying he wanted to see if he could set away with donating blood. Mr. Thornton thought his blood would be screened out. One has to remember the screening process isn't foolproof, in theory it would only catch 99.3 % of cases of infected blood. For this action, Mr. Thornton was found guilty in 1989 of committing a common nuisance endangering the lives or health of the public. He was sentenced to 15 months in jail. This has been the first case the top courts had to deal with involving the transmission of AIDS. Now a under existing laws, any one knowingly donating blood can be prosecuted. In another case this one being on the civil aspect involving a married father of two is suing the estate of his homosexual lover, saying the man failed to disclose that he was carrying the AIDS virus until shortly before dying.(Star, '94) This case is the first of its kind in Canada, and may end up setting the rights and duties of people in sexual relationships that involve AIDS. The man known as C.R. is seeking damages for negligence, negligent misrepresentation, assault and battery and breach of fiduciary obligation from the estate of a man known as J.T. He is suing for $250 000 in general damages and $ 75 000 in punitive and special damages. A good point made by the lawyer representing J.T. estate, " If you are going to have unprotected sex with a member of a high risk group you are partially negligent. This case shows that there are repercussion to ones actions you must be extremely selective of who you have sexual encounters with. It also looks more towards the civil side of AIDS and the law, the decision of the case was not obtained. It's safe to say that AIDS has changed our views on any sort of sexual activities we conduct ourselves in.
Sexual conduct isn't the only thing we must worry about anymore because in a article in the Globe and Mail dating back to November, 11/'94. Those who donate blood must now face the fact that if they are HIV positive when donating, whether it be accidental or purposely the ruling was that the Red Cross would be able to give the names of the individuals to the public health office. "Donors implicated that having names released amounted to mandatory testing for acquired immune deficiency syndrome." (G&M, Nov.11/'94).
In one last case in a recent newspaper ruled that some Red Cross workers could be charged with criminal negligence causing death if Justice Horace Krever's inquiry assigns them blame for their role in the tainted blood tragedy.(Sun., Nov '96) There are a dozen medical directors and senior managers that could be charged. Under these jurisdictions, committing a common nuisance and thereby endangering the lives, safety or health of the public. Criminal negligence in doing something or failing to perform a duty and showing wanton or reckless disregard for the lives or safety of others persons. Criminal negligence causing death and criminal negligence causing bodily harm to another person. The judge stated that the Red Cross failed to adequately fund its program in the 1980's; it didn't screen high-risk donors; it publicly understated the risk of blood borne AIDS virus and hepatitis C; it failed to buy safe, heat treated blood products as soon as they became available. Because of that several notices warning people he might cite them for misconduct.
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