Will marry. Will test?

Despite all these rumblings, no state has imposed mandatory testing for its entire population. Interestingly, a Muslim country, Malaysia, has taken the lead in this regard and enforced premarital HIV testing in an entire state. In a radical move, the state of Johor has passed a law enforcing the principle of ‘‘No test, no Nikah’’. The moment you register for marriage, you are given a form to fill out. This kickstarts the process of HIV testing, the results of which are jointly told to the couple in question in the second round of post-test counselling, and later to their parents too.

The law came into force in 2001 after 78 per cent of the 1991 people registering for marriage over a month’s period approved the move. A year later the number of ‘‘ayes’’ shot up remarkably with 96 per cent of the 492 people registered for marriage supporting the law. Islam says parents must marry their child to a healthy partner. To the list of diseases specified for the purpose, this law added HIV.

Over four years of implementation have led to 77,513 people being screened and 125 found positive, of whom 76 went ahead and got married. The others, 49, didn’t marry. Giving this information at the recent International Conference on AIDS in Asia and the Pacific (ICAAP) in Kobe, Japan, Dr Prathapa Senan, Director of Health, Perak, Malaysia argued that preventing even one person from getting infection was worth it.

There was vehement criticism of this move at ICAAP. A Muslim HIV physician from Malaysia said the bureaucracy was misconstruing Islam. People had come to her asking her to falsify HIV test results because they wanted to marry. “There’s leprosy, syphilis, Hepatitis B and C — why are people not mandatorily tested for these?” she demanded. A positive person told everyone how awful he felt having been forcibly tested for HIV. Mandatory testing is against humane behaviour. Ideally, pre-marital testing should be voluntary.

Malaysia’s experiment with mandatory testing needs to be watched closely. If the government’s figures are to be believed, people favour the move. Finally, time will tell whether the law works or not.