It is unfortunate that one of the first public statements made by the Women, Family and Community Development Minister Datuk Seri Dr Wan Azizah Wan Ismail regarding the HIV epidemic in Malaysia is to call for mandatory premarital HIV testing of non-Muslim couples wanting to get married.
Unlike our success in preventing mother to child transmission of HIV, this mandatory premarital screening programme for Muslims has never been recognised as a best practice by the World Health Organisation. However, it has been a case study for what countries should not do.
No study has yet demonstrated that Malaysia’s 15 year old programme of imposing mandatory premarital HIV testing has been cost effective and yielded the kind of results expected from so much investment. It contributes very little, if at all, to prevention. This is because its rationale is based on religious opinion and incomplete understanding of the disease.
Ironically, though the original argument was to protect women from being infected by their prospective husbands, the experience of more than a decade of mandatory testing and studies have shown that this requirement potentially harms women.
If the test results are negative for both partners, the woman faces significant challenges in negotiating safer sex within the marriage. This creates considerable vulnerability, including being at risk of gender based violence and contracting sexually transmitted diseases such as HIV.
If the bride’s result is positive, she is especially vulnerable to discrimination and violence. She could even be abandoned by her partner, ostracised by family and even suffer from other consequences of discrimination such as the loss of employment.
In many countries, including Malaysia, people living with HIV are still subject to the reality of stigma and discrimination.
This year’s World AIDS Day theme is “Know your status”. Not know her or his status. If it is true that there is so much public awareness and support for premarital HIV testing and knowing each other’s status, then it should not be a problem for the current requirement to be changed to voluntary testing and accompanied by proper counseling throughout the process. Whether you are Muslim or non-Muslim, you should know your own status. This should be the gold standard.