HIV testing must be kept voluntary and confidential, says ICW

Press release - There is a growing and alarming trend by health service providers around the world to routinely test for HIV unless people say no. At the 16th International AIDS Conference in Toronto policy-makers will be talking about opt-out and opt-in testing. Some countries are calling for a dramatic increase in opt-out testing. This means if a person does not expressly say no (opt-out), they can be tested for HIV. ICW is critical of opt-out testing.

‘When I got pregnant at 16 I knew nothing. I didn’t know I had a choice not to be tested. You can’t just ‘opt-out’. (ICW member from South Africa)

ICW supports testing where the individual makes an informed choice to be tested (opt-in). Unless people realise they can say no to an HIV test and have the confidence or power to make that choice, this strategy will take away their control over deciding and preparing themselves for HIV tests and the results.

Other concerns are

Testing services often do not address the stigma, discrimination and related violence, and loss of livelihood that many women face if their status becomes known. This makes seeking treatment and care a devastating prospect for many.

Routine testing will mean that women are deprived of counseling before and possibly after they are tested.

Routine testing in antenatal clinics has led to women being blamed for bringing HIV into the family, even when their husbands have infected them. It also discourages women from using these services.

When people feel they are being pressured to test and when there is limited counseling, care, treatment and support, testing will further stigmatise vulnerable people.

Women who are tested or "offered" an HIV test during labor and delivery are burdened with the need to decide during a time of stress, such that they are prevented from giving truly informed consent and, if positive, from effectively dealing with the implications.

Labour and delivery are stressful times for women. Women who are tested or ‘offered’ a test while in labour cannot give truly informed consent, nor cope effectively with the implications of a possible positive result.

Testing should not be confused with prevention and treatment. All too often the success of testing initiatives is judged by the number of people tested, but this is not a measurement of success.

An ICW representative says, ‘The aim should not be to get as many women tested as possible. The aim should be to ensure that women get their rights to health, informed choices and to live free from violence.’

ICW wants more flexibility in the availability of testing facilities, greater respect for our right to choose whether to be tested and non-judgmental information and support so we can make more informed decisions about testing, child bearing and rearing. We support service provider-initiated opt-in testing which gives people the right to make personally informed choices.

Notes to Editors - ICW can put you in touch with HIV positive women at the conference who are willing to talk openly about these issues and about their own lives.