WOULD you take an HIV test? If this question had been asked a decade ago, most people would have said no. Back then even taking the test was seen by some insurance companies as an admission that a person indulged in 鈥渞isky鈥� behaviour. A positive result was not only a death sentence, it also killed off any hope of taking out a mortgage to buy a home. Then there was the discrimination from employers, friends and even family.
How things have changed. In rich nations the arrival of antiretroviral drugs demoted HIV from killer virus to chronic infection. People who are HIV-positive may find their insurance premiums loaded, but they are no longer excluded from taking out life cover. The stigma attached to HIV and AIDS has not gone completely, but it is disappearing.
In line with changing attitudes, the US Centers for Disease Control and Prevention and the World 91色情片 Organization plan to offer HIV tests to anyone visiting their doctors. The aim is to identify people with the virus early on so they can begin treatment. This will also benefit society, because those who have contracted HIV but do not realise it tend to spread the virus, while after a positive test they are likely to temper risky behaviour.
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There are still some privacy issues over state-run testing schemes (see 鈥淭o know or not to know鈥︹��), but for people with access to antiretrovirals the benefits of testing appear to outweigh the disadvantages. Whether the same is true for everyone is a different matter.
The WHO wants to use routine tests in countries where HIV prevalence is high, particularly in sub-Saharan Africa. Here, it is not certain that people are better off knowing their HIV status. In some places, HIV still carries a stigma: women especially can be shunned or suffer violence after being diagnosed. In the absence of antiretrovirals, a positive test is still a death sentence.
It is true that even without antiretrovirals, HIV-positive people can benefit from taking the test: antifungal drugs and other preventives can improve quality of life. People can also be counselled about nutrition and put in touch with patient groups, but these are minor advantages.
A chicken-and-egg situation exists here. Research suggests that routine testing could help to reduce the stigma and violence associated with a diagnosis of HIV. But for people to agree to be tested, they must be convinced that they will receive some personal benefit if their result is positive. The only way to provide this reassurance is to ensure that antiretrovirals are available at affordable prices to everyone.
