GS2 – Governance
Context:
Meghalaya, following Goa, is considering making premarital HIV/AIDS testing compulsory, sparking debate over health benefits, human rights, and personal liberty.
HIV/AIDS – Basics & Current Status in India
- HIV (Human Immunodeficiency Virus): Attacks CD4 (T) cells, weakening the immune system.
- AIDS (Acquired Immuno Deficiency Syndrome): Final stage of HIV infection, marked by severe immune failure.
- Prevalence in India:
- 2.5 million People Living with HIV (PLHIV).
- Adult prevalence rate: 0.2%.
- ~66,400 new infections and ~69,000 AIDS-related deaths annually (UNAIDS).
- Highest prevalence reported in North-East states (Mizoram, Nagaland, Manipur).
Arguments in Favour of Mandatory Testing
- Prevention of Transmission: ART treatment after detection helps prevent spousal and vertical (mother-to-child) transmission, potentially avoiding thousands of new infections.
- Family Health Protection: Early detection reduces AIDS-related deaths and secures family well-being.
- Women’s Safeguard: Particularly relevant in high-prevalence North-East states, where women face greater vulnerability.
- Awareness & Linkage to Care: Encourages testing, ART enrolment, and viral load suppression nationwide.
Arguments Against Mandatory Testing
- Human Rights Concern: Compulsory testing undermines the principle of informed consent, violating the HIV & AIDS (Prevention & Control) Act, 2017.
- Stigma & Discrimination: May intensify social prejudice against HIV-positive individuals.
- Practical Barriers: Cultural taboos, extramarital norms, and low condom usage could limit effectiveness.
- Privacy & Voluntary Care: Forced testing risks breaching privacy and discouraging voluntary participation in testing/treatment.
Government Initiatives & Targets
- NACP Phase-V: Targeting an 80% reduction in new HIV infections and AIDS-related deaths by 2025–26 (baseline: 2010).
- Mission Sampark: Focused on awareness, testing expansion, and high-risk group identification.
- 90-95-95 Goals: India aims for 95% detection, 95% ART coverage, and 95% viral suppression. Current progress: 81% diagnosed, 88% on ART, 97% with suppressed viral load.