Since moving to Ontario from another province in Canada over four years ago, I have been able to find a caring, understanding and professional physician as my family doctor. Besides helping me with the occasional runny nose or ear infection, she also insists that all her patients submit to a yearly physical. The very first exam that she ever administered included some questions that I had never been asked before. First, did I believe that my spouse was faithful to me? Secondly had I been faithful to my spouse? And, finally, did I want to receive an HIV test along with the other routine tests that she would be requesting for me?
I must confess that these questions took me aback. I really never took the time to think whether or not my spouse was capable of looking outside our marriage for sex. As someone that was working in the sexual and reproductive health and rights field I knew that one of the growing groups for new HIV infections was for young married women and that I fit the bill perfectly. The more I thought about my doctor's questions, the more I began to think that she was doing me a favor by asking me these questions. Still, the choice to have the test was mine alone.
In September of 2006, "United States health authorities recommended all Americans between 13 and 64 be tested when they go for a check up." This prompted the debate to pop up in Canada with various sides weighing in on what should be done. The obvious reasoning as to why there should be mandatory testing is that many people wrongly assume that they are not at risk, or that "it can't happen to them." As well with advancements in treatment HIV can be controlled, therefore many argue that the "death sentence" mentality that used to apply no longer does, and that the sooner that an individual is diagnosed that sooner they can begin treatment to fight the affects of the disease.
Other groups that are being faced with the mandatory testing question are pregnant women and immigrants. Knowing that mother-child HIV transmission can be reduced, should all women be tested for HIV so that the appropriate medicines can be administered to both women and infant? Can and should and individual not be allowed to immigrate to Canada based solely on their HIV status? By asking immigration applicants to submit to mandatory testing will not help to reduce the spread of HIV here in Canada, but it will help to contribute to the myth that HIV is no longer a problem in the "developed world."
Demanding that individuals submit to testing is counter productive to the reproductive rights movement which is based on the principal of choice. We as citizens have a social responsibility to find out our status in order to help combat the spread of HIV. However, the reality of the moment is that HIV stigma is still very much alive and that misperceptions about the disease can have negative effects on those that are at risk. With proper sexuality education and pre-test counselling we will all be as happy to submit to an HIV test as we do cholesterol tests.