InterPress News Service (IPS) - Tuesday, February 17, 1998
Sadhana Mohan

In Maharashtra where the first AIDS case in India was reported in 1987, the state government has ordered all remand homes to conduct mandatory tests for HIV on girls within 48 hours of their arrival.

Reports of girls fleeing orphanages to escape the test and the resulting isolation have begun to come in. One girl who tested HIV positive in an orphanage in Nasik has run back to the SOS Medical and Educational Foundation that sent her to the orphanage.

"Where do we keep these girls?" asks a worried Dr. R. Goud, president of the Nasik-based Foundation. "Tomorrow they (authorities) could start checking women's hostels."

The government order states that if a girl is found infected with the virus that causes AIDS she should be "immediately transferred" to an institution in Sangli, in the state's south, that is being run by a women's welfare group on behalf of the state government. Bombay is the capital of Maharashtra state.

"She should be given appropriate care and treatment, without her knowledge, and this office is to be informed accordingly as soon as possible," the order written in Marathi-language from the state's Department of Women and Child Welfare states.

The government thinks that by identifying and segregating those infected it is protecting those who are not infected in the remand homes. The order not only runs contrary to the principle of informed consent -- it goes a step beyond and even talks of treatment without the knowledge of infected girls.

What is apparent is that the order is a clear imposition of the outdated isolationist approach, involving forced testing and discrimination. AIDS professionals and experts have been recommending an integrationist approach based on confidentiality and voluntary testing that allows a HIV-infected person to live like any other member of society.

The director of the National AIDS Control Organisation J.V.R. Prasada Rao says that the order is against the national policy which prohibits compulsory testing without consent and segregation of HIV positive persons. "I want the Maharashtra government to withdraw the order," he said in New Delhi.

"Such draconian measures are like going ten steps backward and wash out whatever has been achieved in making people accept those with HIV," fumes Anjali Gopalan of Naz, a private group working on HIV/AIDS issues.

In Maharashtra, the various government departments have been trying to disown responsibility for the thoughtless order. Dr S. Salunke, director of health services, said "I will see to it that the order is not implemented by the civil hospitals."

Meanwhile, T. Theckekara, secretary of the Department of Women and Child Welfare said the order had been issued by her director, and HIV was inadvertently added to the list of medical tests that should be done on girls.

However, she added that since a large number of children admitted into remand homes where "from the road", they are likely to have been sexually abused, and "a fair number of them could be infected with HIV".

Girls who test HIV positive would be moved to the Bhagani Nivedita Institution in Sangli, which voluntary organisations say is not equipped to provide specialised care. Bhagani Nivedita, as well as a rehabilitation home set up on the outskirts of Sangli, were part of a state government project to wean HIV-infected sex workers from the red light districts.

But within a year, at least four women who had tested positive but were still asymptomatic had run away and rejoined the flesh trade, two of them testifying that they would "rather survive on one meal a day in Bombay than die a torturous death in Sangli".

"Stigma and autocracy pervade what was to be a home," wrote Rupa Chinai about the experiment in a 1996 issues of 'Nexus', a publication that focuses on maternal, child and reproductive health issues, and AIDS.

Though the idea of a rehabilitation home for sex workers in the later stages of HIV infection was unique for India, the Sangli experiment suffered from the absence of trained counsellors and workers and the inability of those running it to provide even avenues of alternate occupation.

That the state government has not been able to formulate a coherent policy on HIV/AIDS despite the alarming spread of the infectious disease through heterosexual sex is clear.

The December order on compulsory medical testing of girls in remand homes was the second regressive policy decision reported from Maharashtra.

Earlier, it made an abhorrent suggestion of branding with indelible ink sex workers, pimps and brothel owners found to be suffering from sexually transmitted diseases in the draft of the Maharashtra Protection of Commercial Sex Workers Act (1994).

Last year, the AIDS Cell of the Bombay Municipal Corporation, and two remand homes Asha Sadan and St Catherine's conducted HIV tests without consent. A petition filed on behalf of the women by the Lawyer's Collective, a public interest group, put a stop to that.

Officials have not realised that force will not work in a matter so private and sensitive as health, particularly HIV. "It will drive people who want to take the test underground at a time when the concern is to prevent the spread of HIV," says Gopalan of Naz Foundation.

But even India's Health Minister Renuka Chowdhury in the outgoing government has not learnt the lesson. At a meeting of the National AIDS Committee last year she said she would like to make it mandatory for couples to test for HIV before marriage.

"It is scary to invite the government into our bedroom," protests Gopalan. "There is no guarantee that the person tested cannot get infected later in life ... I am not against voluntary testing of couples planning to marry -- if the young are negotiating sex." (End/IPS/sm/an/98)

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