South Africa: Judge Challenges HIV Counselling

Health-e, Cape Town, By Kerry Cullinan, May 4, 2006

South Africa--HIV tests should be routine in health institutions that offer AIDS treatment, says Judge Edwin Cameron. Counselling before an HIV test discourages people from testing and is a barrier to AIDS treatment, according to one of the country's leading AIDS activists.

In a provocative address to University of KwaZulu-Natal (UKZN) students yesterday (Thurs 4 May), Judge Edwin Cameron said that extensive pre-test counselling had been appropriate in an era where there was no treatment for AIDS and HIV positive people faced little but discrimination.

"But we now have a mass epidemic where mass treatment is also possible, so extensive pre-test counselling may be a luxury we can no longer afford if we are to reach everyone who needs treatment," said Cameron.

Health workers should be able to routinely test patients for HIV in places where AIDS treatment was available, there was no discrimination and patients' HIV status was kept confidential, said Cameron.

"When a person is suspected of having breast cancer, their doctor does not have to counsel them extensively before testing them for cancer," said Cameron. Before AIDS treatment had become widely available, human rights activists had "exceptionalised AIDS", he said. Extensive counselling was one of the protective measures "designed in a world where an HIV diagnosis meant discrimination".

"The challenge we now face is to normalise AIDS treatment," said Cameron. "Where treatment is available, exceptionalising AIDS impedes treatment. There is no reason why AIDS should be treated differently from breast cancer or any other disease."

In Botswana, where antiretroviral treatment has been freely available since 2003, HIV tests without counselling are routine at clinics and hospitals unless a patient refuses to have a test.
Cameron was speaking at a memorial meeting for UKZN law lecturer Ronald Louw, who died almost a year ago of AIDS.

Describing Louw as an "eloquent, informed, AIDS-literate man", Cameron said he believed Louw was too afraid to take an HIV test until it was too late because of a sense of "inner shame".
Louw was diagnosed with HIV when he was admitted to hospital less than a month before his death. This was despite the fact that friends concerned about his health had asked him to go for an HIV test some two years before his death.

"Ronald died of a paralysing dread of confronting HIV. He was unable to take constructive action to seek life-saving treatment because he lacked internal self-acceptance," said Cameron.
Cameron added that he had also visited St Mary's Hospital outside Durban, yesterday. Despite the fact that the hospital had a renowned AIDS clinic, staff were dying of AIDS because they were too afraid to get tested, he said.

"Internal self-acceptance [of AIDS] has nothing to do with educational levels or sophistication. It is an emotional, human thing. Pre-test counselling may feed into the internal stigma and mean
that people who need treatment refuse to be tested."

Souce: AllAfrica.com

Viet Nam: Voluntary HIV testing project launched

April 27, 2006, Viet Nam News Service

HA NOI — HIV voluntary counselling and testing (HIV/VCT) plays an important role in the prevention of HIV/AIDS, said Nguyen Huy Nga, director of the Health Ministry’s HIV/AIDS Department, at the signing ceremony for the Mekong Regional HIV/VCT Project in the capital.

Since Viet Nam still experienced discrimination against HIV/AIDS patients, the project is all the more important, the director said, promising his department’s support for the project being carried out by Marie Stopes International Viet Nam (MSIVN).

Lauding the HIV/VCT work done earlier by MSIVN and their experience in treating patients, Dr Nguyen Duc Anh said, "Our patients feel more comfortable and face no discrimination at MSIVN’s HIV/VCT programme."

Other than HIV/VCT, MSIVN’s clinic also provides other services such as reproductive health counselling and treatment, benefiting female patients, the doctor said.Anh added that sex workers, especially those working the streets, required this service more as they travel frequently and have no other facility to check for HIV/AIDS and treatment.

Such clients, who have the potential for spreading the disease, would find the clinics safe.Dr Om Chhorvoin, the project’s regional director, said they would carry out the service not only at the MSIVN but also in other clinics to serve the clients.

Together with China and Indonesia, Viet Nam is a nation with a high growth rate of people having HIV/AIDS among groups such as addicts, prostitutes and homosexuals.

According to Viet Nam’s Department of HIV/AIDS, there are over 100,000 people having HIV/AIDS, including more than 17,000 AIDS patients and 13,000 newly-infected cases.
Nga said though Viet Nam had reported a reduction in newly-infected cases from 17,000 in 2002 to 13,000 in 2005, the country was still at risk if no effective control was in place.

Relevant agencies could not even update the count of HIV/AIDS patients in Viet Nam as many were not aware if they were carrying the disease, rendering the fight against the dreaded disease more complex, Nga said. "Our current figure may represent only one third of the real patients," he said.

The MSIVN clinic would remove the inhibitions of patients who refuse to go to specialised HIV/AIDS testing centres for the fear of being discriminated.With three years experience in this service, MSIVN have pledged to provide their patients with friendly, helpful, high quality, safe and secure service. Furthermore, the project aims to increase awareness among the public about HIV/AIDS.

Nguyen Bich Hang, director of MSIVN, asked domestic and international agencies and organisations to support the project and the fight against HIV/AIDS. — VNS

Source: Viet Nam News Service Online