Anyone who visits a health centre or hospital for treatment will be required to undergo an HIV test if Health Ministry officials get approval for a new plan.
Dr Alex Ario, the HIV/Aids control programme manager at the ministry, said the new ‘Know your Status’ policy is in response to an increase in HIV prevalence in the country. “People who know their status are unlikely to engage in risky behaviour,” Dr Ario said. “The important question is: What do we lose if everybody is tested?”
HIV testing is currently voluntary. Under the new plan, people who attend health centres will have to take the HIV test as part of their treatment or check-up. Those who test positive will immediately be enrolled on a counselling and treatment programme.
Those who do not wish to know their HIV status “will not be forced to receive the results, but will be kept at the facility,” Dr Ario said. Mandatory HIV testing is not without controversy.
The HIV/Aids Prevention and Control Bill 2008, which is still before Parliament, provides for mandatory testing for HIV and forced disclosure of HIV status. It imposes a five-year jail term for people who knowingly infect others with HIV.
UNAIDS country coordinator Musa Bungudu said although testing all people at health facilities would be a good move, it should not be compulsory.
“In the world of today you cannot even force your own children to test but the most important thing is to provide an opportunity for people to test and if found negative, they be given information on how to stay negative and if found positive be given information on treatment and nutrition,” Dr Bungudu said. He called for increased pre-marital testing as well as the rolling out of testing services deeper into the population.
Compulsory testing is likely to face opposition from civil society and human rights groups.
Mr Moses Mulumba, the executive director of Centre for Health Human Rights and Development, a civil society group that has petitioned the United Nations over the mandatory testing in the HIV/Aids Prevention and Control Bill 2008, says the move would violate human rights and would not be effective. “If people are just targeted at health facilities the fact is that it is mostly women who seek for the services so men would be left out,” Mr Mulumba said.
The latest HIV/Aids indicator survey released this year shows that prevention efforts are failing and prevalence rising; at least 500,000 people contracted the virus in the last five years while at least 20,000 babies are infected at birth every year.
On World Aids Day, President Museveni expressed dissatisfaction with the current prevention approaches and warned that the country was paying the price of straying from the original message of abstinence, faithfulness, and condom use. “We are examining everything to see what went wrong,” Dr Ario said. “What we have seen is we need to bring everyone on board; we need everyone to think and see that HIV is still a big public problem.”