God, AIDS, Africa & HOPE

Reflections / Gedanken

21.09.2009 Stop pre-test counselling

After writing about the mandatory testing law to be introduced by our MEC of Health next year – at least that is his plan – I reflected more on it and I came to the conclusion, that mandatory testing indeed once again would medically stigmatize people.  Patients are entitled to refuse examinations and treatment options – and that also goes in my humble opinion for HIV and AIDS.  When I go to a doctor and he recommends a full blood test it is on me to say “yes” or “no” – if I am diagnosed with cancer it is on me whether I chose a treatment option or I let the cancer have its way without any further treatment. So I would suggest to include a HIV test into the normal full blood test, but with a clear “opt out” option.

And consequently  I would do away with the pre-test-counselling. I think it is rather a nice way of keeping thousands of people voluntarily or with low pay busy, but it once again segregates this virus. No one is counseled according to a book when he or she might have cancer or any other disease. It is done after a proper diagnose has been done – and that is how we should also treat the patient, who get’s a positive result.  I strongly believe that with all the – very often very unprofessional counseling – we scare people away and make the situation more complicated than it is necessary. Again, if somebody wants to have more information before a test – so it be like with every other test; but not more and not less. Let’s start to de-stigmatise HIV first in the medical field…

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Reflection, , , , , , , , , , ,

20.09.2009 Mandatory testing

Mandatory HIV testing ‘violates their rights’
(IOL website 19.09.09)

Mandatory testing for HIV would violate the rights of people, the SA Human Rights Commission said on Friday. This comes after provincial Health MEC Theuns Botha announced plans to introduce legislation in the Western Cape to have every patient at every health facility tested for the virus. Botha says the move is the final onslaught in the fight against the disease.
Currently 200 000 people in the Western Cape are estimated to be HIV-positive and 63 000 are on ARV treatment. Botha has started the ball rolling to draw up legislation which he anticipates will be ready by next March. He said the legislation was necessary as people had “avoidance” behaviour and chose to not be tested.
Dr Mark Heywood, of the Aids Law Project, agrees with the rights commission. The Treatment Action Campaign was divided on the issue, spokesperson Rebecca Hodes said. Steven Ngobeni, the national HIV and Aids health rights co-ordinator for the commission, said yesterday mandatory testing “does not make sense”. People, he said, often did not know their rights, counselling at voluntary testing centres was not up to scratch and universal access to treatment was not readily available.  Both Ngobeni and Heywood said the provincial government would make a greater impact by educating people about HIV and testing.  Heywood said: “There is no way that you could justify a law to introduce mandatory testing.” It was also wrong from a public health and HIV management perspective.  “I would suggest a public campaign to get people to go for testing. Right now people are avoiding being tested as there is too little information and routine offerings are haphazard.”  He said a law would not work. “People will still be scared of a diagnosis and they could in fact completely avoid health care facilities.”  The TAC’s Hodes said mandatory testing in Botswana had been successful but it had been rolled out as part of a broader ARV treatment campaign.
“Some say mandatory testing will increase stigma, others say it will destigmatise the disease. But if testing becomes mandatory there should be proper support,” she said.  Botha said on Friday it was a two-pronged approach – testing as well as getting people into treatment sooner.   “We would introduce people much earlier into a treatment programme,” he said.

An interesting article and I would like to add: We have to make HIV testing as normal as any other testing. Which would mean in a first step to remove all “extra doors & extra benches” for HIV testing, counseling, treatment and so on..” I even think we can stop the pretest counseling. Like any other diseases we have to advise after a diagnose and not before. If somebody has cancer, we also do not put him or her through a lengthy intimate process before he or she is allowed to have a result.

Being HIV positive is a medical condition in this frameset, let’s treat it as such.

Filed under: HIV Prevention, HIV Treatment, Politics and Society, Society and living environment, , , , , , , , , ,

21.08.2009 Judging people…

With the elevation of the Pius brotherhood through Benedikt XVI into the public eye we all can see and sense a new dawn of those, who are living in the past of the RC church and have refused to develop their faith. This in itself isn’t worrying. If people feel fine with the good old days and they want to keep them until they die – why not, if they apply it only to themselves. The danger is that with all the discussion now in the public forum, the old pictures from judgement, from evil, hell and condemnation, from a God acting like a policeman or a bookkeeper emerge again and that is the scary part. Reading about a priest in Austria starting to scare First Communion kids with hell and eternal condemnation – such teaching is surely encouraged through all the debate about the Pius brotherhood.

To spell it out again and again – and you can ask my community in Cape Town, they know it meanwhile and dream of it and can memorize it: God is love – unconditional love – and nothing ever can make us say that somebody has fallen out of the grace and mercy of God. Nobody! All those nevertheless doing it, denying that God is so much greater than all our thinking and understanding.

And this non judgemental unconditional love applies especially when it comes to such tricky topics like HIV and AIDS. There are no innocent babies and no not so innocent adults. There are only brothers and sisters with a certain condition. Point. No “Moralin”, no “Gardinenpredigt” – just acknowledgement, embracing of the condition and then the question, how to deal with it in a way beneficial to the person and his or her environment. Changing the stigma to a tool of compassion and mercy, self-knowledge and maturity.

I guess, if there is anything people living with the virus need besides good treatment and good friends it is people fighting like hell the stigma in our societies, fighting the travel bans, the discrimination, the human rights violations and fighting those who point fingers. And I have learned in my life: The more hostile people point fingers, the more they have to hide…

Filed under: HIV and AIDS, Reflection, , , , , , , , , , , , , , , , , , ,

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