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Proposed New AIDS Testing Procedures Stir Controversy

A proposed U.N. policy to require medical professionals to recommend that high-risk patients be tested for HIV has met with disagreement in Asia. Rory Byrne reports from Phnom Penh.

The United Nations estimates that less than 10 percent of people infected with the HIV virus in the Asia-Pacific region are aware that they have it. AIDS experts say this is a major obstacle in the campaign to prevent the spread of the disease.

At an AIDS conference this week in Phnom Penh, U.N. agencies are examining a new policy that would require health-care providers to recommend an HIV test for all patients in high-risk groups, such as sex workers or drug abusers.

J.V.R. Prasada Rao, who heads the U.N. AIDS agency's regional support team, says patients must ask to be tested.

"Under the present policy, any person who would like to know his or her HIV status can come to a hospital or health center and seek a test, but we find that adequate numbers of people are not availing, [taking advantage of this facility], and because of [that], the roll-out of the anti-retroviral program in countries is not picking up adequate numbers of people, because many of them, they do not know their HIV status," said Rao.

Rao says the goal is to combat ignorance of the disease and help those infected get treatment.

"The health-care provider can offer the test. It is not obligatory," he continued. "The patient can still refuse the test. But otherwise the provider gives the test, and, if the person is HIV-positive, there is an obligation to follow-up with services."

But AIDS advocacy groups and other civic organizations warn that the new testing plan might discourage people from seeking health-care services altogether. They worry that people will feel pressured into taking the test.

Other activists say even if more people are tested, many countries in Asia lack the medical facilities to care for those who test positive.

Community medicine specialists like Daniel Tarantola, a professor at the University of New South Wales in Sydney, say that it is important to strike the right balance between protecting the community from exposure to HIV and guaranteeing people's right to make their own decisions.

"The reason is that if you violate people's human rights, if you violate their dignity, then you basically drive people away from services," said Tarantola. "You drive people like sex workers and drug users underground because they are afraid of all sorts of pressures that come from the system - health system and others, and the intended goal, which is to protect public health through the protection of individual health, is defeated."

Tarantola says he and other experts will look carefully at how the new U.N. HIV-testing guidelines will be adapted to the needs of Asia-Pacific countries.

The UNAIDS office will consult with medical professionals and AIDS activists throughout the region to refine the policy.