Wednesday, December 31, 2008

Pre-Marital HIV Test/ 强制性婚前爱滋检验

马华政府政策监督局记者会
日期:2008年12月31日
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为了控制爱滋病毒蔓延,政府强制穆斯林须进行性婚前检验。目前,有些方面建议当局应强制非穆斯林也须进行婚前爱滋病检验,各造正为此争论不休。

马华政府政策监督局认为,非穆斯林婚前进行爱滋病检验,应该是自愿而非被强制这么做。

强制婚前检验措施其实并不能有效控制爱滋病扩散和蔓延。因为:
1)只有被检验当下才有效。患者虽被检验出患病,但若他过后仍继续发生没有安全措施的性行为,将会有更多人继续被传染。
2)在马来西亚,患者资料的保密程度让人担忧。因为许多接受检验的夫妇很可能是潜在的患者,而处理检验的则是普通的医务人员,因不小心泄露资料或提供不实讯息,将对当事人带来打击。
3)动用太多人力、财力和资源,惟效果不大。一般上,每一万接受检验的人群,只有约5%的成功检测个案。与其这样,不如利用有限的资源,进行以下助益更大的项目:
  • 为爱滋病辅导专员提供辅导
  • 为医务人员提供爱滋病管理和医疗培训
  • 用以爱滋病的治疗
  • 赞助爱滋病醒觉和教育活动
  • 推动已证明有效的减害计划和美沙酮替代替代疗法

4)政府的目标不仅是检验爱滋病个案,更重要的必须实行有效的爱滋病管理,而辅导和教育就是必要的项目。这可能需要改变病患的举止心态和工作模式。目前,我们却没有足够的资源专业地展开这些工作。

因此,我们更迫切需要资源为医务人员和辅导专员提供专业培训。若没有良好的管理和治疗,纵是成功检验爱滋病个案,也无法有效遏制病疫继续蔓延。

根据国际爱滋病患人权指南,以爱滋病患必须进行检验并出示检验证书作为授准结婚的先决条件,已经违反了病患的人权,也侵犯了病患结婚的权力。

最近有一位州务大臣甚至建议所有爱滋病患必须隔离,这种想法只突现他对爱滋病一无所知。

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Press Statement

As part of its effort to control the spread of HIV, the government has introduced mandatory pre-marital HIV test for Muslims. 

Now, there is an ongoing debate about extending this mandatory pre-marital HIV test to Non-Muslims.

MCA Government Affairs Monitoring Bureau is of the view that for Non-Muslims, it should be voluntary and not by compulsion.

Mandatory pre-marital HIV test will not control the spread of HIV effectively. Why?

1) It is only good at that point of time of testing but often give rise to a false sense of security.  The sexual behaviour after test is more important since the high-risk individual will continue to be exposed to the risk of infection.

2) In the Malaysian setting, we are worried about the confidentiality since many prospective couples are involved in the tests. A lot of these cases will be handled by mid and low level medical staffs.  The social stigmatism because of leaked or false information can be tremendous.

3) A lot of manpower and financial resources are committed to detect often very few cases.  The pick up rate is low, about 5 per 10,000 cases.  These limited resources should be used for:

a) Training of counselors

b) Training of medical staff

c) Treatment of HIV cases

d) Funding for HIV education

e) The Harm Reduction and Methadone Replacement Therapy that have proven to be effective.

4) Often it is not just detecting a HIV case.  Of more importance is the counselling and education that is required as part of the management.  It may require the change of job and behaviour pattern of the patient.  We just do not have the resources to do this professionally as yet. 

Hence, resources for training the counsellors and medical staffs become more urgent than premarital HIV tests.  A detected case of HIV without proper treatment and management will not prevent the spread of HIV infection. 

In regards to human rights, the international guideline on HIV/Aids and Human Rights states clearly that the right of people living with HIV is infringed by mandatory premarital testing and or the requirement of AIDS - free certificate as a pre-condition for the grant of marriage license under state law.  This implicates the right to marry.

One state MB went as far as to suggest that HIV carrier should be quarantined.  This just illustrates the level of ignorance even among our leaders about HIV.

5 comments:

Bangsa Cina Malaysia said...

there is not a place in this country that is clean tidy and orderly.

rubbish is everywhere from the drain, pavement the market , housing estate whether its the front or back lane, the food court , the industrial area.

apart from all these nonsense the electrical pole , traffic light pole, telephone pole , signboard pole are all in slanting position.

why is it all those majlis perbandaran from the bottom to the top are not sacked when it is proven they cannot perform all these years.

employ only those who really care about cleanliness and love the environment and reward them dearly.

we voted for change and changes are what we want to see.

el said...

this is a "need", but not a "must". i mean, a need shows that we open to our another half, as we love him/her. we want to gain the trust. maybe need to plan out for this.

Pearls said...

Aiyah.. make this mandatory, that mandatory ma si got ppl find ways and means to siam such rules!? What is worse is that it will give "business opportunity" to evil idiots to make a quick bucks from desperados who wants to get married but too scared to go for HIV test. Yes la, a lot of miang men and women out there who love to ra-ra so much until they dont even know who they have ra-ra with!!

The point is this, people must want to go for the test voluntarily because they want to be responsible for themselves la. What is this force force business?? This is Malaysia la.. force just simply means, find other ways to outsmart such ruling la. The fatsoes running the country still dont get it till today! Dense or what?

NEIL said...

DR,When are you going to get your ministerial post!If you don't see eye to eye with him,then challenge him for the president post.You have all our support.

Anonymous Says said...

Dear Doctor,
There was a time when the HIV test is considered a hush hush investigation and the result only known to the patient and the doctor. Sadly the HIV cases have gone up and innocent spouses are infected with it. The good point is it will reduce the cases. But the bad point is it is like interfering in one's private life. One will feel very insulted with the suspicion that she or he might have AIDs. As for the part whereby KKM's staff is not able to keep a secret because not all are highly qualified, well, even the so called professionals are not known to keep secrets. May be it is the typical Asian culture whereby whispering is a favourite past time activity. Education is therefore very important to prevent AIDs.

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