Minority with HIV infection must be identified

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7000.328b (Published 29 July 1995) Cite this as: BMJ 1995;311:328
  1. Eric L Smith,
  2. Ali Raddadi,
  3. Obaid Bin Obaid,
  4. Sherif Abdullah
  1. Head of dermatology and venereology Consultant dermatologist Associate consultant Registrar King Khalid Hospital, PO Box 9515, Jeddah 21423, Saudi Arabia

    EDITOR,--We fully support the conclusions of J A Evans and colleagues.1 In Saudi Arabia, where we practise, all antenatal patients are tested for HIV. Current philosophy emphasises respect for the human rights of people infected with HIV. The associated policies give little consideration to the rights of those who are not infected—and who is more innocent than the unborn child? Present policies concerning anonymity, confidentiality, and the rights of people infected with HIV are based on muddled thinking, ignorance, and fear and will be unsustainable for much longer. HIV infection affects a minority of populations. That minority should be identified and given every care and consideration possible. Fear of the unknown is greater than fear of the known. Those who suspect that they have been infected would be encouraged to come forward if they were not to be stigmatised, shunned, made redundant, or treated as lepers used to be.

    Our role as doctors is to prevent disease when possible, diagnose disease where it exists, treat to the best of our abilities, and always comfort the afflicted. If we are prevented from identifying infectious disease it will spread relentlessly and the human rights of the unaffected will become meaningless. Is it not better for people to know that they have an infection, have it treated in every way possible, be accepted as any other person with any disease should be, and live to the fullest that is possible but to be aware of the restraints imposed by the condition and so prevent unwitting spread to others? For most people infected with HIV the infection will manifest at some time. They may then have on their conscience the fact that they spread the disease unknowingly.

    In most countries, submitting to HIV testing is considered to be blameworthy. In Saudi Arabia all expatriates are tested as a requirement before they are employed. Rather than be seen as an invasion of a person's privacy or an infringement of his or her rights an HIV test should become as routine as any other test carried out in the interests of health promotion.


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