Marriage Blood Tests
Back in the 1930s it became mandatory in most of the U.S. and several other countries for couples wishing to get married to first have blood tests done to detect whether either party was infected with syphilis, gonorrhoea or chancroid .
All three tests prevented prenatal diseases or birth defects, which was the major concern. However, this was before the advent of penicillin and other antibiotics, which could eliminate the sexually transmitted diseases. Thereafter the requirement for the tests gradually petered out.
Today there is a growing body of opinion across the globe for the reintroduction of blood tests in light of new medical knowledge about several genetically transmitted diseases and of course, the global epidemic of HIV/AIDS that is inexorably gaining ground.
For instance, the state of Georgia eliminated the test requirements a few years ago only to rescind it so as to require the testing for rubella (German Measles) and sickle cell anaemia (for African-American women) both of which pose severe health risks for newborn infants.
Iran, Saudi Arabia and Malaysia have made premarital blood screening compulsory by law. Pakistan is about to vote on enacting such a law. Of particular concern to those societies is the prevention of the transmission of HIV/AIDS and thalassemia. The latter is a term used for a range of hereditary diseases caused by faulty haemoglobin synthesis.
Those in whom the disease is manifest have to undergo fortnightly blood transfusions but rarely survive beyond twenty years.
In Guyana HIV/AIDS has reached epidemic proportions. Even though the government has performed yeoman service in trying to get on top of the HIV/AIDS epidemic, the fatal disease continues to be the major public health threat to our nation.
As of the end of 2006, there were 7,831 AIDS cases in Guyana – spread across all ten regions. On Friday, Health Minister Dr Leslie Ramsammy said that there were 12,000 AIDS cases in Guyana.
Extrapolating from those figures, it is acknowledged that we have one of the highest rates of HIV infection in the world. Contrary to the general stereotype, the transmission of HIV is primarily through heterosexual exposure and the majority of the cases are among persons 20-44 age group – the prime child bearing age. In our edition of yesterday the Minister of Health is reported as asserting that the figures quoted above have been reduced significantly since then but that the overall numbers were still unacceptably high.
Apart from the unknown number of children who contracted the disease from their mother, as of 2004 there were 4,200 children who were classified as orphans and vulnerable children as a result of AIDS. The knowledge that the disease can be transmitted by breastfeeding and that this risk can be significantly reduced by the mother taking drugs during pregnancy is relatively low.
It is our contention that a law requiring mandatory testing for HIV/AIDS and other specified diseases or inherited genetic disease ought to be considered and debated at this time in our country.
Such a law would provide clear information with regards to the health status of both spouses before marriage is to take place. Thus, neither spouse will be vulnerable to a disease and would be in a position to make an informed decision concerning the dangers to their future offspring.
There are two major objections to such a law. The first would be that it unnecessarily interjects the government into what is a fundamentally private matter. But the state has an overriding duty to the unborn that must be protected.
We propose that the law would not prohibit marriage but mandate counselling for those infected so that, for instance the mother would become knowledgeable about how to reduce the risk to the unborn.
There is also the issue of implementation costs; but from the Minister’s recent comments, it would appear that the facilities are already in place to deal with the requisite tests.
It is not expected that the law would eliminate the transmission of HIV/AIDS or genetically transmitted diseases but it would certainly go a far way in reducing the risks for the unborn, who are the most vulnerable and innocent.