August 15, 2025

Meghalaya's Health Minister Mazel Ampareen Lyngdoh recently announced the possibility of making HIV/AIDS testing mandatory before marriage, taking a page from Goa's earlier proposal. But wait — should HIV testing be forced on people? This question has sparked a fiery discussion among experts N. Kumarasamy and Jahnabi Goswami, moderated by Ramya Kannan. Dr. Kumarasamy says, "Making anything mandatory is not acceptable" when it comes to HIV. He explains that India's HIV and AIDS (Prevention and Control) Act, 2017, clearly requires counseling before testing and only tests with patient consent. "Mandatory testing without consent is a human rights violation," he warns. With proper antiretroviral treatment, an HIV-positive person can reach an undetectable viral load in 2-3 months. "A person with an undetectable viral load will not transmit infections sexually," he adds, painting a hopeful picture. But Jahnabi Goswami disagrees and supports mandatory testing before marriage, pointing to real-life heartbreaks. In the northeast, many HIV-positive injecting drug users marry without revealing their status. "The spouse finds out only later, or when they test positive," she says. "Children can also be affected." Goswami argues that just like families check horoscopes to see if couples match, why not check HIV status? "This test will ensure the health of the family," she states firmly. On whether mandatory testing empowers women, Goswami highlights that it could protect them from hidden HIV risks. Injecting drug use causes nearly 64% of HIV infections in Meghalaya, many cases where men hide their status. "To safeguard women and girls, mandatory testing with counseling is essential," she asserts. But Kumarasamy cautions that mandatory testing can backfire. People might secretly get tested elsewhere, risking false negatives during HIV's window period and unknowingly spreading the infection. He advocates for wide voluntary testing with confidentiality and consent. Regarding Goa’s situation, Kumarasamy reveals that while widespread testing happens, mandatory HIV tests before weddings are not enforced due to human rights concerns. Meghalaya ranks high in infections due to injecting drug use and sexual contact, but Kumarasamy urges learning from southern states like Tamil Nadu and Kerala, where voluntary testing and treatment linkage help control HIV. Cultural challenges in Meghalaya add spice to the problem. Goswami points out some Christian communities still see condom use as taboo, making HIV prevention tough. Extramarital affairs and live-in relationships are common among youth, increasing risks, but HIV-positive people face harsh discrimination. Stigma is the biggest villain here. Kumarasamy explains that HIV stigma began when the infection was first linked wrongly to commercial sex work. He says, "The message U=U (undetectable equals untransmittable) does work," urging communities to learn that HIV is manageable and not easily passed when treated. Goswami adds, "People openly talk about cancer or diabetes, but HIV is seen as a behavioral issue, which increases stigma." She calls for more awareness, better counseling, and HIV-positive role models to shatter discrimination. This engaging conversation highlights the tightrope between protecting public health and respecting individual rights in Meghalaya’s fight against HIV. Will mandatory testing become reality, or will consent and counseling remain the backbone of prevention? The debate continues with passion and care.

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Tags: Hiv testing, Meghalaya, Mandatory testing, Hiv stigma, Antiretroviral treatment, Hiv law,