Should there be mandatory testing for HIV prior to marriage in India?

The National AIDS Prevention and Control Policy of the government of India states that testing for HIV infection should be voluntary in nature. But from time to time various state governments and the central government have announced their intent of introducing mandatory premarital testing. Though this intent has not yet been translated into action, we present our case against the adoption of such a policy by discussing various social and medical issues. These include the limited population that such a policy would target given the early age of marriage in India; issues related to its implementation considering the low marriage registration rates in India; potential of stigma and discrimination associated with it; issues with defining boundaries and the role of the state; limitations related to the HIV test itself in context of the policy, including the window period and the positive predictive value of the test; its limited impact in population groups at a high risk for HIV infection; its limited role in changing unsafe behaviours; its limited potential to enhance the empowerment of women; its conflict with existing human rights; and the adverse experience of other countries with a similar policy.

Problems related to menstruation amongst adolescent girls.

OBJECTIVE: To study the types and frequency of problems related to menstruation in adolescent girls and the effect of these problems on daily routine. METHODS: Girls in the age group 13-19 years who had had menarche for at least one year at the time of study. 198 adolescent girls have been studied. Data was collected by personal interviews on a pre-tested, semi-structured questionnaire. The questions covered menstrual problems, regularity of menses in last three cycles of menstruation and the effect of these problems on the daily routine. Analysis was done using SPSS version 12. Percentages were calculated for drawing inferences. RESULTS: More than a third (35.9%) of the study subjects were in the age group 13-15 years followed by 17-19 years, 15-17 years respectively. Mean age of study participants was calculated to be 16.2 years. Dysmenorrhea (67.2%) was the commonest problem and (63.1%) had one or the other symptoms of Pre-menstrual syndrome (PMS). Other related problems were present in 55.1% of study subjects. Daily routine of 60% girls was affected due to prolonged bed rest, missed social activities/commitments, disturbed sleep and decreased appetite. 17.24% had to miss a class and 25% had to abstain from work. Mothers and friends were the most common source of information on the issue. CONCLUSION: Screen adolescent girls for menstruation related problems and provide them with counseling services and relevant information on possible treatment options. Besides, there is a need to emphasize on designing menstrual health programmes for adolescents.

Drug use among juveniles in conflict with the law.

OBJECTIVE: To study the pattern of drug use, reasons for initiation and the perception about the effects of using drugs, among juveniles in conflict with law. METHODS: A qualitative study was conducted at Prayas Observation Home for boys, New Delhi. Eight key informant interviews were conducted to find the prevalence of prior drug use among boys. Five focus group discussions were conducted with 34 children using a topic outline guide. RESULTS: The study showed that drug use was related to other criminal activities. Peer group and media were the most important influences for initiation of drug use. All kinds of drugs could easily be procured by children and there was a gradual progression from non-use to tobacco and alcohol use, to marijuana and ultimately to other drugs. Knowledge about medical and social mal-effects of consuming drugs did not seem to effect either the consumption of drugs or the desire to leave this habit. CONCLUSION: Results of the study demonstrate an urgent need for taking stringent measures in order to curb drug use among adolescents.