Scaling up HIV prevention: Why routine or mandatory testing is not feasible for sub-Saharan Africa

Abstract

Testing for HIV is a crucial part of an effective prevention and treatment of AIDS. It is essential for determining the best possible time to start antiretroviral therapy and for preventing transmission of the virus as people become aware of their sero-status. For a number of years voluntary counselling and testing (VCT) has been central in the global strategy for containing the AIDS pandemic. However, with millions of people living with the virus unknowingly and cases of late diagnosis increasing, many have argued for a more pragmatic approach to fighting HIV/AIDS with routine and mandatory testing gaining increasing attention. In this paper, I analyse the feasibility of routine or mandatory HIV testing for containing the AIDS pandemic in sub-Saharan Africa.