Mandatory Testing

An Ineffective Measure
Mandatory testing is fraught with a multitude of issues that suggest that it is not only ineffectual in reducing the incidence and spread of STIs but it may actually cause the spread of more disease. The 1800s saw a rash of Contagious Disease Prevention Acts first in England and then in the United States. Rather than reduce the spread of venereal disease, “the incidence of venereal disease rose steadily during the period until the act was repealed…” (5) As Priscilla Alexander points out “many studies have found the rate of infection is higher among registered than unregistered sex workers, and condom use is higher among unregistered sex workers than in those [who are] registered.” (6)

As the recent scare in the Los Angeles porn industry so aptly illustrates, testing for HIV, whether mandatory or voluntary, means little when it comes to the prevention of disease. Although an unnamed male performer was tested for HIV every three weeks, adult movie producers were forced to shut down when he tested positive for HIV. About 45 actors and actresses who had had sex with this performer or persons who had had sex with him, put themselves on voluntary quarantine as a result. Dr. Jonathan Fielding, director of public health and health officer for Los Angeles County, said that the discovery shows that screening programs are not perfect and the only way to prevent AIDS is not to have unprotected sex. As any health care professional knows, there is a window between infection and seroconversion when no amount of testing can guarantee that HIV will not be spread during sexual contact. Whether prostitution is linked with the increased spread of disease or not mandatory testing will never be a solution. Mandatory testing is illogical and unscientific due to seroconversion rates as well as current statistics which establish the practice as ineffectual in preventing the spread of disease. In addition, mandatory testing has the net result of discouraging targeted populations from seeking medical intervention because of the fear and stigma that it inculcates. Compound this with the false sense of security that can and does lead tested individuals to engage in unprotected sex and testing becomes a sure fire formula for disaster. So why does the myth of mandatory testing persist?

Violation of Civil Rights
If one reviews all the instances where mandatory testing has been successfully introduced, an interesting pattern reveals itself. Mandatory testing has been applied to smaller disenfranchised portions of the population including immigrants, boxers, military personnel, prison inmates, persons convicted of sex crimes including prostitution, and legal brothel workers. Attempts to test the general population in specific instances such as marriage have been short-lived as the voters recognized it for the huge violation of their civil rights that it is. Mandatory testing for HIV was recommended for health care providers (including dentists and surgeons) early on when the public was more fearful of AIDS. Of course it never happened. The medical community is far too powerful to consent to losing their rights to privacy. However, some doctors are currently crying for the mandatory testing of patients, particularly pregnant mothers and their newborns.

I can only observe how typical it is that predominately male doctors wish to exert control over the lives and bodies of women in the name of public health. I do not think it is any accident that the public feels a need to control the lives and bodies of women employed in the sex industry, either. For all the proclaimed interest in preventing the spread of disease, no one is suggesting that we mandatorily test the men who purchase sexual services, let alone ALL men who have sex of any kind with anyone. Does one really need to point to the obvious sexism? If mandatory testing makes medical sense for vaginas (which it does NOT), then it must make medical sense for penises as well. One cannot deny that a population of government inspected sex workers might be a comforting thought for the consumers of sexual services. So while mandatory testing may serve some function as a marketing ploy for brothel owners and the governments which tax them; it cannot be promoted as a public health measure.

Us Against Them
Mandatory testing is the ineffectual cry of fear from those resorting to the oldest human frailty of thought and behavior: “Us against them.” Whether this way of thinking is applied to justify genocide, slavery, detention camps, or mandatory testing, it all boils down to a hateful attempt to separate oneself from a perceived “other” who serves as a scapegoat for conditions we all face as human beings. Sexually transmitted infections are spread by all humans regardless of their gender, race, and occupation – whether the sex act occurs for purposes of procreation, pleasure or profit. Germs don’t care about morals or dollar bills. That was true for the bubonic plague and influenza (which incidentally has killed far more people than AIDS) and it will always be true of any disease.

It is time for the general population to grow up, take responsibility and stop pointing a blaming finger at people who look different from them or lead alternative lifestyles. Educating the public on safer sex practices and away from their false sense of security (induced by prejudice and myth) will help to halt the spread of STIs. I recommend that sex workers be employed to educate the public on safer sex practices. Only sex workers have the experience and knowledge to transform safer sex into an erotic experience that others will wish to imitate.

Copyright Veronica Monet 2004

Notes