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Logo of Phnom Penh Post newspaper Phnom Penh Post - AIDS epidemic sees prenuptial blood tests soar

AIDS epidemic sees prenuptial blood tests soar

The dangers of HIV infection have prompted many parents to take a cautious look at

prospective suitors for their children. Journalist Moeun Chhean Nariddh found

when he married recently that his parents-in-law wanted to know more than just his

prospects and character.

"Thveu srae aoi meul smao. Tukdaak kaunchao aoi meul phaosandaan." ("When

you grow rice, check the grass. When you wed a child, check the family line of the

child-in-law.")

This Khmer proverb advises parents to look into the history of their child's future

spouse before tying the knot, just like clearing the grass before growing rice.

The old rule, however, seems a thing of the past for people in Sdao Leu. When I asked

for the hand of a daughter in this rural village in Kampong Cham province recently,

her parents didn't seem to worry much about my "family line". They asked

to check my blood for AIDS.

According to many villagers, blood tests before marriage became a common practice

after a young couple in their community died from AIDS about two years ago. They

said another family in the neighborhood had to cancel the wedding of their daughter

after the groom-to-be was found to be HIV-positive.

However, Sdao Leu is not the only place people are getting serious about the danger

of the AIDS epidemic. According to Dr Hor Bun Leung, Deputy Director of the Center

for HIV/AIDS, Dermatology and STD Control (CHADSC), blood testing before marriage

has become a practice widespread among Cambodians.

"In general the rate of people having blood tests before marriage has gone up

very high," he said. "This number is higher [compared to] those who have

no tests."

Though CHADSC has yet to collect the data on the number of couples seeking blood

tests throughout the country, Dr Bun Leung said the spontaneous practice increased

as the number of AIDS patients and deaths grows.

"Anybody knows that their neighbors have died from AIDS," he said. "Anybody

now knows that their close or distant relatives have HIV. Now it's come to a stage

when everybody knows about AIDS without anyone telling them about it."

He said the information concerning AIDS is now widespread. A recent study by his

center among young people at schools and those in the community shows the rate of

general understanding about AIDS at more than 80%.

Despite this awareness about the danger of HIV/AIDS among Cambodians, the National

AIDS Authority warned that 60,000 housewives of the estimated 180,000 AIDS carriers

in 1998 had been infected by the virus, mainly from their husbands.

Dr Tia Phalla, Deputy Secretary General of the National AIDS Authority, estimated

that the number of HIV/AIDS-infected people in Cambodia reached 200,000 in 1999 with

100 newly infected people and 20 deaths every day.

Dr Tia Phalla said only 10 percent of the people with AIDS realized they were carrying

the virus. He said the lack of social service for AIDS patients, discrimination against

them and the absence of a cure for AIDS prevented people from getting blood tests.

To help cope with the alarming rate of infection, Dr Bun Leung said CHADSC is discussing

a plan with the National AIDS Authority whether Cambodia should have a law or any

policy on blood tests before marriage.

Any discussions, according to Dr Bun Leung, are based on the models in other more

developed countries. He said some countries have put blood testing into marriage

law, but others have not. The countries which do not have such a law are among those

with low transmission rates, such as parts of the United States and some European

countries.

For his part, Dr Bun Leung said he will support the idea of having a law because

of the current transmission rate, which is "very high and dangerous".

Why should there be a law? The first benefit, said Dr Bun Leung, is that it would

be a signal telling all youths to be careful.

Second, youths would think that when they love a woman and want to ask for her hand

they may have a blood test before they go and ask for her hand. "If they have

HIV, they must forget about the [plan] to ask for her hand."

He said the law will help protect women from becoming victims. "Some women do

not know and they don't want AIDS. But, it's because there's nothing to help them."

However, Dr Tia Phalla disagreed with the idea, saying blood testing before marriage

has now become a widespread habit among Cambodian people.

"I don't think this law is as strong as habit," he said. "If there's

a law there will be discrimination."

Many worry about the willingness of ordinary people to pay the $40 cost for two people

for blood tests of the Weston Blot type, which can detect the virus even one day

after infection.

Dr Phalla is also concerned about the difficulty in enforcing the law and its effectiveness.

He argued that if someone wants to have unprotected sex outside marriage they can

do so afterwards.

"The testing before marriage does not guarantee anyway," he said. "Responsible

behavior is better."

In defense of his support for a law, Dr Bun Leung argued that a woman will be happy

enough to marry a clean man though he becomes dirty afterwards.

"It's like you're buying one thing. If you know it doesn't work, will you buy

it? Now if you have carefully checked that it is good, you will buy it and use it.

But, if it breaks down after one or two months, we will be more satisfied than [if]

we have not checked it and used it."

Dr Bun Leung also rejects fears that the new law will violate the rights of individuals

to get married.

"I don't think there are any points implying that it violates human rights,

because it is done by both sides," he said. "I think this helps people.

And we help a lot of people, not just one person."

Instead, Dr Bun Leung said that the proposed law will help protect the rights of

the people who wish to get married with uninfected partners.

He said people in the countryside, in particular, will benefit most from the legal

requirement. Given the fact that some rural parents have little knowledge about AIDS,

they would tend to marry their daughters to a rich man with no blood tests.

Dr Bun Leung said blood testing centers will provide counseling to those who are

HIV positive and leave it with the two partners to decide if they want to get married.

"If they agree to get married even if their wife or husband has AIDS, it's okay,"

he said.

Thun Saray, President of the human rights organization ADHOC, appeared undecided

between "the right to get married" and "the right to life".

"They're both humanitarian," he said. "If the law is too strict and

does not allow people to get married, it will affect a person's right to choose a

spouse."

When asked what if rural people don't know about the danger and want to get married?

"If we want to help people in rural areas, should we promote the awareness campaign?"

he wondered.

Then he said: "It would be good if we should force people in the countryside

to have blood tests, but leave the possibility for the partners to decide."

Is it a violation of someone's rights if the law forbids people from getting married

without a blood test?

"I don't think this is the violation of [someone's] rights," he said.

However, he said, if the partners are informed of the danger but insist on getting

married the law should preserve their rights to do so.

"If both partners determine that they will get married without blood tests,

we should give them their rights, " he said.

However, he warned that the couple should avoid having a baby for fear that the child

would get infected by the virus.

Although no law has been passed yet, Dr Bun Leung said he hoped people will continue

their blood testing habit like the villagers in Sdao Leu.

"I think that whether there is or there is not a law [or] policy ... both men

and women should think about this before they get married."

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