S. African AIDS Doctor Urges Universal Testing

JOHANNESBURG, Oct. 19 -- A leading AIDS doctor said Thursday that all South Africans should be required to take a confidential HIV test so that they can better protect their health and, when necessary, begin taking life-saving medication.

François Venter, head of the Southern African HIV Clinicians Society, said at a news conference in Cape Town that only a small percentage of the estimated 5 million South Africans with the virus know they have it, hindering efforts to slow the spread of the disease and treat its symptoms.

"Everybody should be tested," he said later in an interview in Johannesburg. "We should be finding ways to get everybody in the country tested."

Venter recommended HIV testing for South Africans whenever they start new jobs, open bank accounts or get driver's licenses. The tests should be repeated periodically so that new cases are caught soon after infection, rather than years later, when the infected person is near death and treatment strains public health systems.

Many AIDS activists say HIV tests must be far more widely available, especially for high-risk groups such as pregnant women and people with tuberculosis or sexually transmitted diseases. Several African countries are attempting to offer testing every time a patient visits a doctor or nurse.

But Venter, who oversees the AIDS clinic at Johannesburg General Hospital, said those efforts do not go far enough. In order to identify people who have HIV, he said, testing must become routine and automatic. The test results should be kept private and not made available to employers or the government, he said. Counseling should also be available.

Most South Africans with HIV wait until they are acutely ill before they seek medical help, making treatment riskier and potentially less successful.

"Once people get HIV, they are a time bomb," Venter said. "They must take care of themselves. What's happening now is people are waiting until that time bomb goes off, and the public health system must pick up the pieces."

His comments generated an immediate backlash among AIDS activists.

"The suggestion that we should introduce some sort of coercive thing, that's pushing it ridiculously," said Mark Heywood, treasurer for the Treatment Action Campaign, the most prominent AIDS activist group in South Africa. "There are sensible ways of dragging people into testing, and there are stupid ways."

An estimated one of every five South Africans between 15 and 49 has HIV, the virus that causes AIDS. A study last year by the Nelson Mandela Foundation reported that fewer than one-third of South Africans have ever been tested for the virus.