The most controversial, if not the only controversial idea put forward by E. Pisani in her book The Wisdom of Whores, is what she sees as the next logical step after opt-out testing for HIV: requiring “people who are getting free AIDS drug to show up for prevention service, too.” She is well aware that activists who have ripened in a “culture of confidentiality” would be horrified.

Now imagine that this was happening, that to ensure that patients adhere to their treatment they receive each month free call time on their cellphone for taking their medicine. Outrage would be at the door, indignation at the window. However, this is what a team at the Massachusetts Institute of Technology has come up with to ensure that tuberculosis patients complete their six-month course of medication rather than them risking boosting the spread of drug-resistant strains by not taking their medicine regularly.

I don’t see anything outrageous in Elizabeth’s proposal. Counselling is customary for people affected with all sort of diseases such as cancer, obesity and mental disorders. HIV has been an exception and thought it is understandable why and how this exception has developed, I do believe that it now contributes to the stigma still associated with the disease. In the case of HIV it should be a duty to ensure that people affected understand and are well aware of behavioural risks associated with HIV transmission. Not only it will help them having a normal life and guiltless (sex) life but it will protect their sexual partners too, hence reducing the spread of the epidemics.

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