Despite the availability of ART, opportunistic infections have continued to cause considerable morbidity and mortality. Although hospitalizations and deaths have decreased dramatically due to ART, opportunistic infections remain a leading cause of morbidity and mortality in HIV-infected persons. This raises a great public health concern as to how the spread of these infections can be curbed. A profound knowledge of the HIV status of two ultimate couples would go a long way to achieve the control of co-infections in HIV AIDS.
Early initiation of HIV vaccination
In a case where two people claim to love each other in such a blind manner as not to bother about their seropositivity to HIV, early vaccination can be initiated to mitigate the risk of transfer of the virus to the uninfected partner. This measure in recent times is pivotal as it respects the right of the people to choose life partners irrespective of limitations posed by the knowledge of the disease. Also, Sexual partners of individuals with acute HIV infection may be candidates for post-exposure prophylaxis
Control of incidence of maternal and child mortality
In as much as the disease is suffered by the woman, the chances of other obstetric complication in case of pregnancy is increased - also implying a higher chance of children becoming orphans within few years. This is of huge public health concern as the necessary parental care may be lost to the fatal effect of the disease.
Immediate initiation of counseling
Premarital HIV screening may help initiate counseling of couple, should laboratory investigations reveal the presence of HIV. This is because, many may attempt suicide or other ills probably because of the mere fact that the love that bounds their relationship together may fade overtime or due to fear of abandonment, discrimination, violence, upsetting family members, and fear of accusations of infidelity. By such counseling, intending couples may be made to appreciate each other once again.
Reducing heterosexuality
Heterosexuality (sexual relationship between too many people of opposite sex) can be brought under control if intending couples get to know their HIV status beforehand. This is because, couples who are both negative before marriage would ordinarily remain faithful and as well be careful as any foul play may jeopardize the integrity of their relationship. In a case where there is knowledge of HIV positive status, motivation toward safe sex behaviors to protect a partner can be upheld. Persons who are infected by HIV infection have a need to be, and are said to be, aware of the ethical ramifications of exposing their sex partners and to assume responsibility to protect their partners. To this end, HIV positive partner will predict lower sex risks in a relationship because the HIV positive person will want to protect the partner.
Conclusion
Premarital screening for HIV and associated antibody is of great public health importance, and in fact has been viewed by researchers as one of the key ways to reduce the spread of AIDS, especially mother to child transmission. It is also envisaged that it is of great social importance for couples as it checks the activities of otherwise heterosexual partners. Control of HIV infection, particularly in the developing countries has defied strategies devised by WHO and other international organizations like USAID and CDC. However, emphasis should be centered on the public awareness aspect of controlling the spread. This implies, to a great extent the education of couples on the need to ensure utmost faithfulness to one another and to avoid discrimination should results reveal seropositive status.
In the early responses to the HIV epidemic, prevention and control strategies were based on previous experiences in the successful control and prevention of many other infectious diseases. Health educational campaigns on the seriousness of the disease and mode of transmission were conducted to raise public awareness. Unfortunately, these methods apparently did not work well because HIV/AIDS is not an acute infectious process and it has complex social implications. Also, the way people get HIV infection relates to individual behavior and legal issues in some cases (i.e. drug use and prostitution). Mechanical barrier intervention has been repeatedly stressed on; a 100% condom use campaign may be intensively promoted among the high-risk sexual behavior groups, with collaboration across many governmental ministries.
