Karnataka has 3rd highest number of HIV cases in India

By Dr. S.N. Mothi, Chairman and Founder Trustee, Asha Kirana Hospital, Mysuru

This year’s theme for World AIDS Day, which will be marking its 30th anniversary today (Dec.1) is “Know Your Status.” Significant progress has been made in the AIDS response since 1988 and today three in four people living with HIV know their status. But we still have miles to go, as the latest UNAIDS report shows, and that includes reaching people living with HIV who do not know their status and ensuring that they are linked to quality care and prevention services.

HIV testing is essential for expanding treatment and ensuring that all people living with HIV can lead healthy and productive lives.

The good news is that there are many new ways of expanding access to HIV testing. Self-testing, community-based testing and multi-disease testing are all helping people to know their HIV status.

Unfortunately, many barriers to HIV testing remain. Stigma and discrimination still deters people from taking an HIV test. Access to confidential HIV testing is still an issue of concern. Many people still only get tested after becoming ill and symptomatic.

Although many strategies will be needed to close the book on the AIDS epidemic, one thing is certain. It will be impossible to end the epidemic without bringing HIV treatment to all who need it.

Powerful momentum is now building towards a new narrative on HIV treatment and a new, final, ambitious, but achievable target:

By 2020…

• 90% of all people living with HIV will know their HIV status.
• 90% of all people with diagnosed HIV infection will receive sustained Anti-Retroviral Therapy (ART).
• 90% of all people receiving ART will have viral suppression.
• Total number of people living with HIV (PLHIV) in India is estimated at 21.40 lakh in 2017

(Source: NACO Fact-sheet).

Karnataka has the 3rd highest number of HIV cases in India.

The cumulative number of patients ever registered at 65 ART centres in Karnataka till March 2015 were 2,65,836, ever started on ART were 1,74,844 and alive on ART were 1,17,469. Out of 175 taluks in Karnataka, 194 taluks have link ART centres. Out of 194 link ART centres, 85 are upgraded as Link ART Plus centres. 20,000 newly-detected positive between Apr. 2016 – Mar. 2017 (Source: KSAPS website).

A young person in an industrialised country who becomes infected today can expect to live a near normal lifespan (or an additional five decades) with the use of lifelong, uninterrupted HIV treatment.

The new target prioritises equity. The world will not end the AIDS epidemic unless all communities affected by HIV have full and equitable access to life-saving treatment and other prevention services. In particular, the ambitious 90-90-90 target demands dramatic progress in closing the treatment gap for children, adolescents and key populations, using rights based approaches.

2017 – 18 is a landmark year in India for people living with HIV/AIDS.

* ‘Treat all’ strategy implemented by NACO to provide ART for all those who are tested positive, thereby an additional 1 million PLWA are targeted to be started on treatment.

* Routine viral load testing during the follow-up has been implemented for early recognition of treatment failure and plan to switch over to 2nd or 3rd line regimen.

* HIV/ AIDS Prevention and Control Bill was passed, whereby it ensures and empowers PLWA from being discriminated and stigmatised in workplace, neighbourhood and Hospitals. No HIV positive woman, who is pregnant, can be subjected to sterilisation or abortion without her consent.

* Supreme Court judgment on Article 377 on decriminalising Gay sex clears the cloud surrounding Lesbian, Gay, Bisexuals & Transgender (LGBT) community. “LGBT community and their family members are owed an apology from society for being denied equal rights over the years,” said Justice Malhotra in their Judgment.

In spite of awareness initiative and efforts to end stigma and discrimination, scenarios which cause concern are:

* A young IT guy and girl have sex without condom and come for HIV testing.

* HIV Positive husband comes home drunk and insists on sex without condom. His HIV -ve wife is unable to negotiate safe sex and she gives in !

* Last month 3 senior citizens (> 60 years) were diagnosed HIV +ve during routine medical testing in different Hospitals and referred to Asha Kirana.

* A woman is advised to terminate pregnancy because she is HIV +ve.

Michel Sidibe – UNAIDS Executive Director, has said:

AIDS is not over. That is why today I am sounding the alarm.

1. We must close gaps.
2. We must break barriers.
3. We must right injustices.

The new report from UNAIDS shows our pace of progress is not fast enough to match our ambition. We have come so far, but we have miles to go.

What we need now in the AIDS movement is love, wisdom and compassion and a feeling of justice for all who suffer. (Source: UNAIDS / NACO)