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HIV elimination surely needs much more efforts
Shashwat Gupta Ray | Friday, 9 December 2016 AT 11:04 AM IST
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The good news is that the number of new Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Disease Syndrome (AIDS) cases have shown a consistent decline over the years.

India is estimated to have around 86,000 new HIV infections in 2015, showing 66 per cent decline in new infections from 2000 and 32 per cent decline from 2007, the year set as the baseline in the National AIDS Control Programme round-IV.

This has been made possible due to the intervention of Government of India over the years and through continuous interventions in ways of educating the masses - including commercial sex workers, truck drivers, installing condom vending machines in areas having brothels and providing medicines (Anti-Retroviral Therapy) to keep the cell counts in check. One of the greatest challenges before the authorities and scientists was to prevent transmission of infection from a mother to her child.

A lot has been achieved on this front also. Pune-based National AIDS Research Institute (NARI) has demonstrated how extended use of a drug called Nevirapine to a pregnant woman can help reducing the risk of mother to child transmission.

Despite these efforts, a lot still has to be done as the challenges are plenty.  According to the National AIDS Control Organisation (NACO), among the States/Union Territories, in 2015, Manipur showed the highest estimated adult HIV prevalence of 1.15 per cent, followed by Mizoram (0.80 per cent), Nagaland (0.78 per cent), Andhra Pradesh & Telangana (0.66 per cent), Karnataka (0.45 per cent), Gujarat (0.42 per cent) and Goa (0.40 per cent).

Besides these states, Maharashtra, Chandigarh, Tripura and Tamil Nadu have shown estimated adult HIV prevalence greater than the national prevalence (0.26 per cent), while Odisha, Bihar, Sikkim, Delhi, Rajasthan and West Bengal have shown an estimated adult HIV prevalence in the range of 0.21- 0.25 per cent. Unsafe sex continues to be the major cause of HIV/AIDS in the country.

According to the Goa AIDS Control Society report, of 329 HIV cases detected in the year 2015, 311 cases were due to unsafe sexual contacts. The second major cause of HIV transmission passed from parent to a child followed by virus transmission through transfusion of infected blood and blood products and usage of infected syringes.

This shows that a lot has to be done if we have to achieve zero HIV status. First and foremost, it is time that Indian society sheds its inhibition on talking about sex. Last two decades have shown a rise in prevalence of Sexually Transmitted Diseases in children. The WHO estimates that 150 million girls and 73 million boys under 18 have experienced forced sexual intercourse or other sexual violence. This increases the risk factor for contracting STDs like HIV along with unwanted pregnancies.

Children under 15 years accounted for 12 per cent of total new HIV infections while the remaining new infections were among adults. Drug abuse is another major problem with many relying on an injectable route. Medically speaking, drug resistance amongst HIV+ patients taking the ART is another emerging threat along with Multiple and Extreme Drug Resistance (MDR/XDR) Tuberculosis. TB is the most prevalent opportunistic disease that leads to AIDS in HIV patients once their CD4 cells count reduces. CD4 cells (often called T-cells or T-helper cells) are a type of white blood cells that help in maintaining immunity levels in the body against any disease.

Lot more money has to be pumped in the healthcare sector to open new hospitals and ART centres. Less toxic and more effective drugs are the need of the hour to keep the virus in check and simultaneously, improve the living condition of the patients. Despite all these years of research, we have not been able to discover any antidote for the disease. There is still no vaccine or a drug that can cure an HIV+ patient.

Hence, the Ministry of health and Family Welfare along with Ministry of Science and Technology through its chain of laboratories under the Indian Council of Medical Research (ICMR) and Council of Scientific and Industrial Research (CSIR) have to jointly work more intensively on anti-HIV drugs.

Discrimination faced by orphaned children of HIV/AIDS parents, lack of funding or utilisation of funds in giving treatments, unsafe health care practices, and lack of attention to HIV/AIDS amongst children in health policy are some more concerns that need to be addressed by the government. Only then, we can move towards an HIV-free society.
 
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