World AIDS Day

HIV and AIDS are still a major health concern for the modern world. Precaution is the key to prevent HIV and we must offer preventative care for free. Even in this 21st century there are many people who are unaware of their infection. Myths and stereotypes continue to fuel discrimination and prejudice against them world over.

According to WHO (World Health Organization) statistics, almost 78 million people have been infected with the HIV virus and about 39 million people have died of HIV, so far. Today almost 35.0 million people are living with HIV, although the spread and reach of this noxious infection continue to vary considerably between geographies and social groups.

Those who are exposed to this infection, incidentally or accidentally, are highly reluctant to do a check up to confirm it. High level awareness programmes were conducted by various national and global agencies. Nevertheless, misconceptions and myths are not less. Stigma continues towards the person and nobody misses the opportunity to corner them. A lot of health education and awareness activities are going on without much result. As a health care professional, I myself have witnessed many cases where people admitted with minor infections, after routine blood results show positive retro - to their utter shock. Disbelief, anger, and denial follows, which eventually lead to depression in most cases before they finally decide to fight it out clinically. But this delay might be too costly for them and it might be too late for any treatment.

The social disgrace associated with AIDS as a sexually spread disease has significantly reduced the effectiveness of preventive and curative measures towards HIV. When the 1st infections were reported in the early 1980s, very little was known or understood about the character of this virus and fears were rampant over the modes of its spread. There was absolute lack of awareness about the therapeutic possibilities to mitigate it; its modes of transmission and even means of prevention were ambiguous even to those from the health fraternity.

What is AIDS?

In simple words, Acquired Immune Deficiency Syndrome (AIDS) is a group of conditions caused by the infection of Human Immuno Deficiency Virus (HIV). Infected person will lose immunity day by day. Initially the person may get a common cold or an episode of influenza, which are most likely ignored. He or she may take some pills for these symptoms and gets cured within few days without knowing that the devil inside them continues its deadly siesta. It is typically followed by a prolonged uneventful period, mostly symptom free. Probably this is the difficulty, the health care system faces in addressing these kinds of infections. This dormant period differ from person to person. It is called as the window period - the time between first infection and the time of test which reliably detects ad confirms the infection. As the infection progresses, it interferes more and more with the immune system, making the person much more susceptible to other common opportunistic infections (like tuberculosis). Thus, a person who was previously immune to such ordinary ailments starts harbouring a bundle of diseases.

There are so many misinformation about the transmission of AIDS -  HIV is transmitted primarily via unprotected sexual intercourse (anal or oral sex), contaminated blood transfusions, needles which are infected by HIV patients (usually seen in potent drug users), and from mother to child during pregnancy, delivery, or breastfeeding. We should clearly note that bodily fluids, such as saliva or tears, do not transmit HIV. No such cases were reported, till this date.
Unfortunately, as on today, no vaccine or cure can wipe HIV out completely. However, it must be noted that with early diagnosis, and with effective antiretroviral treatment, we can definitely slow down the course of the disease and the infected can lead a near-normal life for a very long time.

What can be done?

As already mentioned, prevention is the key. By discerning the modes and peculiarities we can effectively prevent this condition. HIV is considered a pandemic— because its outbreak which is spread over a large area and is actively proliferating. The disease has significant economic impacts and great impact on society. As antiretroviral treatment is the only means to reduce the risk of death or other complications, every infected person seeks it, but these medications are very expensive and have side effects too. It causes a long list of potential consequences ranging from lose of income, livelihood, , discrimination, Moreover, the stigma which prevents them from taking  therapy which lead the situation more and more pathetic.

At least in some parts of the world, poor access to health care facilities worsens the situation. In 2014 more than 40 % of the cases were diagnosed very late. Although medical treatment should be confidential, research by the WHO found that 34% of respondents in India, Indonesia, Philippines and Thailand reported breaches of confidentiality by health workers themselves. Both discrimination and distrust of healthcare workers can limit access to life-saving treatments.

ELISA and Western blot (antibody detection test) are some of the conventional tests which are used to diagnose HIV/ AIDS. Now a days some newer techniques like Recombinant Immunoblot Assay (RIBA), Rapid or Point-of-care tests are being evolved for testing. Although these tests have high specificity, and time saving but false positives do occur. Any positive test result should be confirmed by a lab using the western blot, say researchers.

Because of the extensive spread of this infection global participation is needed to curb it effectively. Various agencies have joined hands to fight against this deadly disease. It has attracted international medical and political attention as well as large-scale funding. In India we have NACO - National Aids Control Organization, which is the key agency for the survey, public awareness, coordination and implementation of rehabilitation schemes. It runs therapeutic shelter homes for HIV positive clients, co-ordinates and ensures the effective participation of various health sector players both from civil society and government viz. NGOs, public health centres etc.

Apart from  this, NACO conducts monitoring and evaluation of HIV/AIDS programmes, and surveillance of the infection among various population segments throughout the country. The organisation also documents highly successful programmes for their replication in different cultural setting. We can't simply avoid people who are engaged in prostitution. Still in our streets. Thousands are getting infection and spreading it to others  each day in our country. lot of them are out of band from the health care system even absent for screening. It raises the question of legalising the prostitution which could bring them to the vision; to spread a positive light to their life.

World AIDS Day

World AIDS Day is an opportunity to talk about HIV, to show support and kindness towards the millions of people living hardly to cope up with this corrosive health condition. Wearing a red ribbon is one simple way to do this but that is not enough. WHO demands global participation to curb it to zero mentioned in their theme "getting to zero."

Latest data shows New HIV infections have fallen by 35 percent since 2000, and AIDS-related deaths have dropped by 42 percent since a high in 2004 by June 2015, according to data from the United Nations AIDS program. Stringent policy making and implementing without any fail can lower this to a remarkable level. Change in social outlook and attitudes will give a helping hand to those people who are facing physical and psychological pressure, and encourage them to face the world. I would like to say that it's coming down, but it is just a number; it can shoot up again with negligence and ignorance. Today on 1st Dec 2015, we unite on this occasion. Let us listen to them, live for the day and spread the word.