At present, India has the third-largest HIV (Human Immunodeficiency Virus) epidemic in the world with national prevention of 0.22% i.e 2.1 million (21 lakh) people living with HIV (PLHIV). States like undivided Andhra Pradesh (the Telugu States), Mizoram and Himachal Pradesh have a four-fold higher prevalence of 0.8 %. This is despite a decade of decline from 2005 to 2015 in the infection seen in other states.
In Telangana, the estimated number of PLHIV in 2016 is about 1.75 lacs. Across India, 87,580 people were reportedly infected with HIV in 2017, of which 9,324 occurred in TS. Though it is a decline from 11,846 cases seen in 2016, it constitutes 11 per cent of the total cases in the country. The total deaths in these Telugu States are 12169 in the financial year 2016-2017. This accounts for one-sixth of the national deaths.
The Telangana AIDS Control Society (TSACS) provides free antiretroviral drugs, including 2nd and 3rd line drugs, whenever and wherever necessary to all those PLHIV individuals through the State Antiretroviral therapy (ART) centres. The ART centre at Apollo Medical College at Jubilee Hills Hyderabad is the first among private medical colleges in the state to provide free ART using the PPP model, to PLHIV.
The Government of India, NACO and TSACS have embarked on the challenge to minimize deaths as well as viral transmission to non-infected sex partners thereby leading to zero transmission of the HIV and ultimately its elimination by 2030. To do so, this year the theme chosen on World Aids Day, Dec 1st is that “Communities will make the Difference” in ending the epidemic. The strategies and plan of action to achieve the target of 100-100-100 globally, as well as in India, is in place. To achieve these targets, communities should help and assist in the government program. The community must participate to minimize the high level of stigma and reduce workplace discrimination.
For the 1st 100 targets, 100% of people visiting with HIV must know their status, which will be made possible with proper testing and detection.
At the Antenatal clinics, we should test all pregnant mothers and treat them with ART, and prevent mother -to – child transmission as well. This will minimize the occurrence of pediatric HIV. Testing targeted population such as MSM and transgenders, and the bridge population, such as truckers and migrants and referring those testing positive to ART centres for treatment initiation will minimize transmission to the general population. After testing, we need to refer all patients who test positive to the ART or link centres to receive the ART drugs.
Ensuring that all those tested positive are on treatment will achieve the “second 100.” Following this, all who are on this drug must ensure that they take this drug regularly for an indefinite period. This will help us achieve the “third 100”. It would also ensure that the viral loads are brought down below detectable levels. This zero level of the virus will ensure that no transmission will occur. Currently, only 56% of this affected population is on treatment. We can eliminate HIV as a threat that can destroy people’s lives and livelihoods.
Communities should target the younger generation. They need to be made more aware about accessing HIV prevention, testing, treatment and care.