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HIV AND AIDS
Read more on - Polity | Economy | Schemes | S&T | Environment
- What is it: HIV causes AIDS and interferes with the body's ability to fight infections.
- How: The virus can be transmitted through contact with infected blood, semen or vaginal fluids.
- What happens: Within a few weeks of HIV infection, flu-like symptoms such as fever, sore throat and fatigue can occur. Then the disease is usually asymptomatic until it progresses to AIDS (Acquired Immuno-Deficiency Syndrome). AIDS symptoms include weight loss, fever or night sweats, fatigue and recurrent infections.
- Cure: No cure exists for AIDS, but strict adherence to antiretroviral regimens (ARVs) can dramatically slow the disease's progress as well as prevent secondary infections and complications.
- Spreads: By blood products (unclean needles or unscreened blood), By mother to baby by pregnancy, labour or nursing, By having unprotected vaginal, anal or oral sex.
- HIV and AIDS in India:
- Due to its large population size, India has the third largest HIV epidemic in the world
- India’s epidemic is concentrated among key affected populations (sex workers and men who have sex with men)
- Compared to neighbouring countries, India has made good progress in reducing new HIV infections by a half
- Despite the availability of free antiretroviral treatment , uptake remains low as many individuals face difficulty in accessing clinics
- Third largest prevalence: India has the third largest HIV epidemic in the world. In 2016, HIV prevalence in India was an estimated 0.3%. This figure is small compared to other middle-income countries but because of huge population (1.324 billion) this becomes 2.1 million people living with HIV. In 2016 approximately 62,000 died from AIDS-related problems.
- Slowing down now: Overall, India’s HIV epidemic is slowing down, with a 32% decline in new HIV infections (80,000 in 2016), and a 54% decline in AIDS-related deaths between 2007 and 2015.
- Heterosexual incidence: The HIV epidemic in India is driven by heterosexual sex, which accounted for 87% of new infections in 2015. The epidemic is concentrated among key affected populations such as sex workers. The vulnerabilities that drive the epidemic are different in different parts of the country. Prevalence among people who inject drugs was previously stable but has been rising in recent years.
- Most affected states: The three states with the highest HIV prevalence (Manipur, Mizoram, Nagaland) are in the east of the country. Some states in the north and northeast of the country have also reported rising HIV prevalence.
- Sex workers and HIV: In 2016, an estimated 2.2% of female sex workers in India were living with HIV, although figure varies between states. Although sex work is not strictly illegal in India, associated activities such as running a brothel are. This means authorities can justify police hostility and brothel raids. Stigma and discrimination restrict their access to healthcare.
- NACO: Sex workers are one of the high-risk groups targeted by India’s National AIDS Control Organization (NACO) with peer-to-peer HIV interventions.
- Same sex conduct : The legal status of same-sex conduct in India has fluctuated in recent years. After the 2013 and 2016 flip-flop, the Supreme Court reconsidered it in 2018.
- Hijras/transgender people and HIV: Hijras is the name given to people in South Asia who are transgender. NACO estimates HIV prevalence among this group to be 7.2%. In April 2014, the Indian Supreme Court recognised transgender people as a distinct gender. Since then, health and welfare programmes to meet this group’s specific needs have been set up.
- People who inject drugs (PWID) and HIV: The number of people who inject drugs (sometimes referred to as PWID) living with HIV in India is rising. The prevalence rate remained steady at around 7% between 2007 and 2013, but was estimated at 9.9% in 2015. Injecting drug use is the major route of HIV transmission in India’s north-eastern states.
- Prevention activities: HIV prevention activities for people who inject drugs in India include needle and syringe exchanges and opioid substitution therapy (OST), with the former intervention more common. NACO reports the number of clean needles and syringes distributed as 16.5 million as of September 2015, a figure that is rising year on year.
- Migration and HIV: Research links migration to increases in HIV transmission. There are an estimated 7.2 million migrant workers in India, of whom 0.19% are living with HIV - much higher than the national prevalence of 0.26%. NACO calls migrants as a ‘bridge population’, as they form a link between urban and rural areas, and between groups that are at high and low-risk of HIV transmission.
- Truck drivers and HIV: A number of studies have reported high vulnerability of truckers to HIV transmission. NACO estimates that 2.59% of the two million truckers in India are living with HIV. NACO also categorises truck drivers as a bridge population because truck drivers often have unprotected sex with high-risk groups such as female sex workers as well as their regular sexual partners, which increases the risk of transmitting HIV into the general population. A 2012 study found 47% of truckers reported paying for sex, of whom only 40% had used a condom.
- HIV testing and counselling (HTC) in India: In 1997, there were just 67 HIV testing and counselling (HTC) sites in India. By August 2016, there were more than 20,000 facilities offering HTC.
- HIV prevention in India: NACO is the body responsible for formulating policy and implementing programmes for the prevention and control of the HIV epidemic in India. The most recent programme, NACP-IV (2012-2017), aims to reduce annual new HIV infections by 50% through the provision of comprehensive HIV treatment, education, care and support for the general population and build on targeted interventions.
- Project Sunrise: Responsible for the expansion of HIV interventions in north eastern states with a focus on key affected populations, particularly people who inject drugs. The project began in 2016 with the central goal of getting 90% of people who use drugs who are living with HIV from this area on treatment by 2020.
- Project NIRANTAR: This three-year project began in 2014 and focuses on building the capacity of civil society organisations working with key affected populations in the states of Chhattisgarh, Madhya Pradesh and Odisha.
- The Condom Social Marketing Programme (CSMP): The CSMP aims to promote safer sex. A key focus of the programme is making condoms readily available in rural and remote areas and in high-risk places such as truck stops.
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