World AIDS Day : More than HIV, Stigma and Discrimination Claims People’s Lives’: Dr. V Sam Prasad

New Delhi, December 1- Every year since 1988, the international community has been observing December 1 as World AIDS Day with a special theme to focus on. The theme for this year is “Communities make the Difference”.

The general motive behind this day is to bring attention of the world to the HIV epidemic, to make common people aware of HIV, to address stigma around HIV in every society, and act swiftly in the direction of a coordinated response across the globe.

On the occassion, Healthwire (HW) spoke to Dr. V Sam Prasad (Dr.), Country Program Director for AIDS Healthcare Foundation (AHF), on the causes, symptoms, treatment of HIV and misconceptions surrounding HIV and AIDS.

AHF is providing cost-free medicines to people affected with HIV in India for the past 13 years.

HW. What is HIV? What are its symptoms? How is it caused and how do we diagnose a person with HIV?

Dr. It transmitted primarily through blood and body fluids, infected needles and unprotected sexual intercourse and transmission of virus from mother to child.

HIV can be easily diagnosed today. There are kits which are available now just like we diagnose diabetes today. We just have to put the cartridge and put one or two drops of blood and in 15 minutes you can get the diagnosis. The kits are called Rapid HIV Testing Kids.

HIV is quite asymptomatic. You will never know by looking at someone that a person is HIV+. However, after a certain period of time virus gets inside the body and starts negatively affecting the immune systems of the body. There are blood cells called T4 cells in our body, which are another kind of white blood cells, that are responsible for strengthening our immune system. It is is because of our immunity that we don’t get sick everyday despite the polluted air that we breathe etc. So the HIV attacks the immunity of our body and when there is no immunity then one can have common cold, Pnemonia, diahrrea, tuberculosis etc. very easily.

So anybody who is having loss of body weight more than 10% in a period of 2-3 months, having cough or TB or multiple  infections over a period of time, having immunity going down, there’s diahrrea, there’s skin infections, nightsweating and weight loss then one should go for HIV diagnosis.

HW. Can you tell something about your NGO and how does it help HIV patients?

What is the course of treatment? What kinds of tests does it involve?

Dr. I’m country program director for AIDS Healthcare Foundation (AHF), We are spread over 43 countries today and the largest HIV NGO which completely free service- right from HIV testing, treatment and post-treatment also. In India, we have been working for the last 13 years and we done over 20 lakh HIV testing and detected more than 10,000 people and linked them with HIV care and we have clinics in Delhi and Mumbai but we work in 11 states along with the government.

AHF is a pioneer in bringing second-line Anti Retro-Viral Therapy (ART) treatment first time to India and also doing this community based screening as a model in India.

We have been looking at different age groups. We have sex workers, drug addicts, doctors and engineers and even political leaders. We also have transgender population, homosexual community, women and children.

Many of our patients have hugely benefitted from the treatment and I’m sure they are moving forward in their lives.

Hw. Since the treatment of an HIV patient is expensive, how does your NGO help with that?

Dr. We have 3000 people who are taking ART which is the medication for HIV. How we do this is that buy medication from private pharma companies at a reduced price and make it available to our people. After the law came into existence, the government is bound to give anyone free HIV treatment. But we are also looking to receive ART from the government soon and sign an MoU with National AIDS Control Organization (NACO) so right now we are purchasing medication and giving it to those for free who can’t afford such expensive treatment. But in the process this exercise becomes expensive for us also. Now, if the government can provide ART for 3000 people, we can also increase the size of our patients also.

HW. What’s new in the treatment of an HIV patient today which was not there, let’s say a decade ago or so. Have made progress in the treatment?

Dr. Absolutely, there are a couple of newer molecules which are coming up with big pharma companies who are looking for a cure. However, we still have firwt-line, second-line and third-line regimen of treatment available in this country. We have more people getting first-line treatment where if people actually are treated for a long term and then have viral suppression, means if you detect less virus, then there is also chance of preventing the transmission of the virus, which means if somebody is HIV positive and having ART treatment, there is a 98% chance of protection from the transmission of virus even after the person on treatment had unprotected sex. So it is very important to detect people early for the treatment to prevent the spread of virus from one person to the other. That’s the only way to stop the virus. So with the help of newer molecules, we have effective first-line, second-line and third-line treatment.

HW. Is there data of affected HIV patients in India and is it on the rise or decline?

Dr. Yes. According to our estimate, 2.14 million HIV patients in the country. There are 14-15 lakh people under government-run ART. Now there is a gap of around 5 lakh people and we need to identify them and put them on treatment. The prevalent HIV positivity in our country is 0.22, which means that out of every 100 people tested for HIV, 0.22% people would be detected as HIV positive.

HW. Can small children or elderly people also be affected with HIV? If yes, then how?

Dr. In our national programme, children are put under the age of 14 years. In their case, the usual transmission is seen as from mother to child. If the mother is HIV+, the baby would already be born as HIV positive. This can be avoided by doing Anti-Natal Clinic (ANC) check-ups and if the mother is tested positive, she could be given medication so that the child does not have HIV at the time of birth. Even when the child js delivered through ceasarean process, the child would still have less chances of having HIV. The child is also given anti-retro viral formulations for about six weeks after birth. If these protocols are taken care, no child will become HIV positive. Many children have successfully received these treatments and have gone on to lead healthy and happy married lives.

HW. What are the most common misconceptions about HIV?

Dr. One of the most common misconception is that mosquito bites can transmit HIV. Another one is that when the barber uses a shaving blade, one can catch HIV. I’m not saying there is no chance but it is rare, unlike the rumours. Similarly, another misconception is that if someone goes to swimming one can become HIV positive. Not to mention misconception about hugging, dry kissing and sharing food from the same plate.

People working in hotel industry have misconceptions. There was a message being circulated in WhatsApp that someone had mixed blood in Frooti so don’t drink Frooti. These are not the ways in which HIV can be transmitted but only through blood transfusion or semen, anal or vaginal fluids or high concentration of transmissible saliva but usually saliva doesn’t have transmissible amounts of HIV virus. Only an exchange of virus from an infected person to a non-infected person can have a chance of becoming HIV positive.

HW.Do you feel there is a lack of awareness about HIV which further fuels the social stigma among common people?

Dr. Absolutely. I think, the information, education, communication and dissemination is not happening among us. Even in the age of social media many people are reluctant to talk about HIV, condoms, prevention methodology and all so there is definitely a stigma around it. Many people don’t feel like talking about the use of condoms. Many NGOs are working at grass root levels but when you ask them to talk about HIV, mother to child infections, condoms etc. they come forward with answers like it is not our department. We need to go beyond these limitations and discuss more about HIV. Like Diabetes, HIV is also a chronically managed infection but while we talk openly about diabetes no one wants to talk about HIV. We have to talk about it by making it as a public health issue.

I want to categorically state this from your website. More than the lives claimed by HIV, it is the stigma and discrimination which kills people.

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