Mohinder Verma
Acquired Immuno Deficiency Syndrome commonly known as AIDS can be a scary four-letter word. The word alone may invoke fear of sickness, death and worst of all exclusion. Ironically, these very stigmas actually feed the epidemic that is so widely spurned.
AIDS weakens the immune system over the time making the body vulnerable to other diseases that it would normally not get. It is caused by the virus known as HIV. People can be infected with HIV but do not display any symptoms of AIDS for several years.
The stigmas attached with it persist in the society despite much awareness activities and all the AIDS affected people have not yet come out of the same. A major social stigma surrounding the disease is that casual contact can spread HIV/AIDS infection. The second major misconception about the disease is that a positive diagnosis is a death sentence.
However, the fact is that HIV/AIDS can not spread from everyday contact like shaking hands or sharing a toilet seat. The virus is mainly spread through sexual contact, sharing needles and via untested blood transfusions. Moreover, diagnosis does not mean end of life as proper treatment can help the affected persons live longer and healthier lives.
While there are several stigmas associated with AIDS, the social ones are particularly disturbing. They make people afraid of getting tested and diagnosed for fear of being socially outcaste.
But during the past some years the massive awareness activities carried out by the J&K State AIDS Prevention and Control Society by involving ASHA and Anganwari Workers, Industrial Workers, Non-Governmental Organizations, by organizing inter-department workshops and roping in folk artists have started yielding positive results vis-à-vis bringing AIDS affected people out of the stigmas.
The scenario vis-à-vis AIDS affected people getting freedom from stigmas and coming forward to get treated is more encouraging in Jammu region as compared to Kashmir valley where more vigorous awareness campaigns are required to be carried out in order to help people suffering from such disease. As long as such people don’t come out of stigmas they cannot be helped out in any way as National AIDS Control Organization (NACO) guidelines clearly state that testing and medication should be purely on the voluntary basis and on the consent of the sufferer.
According to the figures of J&K State AIDS Prevention and Control Society, around 3800 HIV Positive people were registered across the State since 1999, when the society was established, till date. A total of 2599 PLHIV were registered in HIV care in Artiretroviral Treatment (ART) Centre set up in Government Medical College Jammu while as 362 people have lost their lives to this disease during this period.
A total of 317 HIV positive patients have been registered under Last Follow Up indicator while as 1151 sufferers are alive on ART.
The figures of ART Centre at SKIMS indicate that 149 sufferers are Alive on ART, 88 registered under Last Follow Up indicator and 50 lost lives due to the disease since 1999.
The figures vis-à-vis Alive on ART, which have gone up in Jammu region during the past some years, clearly indicate that more and more sufferers have started saying good-bye to the social stigmas in order to get treatment for prolonging their lives. The antiretroviral treatment acts as an incentive for HIV testing as it enables people living with HIV to enjoy longer and healthier lives.
Since the availability and accessibility of antiretroviral treatment is crucial, four Link ART Centres have been established in District Hospital at Kathua, SNM Hospital Leh and District Hospitals of Rajouri and Udhampur in order to facilitate the sufferers get treatment at nearest possible destinations instead of travelling to ART Centre in Government Medical College Jammu and SKIMS.
As counseling and testing play significant role in taking the sufferers to the treatment stage, even 35 Integrated Counseling and Testing Centres (ICTCs) have been established across the State. Moreover, in order to prevent untested blood transfusions, 22 National AIDS Control Organization (NACO) supported blood banks have been established in health institutions across the State.
Since all required measures have been taken for awareness, counseling, testing and providing care, support and treatment, it is expected that J&K would shortly cover the journey from low prevalence to zero prevalence stage in the years to come.
Project Director, J&K AIDS Control and Prevention Society, Dr Madhu Khullar said that since J&K falls under the low prevalence state, the mission of the Society is to disseminate wholesome AIDS awareness to every citizen of the State especially in the age group of 15 to 49 years.
Stating that one of the key objectives of National AIDS Control Programme is to provide care, support and treatment to all PLHIV, she said that various service delivery points like ART Centers and Link ART Centres have been established.
At such centres, PLHIV requiring ART are identified and then provided treatment as per the NACO guidelines. Moreover, such centres are providing treatment adherence and counseling services before and during treatment to ensure high levels of drug adherence, Dr Khullar said, adding such centres even counsel and educate the PLHIV, caregiver, guardians and family members on nutritional requirements, hygiene, positive living and also on measures to prevent further transmission of infection.
In response to a question, Dr Khullar said that apart from PLHIV getting ART the main focus of the Society was also on tracing the LFU (Last Follow Up) cases to ascertain whether they are dead or left the treatment.
She disclosed that recently ART Centre at GMC Jammu was designated as ART Plus as the number of PLHIV getting treatment has crossed 1000 mark. “Unlike earlier, now the sufferers are not referred to Chandigarh for 3rd line treatment, which has been made available at Jammu also”, she added.
Admitting that social stigmas are no longer shackles for PLHIVs in Jammu region, she said, “in Kashmir valley people are not coming forward for screening and counseling as such we will lay more focus in this part of the State”. She disclosed that Society was making efforts to ensure that even every Sub-District Hospital where deliveries are conducted have Integrated Counseling and Testing Centres
About the Targeted Intervention, which is one of the main components under National AIDS Control Programme-III, Dr Khullar said, “the programme is designed to reduce the rate of HIV transmission among the core group viz. female sex workers and injecting drug users & bridge populations like migrants and truckers.
“Targeted interventions in JKSACS are a resource-effective way to implement HIV prevention and care programmes in settings with low-level and concentrated HIV epidemics in the State”, the Project Director said, adding they are also a cost-effective method of reaching people who are most at risk in more generalized epidemics.
Moreover, Targeted Interventions are aimed at offering prevention and care services to high risk populations by providing them with the information, means and skills they need to minimize HIV transmission and improving their access to care, support and treatment services. These programmes also improve sexual and reproductive health (SRH) among these populations and improve general health by helping them reduce the harm associated with behaviour such as sex work and injecting drug use.
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