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World AIDS Day: Can we help lower the struggle load?

  • Illustration : Purabi Deshpande / Research Matters
    Illustration : Purabi Deshpande / Research Matters
  • Illustration : Purabi Deshpande / Research Matters
    Illustration : Purabi Deshpande / Research Matters

It was a struggle. The death of parents, poor health, social discrimination, expulsion from school. But they were together. In May 2010, 15 years old Bency, took her last breath and left her companion in struggle – her little brother, 13 years old Benson. The cause of their separation, same as the cause of their struggle, was the widely stigmatized Acquired Immune Deficiency Syndrome (AIDS).  

Bency and Benson contracted the infection from their mother, who contracted it from her husband. She was unaware of his condition, unaware of hers. No school would admit Bency and Benson, as the people were afraid their kids might contract HIV from them. The entire neighborhood ostracized them for the same reason. Clearly, they people were unaware of what AIDS entails and how it spreads. The fact that this incident happened in the state with the highest literacy rate makes one wonder the abysmal situations in the rest of the country.     

AIDS is the most advanced stage of human immunodeficiency virus (HIV) infection. HIV attacks the CD4+ T cells – a type of white blood cells, which form an essential part of our immune system and prevent us from deadly diseases. The typical CD4+ count in a healthy human lies between 500 to 1500 per cubic millimeter of blood. In an HIV infected person, when the count falls below 200/mm3, he/she is diagnosed with AIDS. Thus, in wake of AIDS, our immune system weakens, making us susceptible to a plethora of deadly diseases.

Not all HIV infections proceed to AIDS. The only treatment option against HIV infection – antiretroviral therapy, if started on time, can help the patients lead a healthy life for as long as 70 years.  But, to start the treatment on time, it is important to diagnose HIV infection as soon as possible. And therein lies the challenge. The initial symptoms of an HIV infection are similar to those of flu – fever, chills, muscle aches, sore throat, fatigue. Moreover, some people do not show any symptoms at all for as long as 10 years after contracting the virus. Both these cases lead to a delay in HIV diagnosis, which in turn delays the treatment and leads to a poorer life quality.

HIV infection spreads through the exchange of bodily fluids – blood, breast milk, semen, vaginal and rectal fluids. Thus, people who practice such exchange with an HIV infected person in an unsafe manner on a regular basis are more likely to get infected.

As of 2016, India had the third largest HIV epidemic in the world, with 2.1 million people infected with HIV. Sex workers and people involved in injecting drugs remain the highest risk groups. Even though a free anti-retroviral treatment has been in place in India since 2004, not all have access to it . The access is limited primarily by the number of clinics providing the treatment and the number of HIV positive people visiting the clinic. Stigma and discrimination surrounding AIDS comes in the way. This discrimination stems from the myths about HIV infection. Some popular myths revolve around the spread of HIV infection – through touching, hugging, sharing food, water, air. As the laws around sex work in India remain ill-defined, and sex a taboo topic, sex workers shy away from getting HIV diagnosis or treatment. Thus, education and awareness are the need of the hour.

With the goal of improving public awareness about AIDS, every year, the 1st of December is celebrated as the World AIDS Day. The Red Ribbon is used as a symbol for solidarity and support towards HIV positive people. In April 2017, the Indian Parliament passed the HIV and AIDS (Prevention and Control) bill 2014, which makes it illegal to discriminate against HIV positive people. The law prohibits discrimination in education, housing and employment of HIV positive/people living with HIV positive people. The law makes it necessary to get an informed consent on HIV testing, treatment and status disclosure.  Furthermore, it contains  provisions for protection of whistleblowers - people who make complaints or give information about mistreatment of HIV positive people. Anyone convicted of breaking the law can face imprisonment of up to 2 years and/or a fine of up to 100,000 rupees. But the question is, will people abide by the law? On a more fundamental level, are people aware of the law?

Is there a permanent cure to AIDS? Currently, no. But scientists are working towards an HIV vaccine. Two big experimental trials are currently underway in the African continent. The primary results of the studies will be out in 2020. If successful, these vaccines could potentially wipe HIV off the planet. Until then, the best we can do is educate ourselves and others with HIV infection, modes of transmission, diagnoses, treatments and laws in place. Having a weak immune system due to HIV infection, is, in itself, a rough experience. Let us not increase their struggle load by adding another layer of discrimination.