Time to admit AIDS crisis in state and fight it

BANGALORE: A decade after Karnataka began detecting HIV/AIDS cases, there is no escaping the crisis on hand. HIV/AIDS is no longer mere statistics on paper. Faces are emerging for the disease in villages, towns and cities across the state.
From seven AIDS cases between 1987 and 1992, the state has reported 1,849 cases as of September 2003. In the last four years alone, 1,482 cases of full-blown AIDS have been reported, and 104 of the 201 deaths due to the disease have occurred in the same period — a sign that early infection is beginning to take its toll.
Karnataka reports the fifth largest number of AIDS cases in the country.According to the annual sentinel surveillance for HIV/AIDS conducted between August and October 2002, 1.7 per cent — one of the highest for the country — of pregnant women attending antenatal clinics here are testing HIV positive.
HIV prevalence above one per cent at antenatal clinics is considered a sign of the disease moving from high-risk communities into general population.
According to Karnataka State AIDS Prevention Society project director Vandana Gurnani: “Rural populations have been affected as severely by urban populations. The illiterate are more vulnerable. Women are infected with HIV at a much younger age than men, and HIV infection is as high in agricultural and among unskilled workers as it is among the transport sector.’’
The Karnataka government, in the past year, has in its efforts to arrest the spread of the disease taken voluntary testing and counselling facilities to all the districts and two taluk hospitals. Clinics for sexually transmitted infections have been established in the districts to treat and guide people.
Also established in the past year are 40 centres — covering all the districts, for prevention of parent to child transmission (PPTCT) of HIV — through the use of the anti-retro viral drug Nevirapine. Such centres will now be extended to taluk hospitals, taking their numbers to 149.
“The PPTCT programme ensures that children born to HIV-positive mothers are protected against infection at birth,’’ says KSAPS additional director Dr S.M. Jangay.
NGO-run targeted interventions, which focus on sex workers, truckers and other high-risk groups, are beginning to move from urban centres to the worst-affected northern districts.
Condom usage has been found to be low. A new strategy for social marketing of condoms in rural areas is being initiated. Stigma remains an issue with many government and private doctors not willing to, or not equipped to, treat people with HIV/AIDS.
Hospital care for the AIDS affected is restricted to a few institutions. Anti-retro viral drugs, which can ensure longer lives for the HIV infected, are too costly for most people.
The silver lining comes from Andhra Pradesh, Tamil Nadu and Maharashtra — which, along with Karnataka, Mizoram and Nagaland — have the highest HIV prevalence yet managed to check the disease. Tamil Nadu has stabilised HIV prevalence in antenatal clinics around 1 per cent. Andhra has reduced it from 2.63 to 1.25 in the past three years. (This report has been published under the KSAPS-ICHAP Press Fellowship for HIV/AIDS)