World AIDS Day

1 December 2020

World AIDS Day is celebrated on December 1 every year since 1988. It is dedicated to raise awareness, educate and improve the understanding of HIV as a global public health problem. It provides an opportunity to understand the interdependence between progress in ending Acquired Immunodeficiency Syndrome (AIDS) and progress towards Universal Health Coverage and the right to health.

During COVId-19 pandemic with a devastating impact on communities and people, the global targets for HIV “90-90-90” for 2020 are missing, which were to ensure that: 90% of people living with HIV are aware of their status; 90% of people diagnosed with HIV are receiving treatment, and 90% of all people receiving treatment have achieved viral suppression.

According to WHO, in 2019,

• 38 million people were living with HIV infection.
• One in five people living with HIV were not aware of their infection.
• One in 3 people receiving HIV treatment got disruption in their treatments, testing and prevention services, especially children and adolescents.
• 690 000 people died from HIV-related causes.
• 1.7 million people were newly infected.

But missing the global targets for HIV for 2020 should not be a setback, it should be taken as a renewed call to do better. It is time now for global leaders and citizens to work together to end COVID-19 and get back on track to end HIV by 2030. WHO calls for “global solidarity” to overcome the challenges posed by COVID-19 on the HIV response.

The WHO theme for World AIDS Day this year is Global solidarity, resilient HIV services.

The key actions are:

• Renew the fight to end HIV: The global AIDS response has slowed down during COVID pandemic, hence innovate HIV services with broader health care and the pandemic response to get back on track to end HIV by 2030.
• Use innovative HIV services to ensure continued HIV care: WHO has recommended multi-month prescriptions of HIV medicines to protect the health of people on HIV treatment and to reduce the burden on overburdened health services.
• Engage and protect the nurses, midwives and community health workers: The frontline health workers, nurses, midwives and community health workers should be protected when delivering services for HIV and COVID-19. 

• Prioritize the vulnerable – youth and key population: Youth and key populations (such as people who use drugs, men who have sex with men, sex workers, transgender people and people in prisons) should get health care services along with the response to COVID-19 pandemic.  

What is HIV/AIDS?

Infection caused by the Human Immunodeficiency Virus (HIV) in the human body results into weakening of people’s immune system (defense system) against infections and some types of cancer. This immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off.

The most advanced stage of HIV infection is called as Acquired Immunodeficiency Syndrome (AIDS). It is defined by the occurrence of any of more than 20 opportunistic infections or HIV-related cancers.

Signs and symptoms:

• The symptoms of HIV vary depending on the stage of infection. The first few weeks after initial infection, individuals may experience no symptoms or an influenza-like illness including fever, headache, rash, or sore throat.
• As the infection progresses, an individual can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough.
• Without treatment, they could develop severe illnesses such as tuberculosis, meningitis, severe bacterial infections and cancers.

How is HIV transmitted?

• Sexual Contact: The most frequent mode of transmission of HIV is through sexual contact with an infected person.
• Sharing needles or syringes: HIV can be transmitted through needles and syringes contaminated with HIV infected blood.
• Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV can result into HIV infection.
• From mother to child: A pregnant woman infected with HIV can transmit the virus to child during pregnancy, birth, or breastfeeding.

High Risk groups (HRGs)- Female sex workers (FSW), men who have sex with men (MSM), transgender (TG)/Hijra and injecting drug users (IDUs) belong to high risk groups. 

Bridge Populations- Individuals who have sexual partners in the high risk groups as well as other partners of lower risk (general population) are called a “bridge population” because they form a transmission bridge from the HRGs to the general population. Truckers and Migrant workers are named as bridge population due to their close proximity with high risk groups and are at the risk of contracting HIV.

HIV is not transmitted:

• By hugging, shaking hands, sharing toilets, sharing dishes, or closed-mouth or “social” kissing with someone who is HIV-positive.
• By mosquitoes, ticks or other blood-sucking insects.

Prevention and control of HIV/AIDS:

National Aids Control Programme (NACP) is a 100% centrally sponsored scheme by the Ministry of Health and Family Welfare, Government of India. The programme is being implemented through the State AIDS Control Societies (SACS) and District AIDS Prevention and Control Units (DAPCUs) in the country to reduce new infections by 50% (2007 Baseline of NACP III) and to provide comprehensive care, support and treatment to all persons living with HIV/AIDS.

Even though the prevalence of HIV is decreasing over the last decade, following activities under the NACP would provide essential support in arresting new infections and thereby achieving the target of "Ending the epidemic by 2030" for Sustainable Development Goals.

• Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Disease (AIDS) Prevention and Control Bill to ensure equal rights to the people infected with HIV and AIDS in getting treatment and prevent discrimination of any kind.
• ‘Test and Treat Policy’ for HIV with the objective of “as soon as a person is tested and found to be positive, he will be provided with ART irrespective of his CD count or clinical stage.”
• The life-saving third- line ART treatment for HIV patients free of cost
• 90–90–90 strategy will identify 90% of people living with HIV, place 90% of people identified as living with HIV on treatment and ensure that 90% of people on treatment have sustained viral load suppression by 2020.

Red Ribbon Express- It travels across the country through a specified route chart to spread awareness on HIV/AIDS, promote safe behavioural practices, strengthen people's knowledge about the measures to be taken to prevent this epidemic and develop an understanding about the disease to reduce stigma and discrimination against People Living with HIV/AIDS. 

Keyways to prevent HIV transmission

• Practice safe sexual behaviours such as condoms
• Get tested and treated for sexually transmitted diseases.
• Never share needles or other injecting equipment, including syringes, spoons and swabs (injecting drug users).
• All pregnant women should be tested for HIV as a part of routine antenatal screening, and start HIV treatment immediately if found positive for HIV.
• Post-exposure prophylaxis (PEP): It is the short-term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure, either occupationally or through sexual intercourse.
• Pre-exposure prophylaxis is advised to those people who do not have HIV but are at very high risk of getting HIV to prevent HIV infection by taking medicine.

FAQs- http://naco.gov.in/faqs

For more information- http://naco.gov.in/,www.nhp.gov.in

National Strategic Plan for HIV/ AIDS and STI 2017- 2024

HIV and AIDS Prevention and Control Act 2017-click here

References-

https://www.who.int/campaigns/world-aids-day/2020

https://www.who.int/news-room/fact-sheets/detail/hiv-aids

https://www.who.int/hiv/topics/prep/en/

http://naco.gov.in/