Pandemic was a blessing in disguise. While it was sad that many people lost their lives due to COVID-19 virus, the overall HIV burden in states were reported to down due to lockdown. I wonder if people stopped getting intimate during lockdown. Of course, they did, and you can see record sales of contraceptives including condoms. Yes, cross intimacy was limited, as movement was restricted and spread of HIV virus was almost controlled.
Till Dec 2022, there were an estimated 0.169% or 24 lakhs (2.4 million) Indians living with HIV in an overall population of 1,412,940,376 (based on UN data, Dec 8th) compared to pre-pandemic numbers i.e. 1.71% or 23.49 lakhs (2.3 million) of PLHIV in a pool of 1,380,004,385 Indians. HIV prevalence in India continues to be 0.22 per cent low. So finally, we were able to tame the virus and did not let it spread or increase.
Based on published reports, annual new infections have declined by 48 per cent compared with the global average of 31 per cent. Additionally, AIDS related deaths hit an all-time low at 82 per cent, against the global average of 42 per cent (Indian express, Dec 1,2022).
All of this did not happen overnight, but there were strategic initiatives taken by current Government towards the attainment of United Nations’ Sustainable Development Goal 3.3 of ending the HIV/AIDS epidemic as a public health threat by 2030.
The HIV & AIDS Prevention and Control Act, 2017 The Act offers a legal and enabling framework to safeguard the human rights of infected and affected populations in India. It also protects the rights of people living with HIV and affected by HIV. NGOs and helplines created by National AIDS and STD Control Program (NACP) that has been working since 1992 have worked hard towards its containment. We must admit that whether its COVID or HIV, we have the intent and infrastructure to control any such infectious disease. At a time when rest of the world is reporting COVID deaths and HIV infection, let us take examples of few densely populated states in India that have set an example.
a) Maharashtra (estimated population of ~124 million)
- Infections among new mothers have been dropping by an average 20%
- 2.5 lakh patients are currently in ART (reports of 90% suppression of viral load)
- First seven months of 2022-23, almost 8,500 new cases of the viral disease have been found in the state as against 11,196 in the entire 2021-22, official data has revealed ahead of World AIDS Day.
- Maharashtra is likely to have missed nearly 10,000 cases of HIV (human immunodeficiency virus) infections due to a significant drop in testing in 2020-21 but the state is confident that it will increase number of testing in 2022-23.
- Pune has reported a drop in HIV cases since 2016 (1,828 versus 1,136 in 2022 till October)
- Mumbai has infact shown drastic change in HIV numbers in 2022.
Source: SUMITRA DEBROY / TNN / Updated: Dec 1, 2021, 06:56 IST (Times of India)
b) Karnataka (estimated population 66.17 million)
- Till Oct 2022, out of 1,865,141 people tested, 7,696 have tested positive (0.4%). The numbers were far more alarming if we look at the historic data. Based on an article by Indian express, 2,582,946 people tested in 2019-2020, 15,683 tested positive (0.6%)
- In 2019, one of the multispecialty private hospitals BGS Gleneagles Global Hospital in Bengaluru reported 19 HIV positive cases, in 2020 eight cases were reported, followed by 7 in 2021 and in 2022 till December there were total 12 cases. (Source: Indian express, Dec 1,2022)
- There are 54 designated sexually transmitted infection clinics across all districts and taluka level hospitals with two State reference centres or SRCs in Bengaluru and Hubballi.
Dr Aravind S N, Consultant, Internal Medicine, Aster RV Hospital, said, “We have not attended too many cases of HIV at Aster RV Hospital this year. The patient footfall has drastically come down, which is a tremendous progress in curbing the spread of HIV.”
Source: published interview with Indian express reported by A Thakur, Dec 1,2022
- In a story published by a leading daily in August 2022 (TOI) it was reported that 65% of the HIV/AIDS-positive people in the state were infected because of unsafe sex while around 32% were intravenous drug users (IDU). Mizoram reports high number of HIV positive cases each year and leads the tally among other states in India (10 times higher).
- As per PTI reports, During the fiscal 2021-2022, at least 1,620 people were diagnosed with AIDS against 1,900 in 2020-2021 and 2,338 in 2019-2020. It can be safely assumed that the cases and HIV programs are under high vigil and if the state can maintain and hold on to the prevalence rate, it will see a de-growth in next 2-3 years.
Living with HIV in India
It’s true that HIV doesnot have a permanent cure but it has become manageable in 2022. In India, patients diagnosed with HIV are put on ART which is a life long therapy irrespective of CD4 count/viral load. People with advanced conditions or high viral load are given more focus and interventions. ART is a combination of different classes of drugs which suppresses the viral replication and deals with drug resistance. It is safe and available via government and private clinics.
Image source: cmeindian.in
In 2022, we have come a long way from fearing the virus and dealing with deaths due to HIV. We understand that 40% of HIV cases can be controlled if STI are diagnosed and treated well. We have started accepting that ART is a possible way of survival, people have started using PREP as part of their precautionary measure in the event they have unprotected sex or feel they have been exposed to HIV.
About the Author
Dr Siddhartha Dutta is an advisor to the board of Femtech India and Practice Head of SG Analytics Pvt Ltd. He is a medical microbiologist by background and has degrees in marketing and clinical trial. For the last 23 years, he has been tracking the global pharmaceutical and diagnostic space and for the past few years has been passionately driving and mentoring start-ups in the femtech and health-tech space. He believes in a gender-neutral, inclusive society for all with access to quality and sustainable healthcare practice.