HIV /AIDS INDIAN DATA: HOW MUCH THEY ARE TRUE AND RELAIBLE? DOES FOREINGN COUNTRIES RELIES THEM OR A COVERUP FOR NATIONAL PRIDE ?IS ZERO DISCRIMINATION,ZERO CASES FOR HIV IS POSSIBLE IN INDIA ?

PROF.DRRAM ,HIV/AIDS,SEX DISEASES,SEX WEAKNESS & ABORTION SPECIALIST
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On the eve of World AIDS Day, the AIDS Healthcare Foundation (AHF), the largest US non-profit healthcare provider for HIV/AIDS in the US, questioned the efficacy and the claims of the National HIV policy and India’s celebrated AIDS model . A conference they held on the eve of World AIDS Day looked to provide a reality check on the progress in India towards the UNAIDS slogan – Getting to zero – zero discrimination, zero AIDS related death and zero new infections.Globally, according to the UNAIDS report, 34.0 million people have been estimated to be living with AIDS in 2011 and about half of them do not know their HIV status.In South and South-East Asia, the estimated 270 000 [230 000–340 000] new HIV infections in 2010 is 40 percent less than at the epidemic’s peak in 1996.
In India 2.4 million HIV positive people. It’s estimated that out of these 61% are male, 39% are female and 3.5% are children. As of 2009, the adult prevalence is believed to be 0.31%. Despite, the huge number the prevalence of HIV is low when compared to our today population. On the other hand, HIV epidemic regions like South Africa have over 5 million cases with a prevalence of 18% in adults.
India has reduced new HIV infections by 57% since 2001,The recently released UNAIDS Report 2013 claims that India has managed to reduce new HIV infections by a staggering 57% since 2001. To put this in perspective, in the same time frame, our neighbours Pakistan have seen an eight-fold increase in the number of cases.siiliarly although our infnt mortality rate is higher than srilnka and bangladesh but in HIV CONTROL we are 25% ahead of them. A major reason for this a concerted effort by the Central government to tackle the ailment head on through information dissemination, education and communication. Also there has never been a case of AIDS denialism in India like there was in other epidemic countries which prevented the disease from spreading far and wide.
Drug addicts, men who have sex with men (MSM) and female sex workers are the high risk groups.In India, HIV is mainly concentrated among high risk groups who are 15-30 times more likely to contract HIV than non-high risk groups. The main high risk groups are intravenous drug users, men who have sex with men and female sex workers. HIV prevalence in men who have sex with men (MSM) stands at 4.43 percent and for female sex workers (FSW) the figure is recorded at 2.67 percent respectively.Getting treatment for high risk groups is even harder because of the stigma attached to each of the aforementioned activities. Nationally, the prevalence rate for adult female is 0.29 percent, while for male it is 0.43 percent. This means that for every 100 people living with HIV and AIDS (PLHAs), 61 are men and 39 women. Prevalence is also high in the 15-49 age group (88.7 percent of all infections), indicating that AIDS still threatens the cream of society, those in the prime of their working life.

Not enough ART – anti-retroviral therapy: Less than 10% people getting drugs.The reason HIV has become a more manageable disease instead of a death knell is because of something called anti-retroviral therapy in which a cocktail of drugs are given to HIV positive people which helps them manage their condition and prevents HIV from becoming AIDS. In fact, a study in India showed that early treatment not only prevents HIV from becoming AIDS but also lowers the chance of transmitting the virus. This has been observed in HIV discordant couples (one positive, one negative) and also mother-to-child transmission. Sadly, not enough people are getting treatment. India remains one of the countries where less than 10% HIV positive people receive ART and there are frequent cases of drug shortage. In India approximately 40 -59 percent of eligible people were receiving ART at the end of 2011.
Globally, the biggest gain has been made in reducing new HIV infections among children. Half of the global reductions in new HIV infections in the last two years have been among newborn children. The new HIV infections in children have dropped by 24 percent in the last two years.But in india less work has been done in this group and giving ART to pregnant mothers and giving ART to affected childrens.
REASONS WHY HIV /AIDS IS NOT THAT SUCCESSFUL IN INDIA:----
Still need to fight the stigma
The biggest challenge in India after the lack of drugs is the stigma attached to the ailment. When HIV was rife in the US, most people thought it was a disease that afflicted people who had it coming – the homosexuals, the drug users and the sex workers. While this view has changed over time, the stigma issue remains a problem in many parts of the world including India. We keep on coming across news items which talk about HIV positive families being ostracised, or an HIV positive people losing their jobs. It’s been often said that stigma of the ailment makes it much harder to deal with than the ailment itself. We need strict laws to curb anti-HIV discrimination and need to provide sensitisation to people to deal with people who suffer from the condition.Recently LGBT criminalisation and our hard drug control laws put all patiens of HIV under bar,MSM<FSW<DRUG INJECTOTRS where it is high hide it so disease has got large reservoir and opely available escort services,raised economical condition,more brothels and Red light areas,social living relations,open mindness, freedom to live as per choice and sex purchased by money,pressure,liquor or drugs ,pornography and sexual exhibinitism in open uncontrolled net,newspaper, socil midi,TV,Film,Rev parties all increase HIV/AIDS IN VULNERABLE GROUP AND IN AGE GROUP 15-49
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This comes in a time when the national body, NACO, claimed to have decreased HIV prevalence from 2.4 million at 0.31% to 2.1 million at 0.27% in the International Conference for AIDS in the Asia Pacific (ICAAP) held in November. The years of 2012 and 2013 saw many incidents of test kit stock out complaints from various community members and District officials in various forums. ‘Are the lower numbers due to lower access of testing facilities due to a decreased faith in the testing centres as a result of the continuous lack of test kits?’ asked AHF India.
Outdated treatment protocols?
According to Dr Nochiketa Mohanty, Country Program Manager, AIDS Healthcare Foundation, India, ’In India, outdated treatment guidelines are followed for people living with HIV on treatment as compared to the latest recommendations by WHO on CD4 count, which could help them fight the disease at a much earlier stage of disease. Not only this, outdated policies and methods of testing are implemented i.e. Serum based testing, which is less accessible, lengthy, requires venipuncture, trained technician & is cumbersome as compared to the implementation of Whole blood finger stick rapid tests, which is recommended by WHO, is more faster, & easy to perform at any place. Many lesser economies like Sierra Leone in Africa have started following these guidelines and have shared their success stories in various international forums. If they can, India definitely can implement these strategies. Is there an effort to decrease testing to find lesser people living with HIV so that a success story of a decreased HIV burden can be shared to the world?’)

Move to a two-test process

‘Developed countries like Australia and many other countries like Vietnam, China and Uganda have changed their national policies from a 3 HIV test policy to a 2 test policy in order to make testing more accessible, less cumbersome, faster as well as economical and also since the specificity and sensitivity of the results were shown to be comparable. Even in India, the Revised National TB Control Program (RNTCP) has moved from a 3 test to 2 test policy for sputum smears on similar grounds. The Department of AIDS Control in India needs to learn from these strategies to make testing more accessible especially since more than 40%, based on the earlier estimates of 2.4 Million provided by NACO, are still unidentified’, said Dr Chhim Sarath, Asia Bureau Chief, AIDS Healthcare Foundation.

‘The treatment guidelines for HIV in India are archaic and follow older versions of international guidelines of WHO and CDC recommended prior to 2009 and do not follow the current international recommendations. While WHO recommends early initiation of treatment irrespective of CD4 count and many countries have initiated treatment provision for those with CD4 count below 500, India still recommends waiting till a CD4 count of 350 and lesser to initiate treatment. For pregnant women, it is recommended that treatment be started irrespective of the CD4 count to decrease transmission but there are many instances of pregnant women who are not initiated on treatment since there CD4 count is above 350. There seems to be a greater focus on the economics of putting more people living with HIV on treatment over the larger public health perspective in India’, said Ms Terri Ford, Chief of Global Advocacy, AIDS Healthcare Foundation.

‘Department of AIDS Control, India needs to step up to the modern world instead of holding on to antiquated recommendations for testing and treatment in order to help the world curb the epidemic’, said Mr Michael Weinstein, President, AIDS Healthcare
About AHF.Globlly,NAIDS latest says to achieve universal access to HIV treatment, prevention, care and support by2015, and to maintain it, HIV programme funding needs to be scaled up from US$ 16.6 billion in 2011 to US$ 24 billion in 2015, before declining to US$ 19.8 billion in 2020.