PROF.DRRAM ,HIV/AIDS,SEX DIS.,SEX WEAK.& ABORTION SPECIALIST
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Every two years, researchers, implementers, policy makers, and community activists come together at the International AIDS Conference to take stock of the pandemic: Where are we now? Where have we been? Where are we heading? Discoveries are heralded and strategies dissected. There are always more questions than answers, but there is one question that needs to be answered at AIDS 2014 and beyond: Do we conssider fot diagnosis,care and treatment of key poor aafected persons like flying or commercial sex workers,stigmatised and criminalised members of LGBRT ,many fall prey to MEN to MEN SEX ,drug injectors,trangenders,migratory labors and even truck drivers who move from one place to another for lifehood and ultimatelyfall prey to unsafe sex?
On a basic level, the answer must be a resounding and unequivocal “YES!” Every human life counts. Every life has equal value. Yet, while an affirmative chorus may echo in the halls of the conference, easy rhetoric will not be enough.Data analysis by UNAIDS indicates that as many as half of all new HIV infections globally occur in key populations. This should come as no surprise. The disproportional concentration of the virus in these groups is hardly news.Though we are frequently reminded that we are in the era of evidence-based public health, data-driven decision-making, and performance-based metrics, the evidence on HIV vulnerability in key populations is routinely ignored. We aren’t even counted in many places. Surveillance fails to find us. Not surprisingly, funding for HIV services responsive to our needs remains slight.

On July 11, 2014, the World Health Organisation released a long-awaited and rapidly developed publication, Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations. It is an impressive document written and reviewed by a Who’s Who of experts working with and representing these groups.

There can be no doubt about the sincerity or good intentions of the guidelines’ authors, and this document has the potential to influence policy and practice globally. Yet questions persist in the willingness of institutions — governments, donors, development agencies and civil society — to embrace their fundamental responsibility to the health of key populations and invest accordingly in a sustained and broad-based effort to end the unremitting toll of HIV and AIDS on our lives.
As existenec of UNO under which WHO works compromised in this world politics where nations are fighting with each other with no listening to UNO and its world bank and financial institutions are many time politicall driven as their funds decide on poerful countries like USA,UK,GERMANY, AUSTRALIA,FRANCE,CHINA ,RUSSIA ETC which provide fund for the welfare of hiv people in south usa,african and asian countries where such poor key persons of HIV RESIDE

MANIPUR CAG REBUTS MANIPUR SAC REPORT FOR HIV PREVALENCE AIDS CASES HAS RAISED TO 40,855 BY 2012 THAN 25919 IN 2007 ALTHOUGH GOVERNMENT SPEN 50 CRORES FOR ITS PREVENTION

PROF.DRRAM ,HIV/AIDS,SEX DIS.,SEX WEAK.& ABORTION SPECIALIST
profdrram@gmail.com,+917838059592,+919832025033,DELHI –NCR,IND
HIV/ AIDS,CANCER LATEST MEDICINES AVAILABLE AT CHEAP RATE.
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MANIPUR CAG Report, said that in March 2007, about 25,919 HIV cases were reported but The count increased to 40,855 in March 2012, is of a great concern, over the increase which is of a serious magnitude. Despite spending Rs 43.39 crore for implementation of Targeted Intervention (TI) programme, there's an increase in HIV positive cases. This just reflects poor performance and unsatisfactory results in curbing new infections in high-risk individuals, said the report.
Although Manipur AIDS Control Society (MACS) has rebutted the CAG report that was presented in Manipur legislative assembly..MACS authority as well as Targeted Intervention Programme Centres running in the state that the figure that have been projected cannot be an indication of transmitting of new HIV positive cases, rather the increase of HIV positive cases are the contribution from old cases which have been concealed in view as stigmatisation and discrimination, also many HRG persons from the neighbouring country and state who have got tested in the state is also one of the factors in the increase of HIV positive population.
Six countries – China, India, Indonesia, Myanmar, Thailand, and Vietnam account for more than 90% of the people living with HIV in the region.
'India has the third largest number of people living with HIV in the world – 2.1 million at the end of 2013 – and accounts for about 4 out of 10 people living with HIV in the region,' the report said.

It said HIV treatment coverage is only 36% in India, where 51% of AIDS-related deaths occur. The report said new HIV infections in South and South-East Asia declined by 8% and by 16% in the Pacific between 2005 and 2013.In India, the numbers of new HIV infections declined by 19%, yet it still accounted for 38% of all new HIV infections in the region. The proportions of people who do not have access to antiretroviral therapy treatment are 64% in India.
SUCH DATA HAS BEEN PUBLISHED BY INDIAN GOVERNMENT AND MANY NGOs WHICH ARE S[ENDING CRORES OF RUPEES AND GETTING HUGH INTERNATION GLOBAL FUND,CLINTON AND BILL GATES BUT MANY INTERNATIONAL AND COUNTRY SOCIETIES DOENOT AGREE WITH THIS AS IT APPEARS MANIPULATED AS KEY PERSONS AFFECTED BY HIV ARE POOR FLYING AND COMMERCIAL SEX WORKERS WHO ADAPTS SUCH THING FOR LIFE HOOD AND OFTEN HIDE FOR POLICE ARREST AND DO SUCH BUSINESS IN HIDE,SAME WAY TRANSGENDER PERSONS AND GAY PERSONS CRIMINALISED AND STIGMATISED IN SOCIETY SAME WAY DRUG INJECTORS CATCH SUCH HABIT MOSTLY AS POOR AND FOR ILLICIT TRADE FOR EARNING MONEY ,SAME WAY MIGRATING LABORS AND MOVING TRUCK DRIVERS HARDLY GET TREATMENT SENTRES FREE FROM STIGMA AND CRIMINALITY SO AIDS IS LAT DIAGNOSED AND TREATED.
SOCIETY IS ADVANCING SO MIDDLE AND LOWER MIDDLE DO MIXING IN SOCIETY,RISING RAPE CASES,DETERIORATION OF SOCIAL VLUE IN SOCIETY FOR ADVANCEMENT BY MONEY EASY PRNOGRAPHY MATERIALS IN NEWS MAGAZINE AND IN FILMS AND ON NET AND MOBILE PHONES ,PARTY IN HOTELS WITH DRUG AND ALCOHOL ALL SAY HIV AND STDs are on rise but actual their estimation is lacking as most donot go for testing and even do then privately hiding report and seeking treatment for fear off stigma and myth prevalent in society against HIV/AIDS OR SEX TRANSMITTED DISEASE.THERFORE DATA OF HIV OR STDs PREVALENCE IS NOT ACCURATE IN INDIA OR MANY DEVELOPING COUNTRIES AS REVEALED IN CAG REPORT IN MANIPUR ASSEMBLY

HIV/AIDS :WHAT SHOULD BE TESTED AND HOW AND WHEN ? TEST RECOMMENDED AT DIFFERENT STATES FOR HIV/AIDS -DO IT UNDER MEDICAL GUIDANCE ONLY AS NEED INTERPRETATION BY EXPERT

PROF.DRRAM ,HIV/AIDS,SEX DIS.,SEX WEAK.& ABORTION SPECIALIST
profdrram@gmail.com,+917838059592,+919832025033,DELHI –NCR,IND
HIV/ AIDS,CANCER LATEST MEDICINES AVAILABLE AT CHEAP RATE.
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After any reason mentioned in previous page the suspected person should undero different tests for conformation:

1.antibodies test: done by Elsia,western blot and simple antigen,antiody card test must be confrmed at least two times and if possible by western blot for confirmation of HIV I AND II,KIT SHOULD DETECT BOTH HIV I AND II,althouh HIV ii is rare in our country and these tests are never positive befor 21 days post infection but maynot positive in some patients even upto 6 months and rarely upto 12 or a8 months in slow progressors .It may be negative in advanced stage and may be false positive if coinfection with hbsag or hcv infection or serum kept for long time ,other immunity disorders.
2.P-24 Antien test and antibodies test: may be positive within 14 days of infection and may show positivity in new born of infected mother even within 1-3 months,antibodies test positive after 6-8 months and then p24 antigen disappears but may re appear if disease is advanced .
KEY to diagnosis of HIV /AIDS or any other Sex transmitted disease is testing by blood or body fluid like csf,vaginal,semen or ascitic or pleural fluid and now a days urine and salivary secretion too.
3.HIV DNA PCR : detect hiv even in early sae in new born and in a patient although positive but hiv rna pcr is negative.
4.HIV RNA PCR : both qualitative and quantitative indicate positivity strongly and determine stae of disease as per viral load.
5.HIV Genotype : both for HIV I and II differnet enotype study indicate for different strains prsent
6.Hiv drug sensitivity: different strains and drugs sensitivity done to know resistance and change the drug.
7.Simple Blood test nd test of total wbc count and Lymphocytes,esr ,crp and neutrophils count.
8.CD$ and CD8 cells count cd4 diminishes and cd8 increases in HIV infection so ratio is always low,if cd4 count is fallin 30-40 pm disease progressin very fast.CD$ cells percentae to lymphocytes is more important in children if fall beow 20% treatment is started but now for every asymptomatic child too we offer treatnment.
9.Neopterin level : it increases as more macrophages infection.it is non specific.
10.B2 micoglobulin level: due to increase macrocytic activity reaction it is more liberated.
11.Interleukin -2 level it increases as more cellular immunity comes in focus.
SO MANY TESTS AND THEIR INTERPRETATION IS DIFFICULT SO ONE PERSON SHOULD NOT GET FRIGHTENED IF ONE POSITIVE SHOULD O FOR MORE DETAILS AND THIS IS POSSIBLE BY ONLY AN EXPERT SO SELF TESTIN WILL INCREASE DIFFICULTIES ONLY,ONE SHOULD GO TO EXPERT AND HE./SHE WILL DECIDE WHICH IS BEST FOR ONE PATIENT SEEING HIS GENERAL CONDITION AND OTHER INFECTIONS AND STATUS AND DAY OF REPORTING AND ECONOMICAL STATUS.
Now a days any person can ask for testing although advanced nation are asking for everybody to et tested for hiv but still in India,FSW,CSW, Sexworkers, Migratory labors,truckdrivers,all patients at std clinic,prenant mothers and blood donors are tested only.
But in all private hospital of metro and big cities are getting tested for HBSag,HCV and HIV mandatory without counselling (which is illegal)