Challenges that the AIDS scourge pose have not changed much over the years it's still all about creating awareness,fighting discrimination and providing interventions for prevention and treatment.
Gujarat stands third in the country in number of targeted intervention (TI) projects to tackle AIDS. This is surprising, considering that the state is categorised as a moderate HIV-prevalence state.
As per a UNAIDS estimate, India has the largest number of people living with HIV outside South Africa. However, heartening figures from NACO's 2007 sentinel survey indicate that number of people with HIV/AIDS in India has dropped to 2.31 million from 2.41 million as per the 2006 survey.
Gujarat has 76 TIs as compared to 96 in Andhra Pradesh and 82 in Tamil Nadu, as per 2006 National AIDS Control Organisation (NACO) figures. This was revealed in a recent paper by faculty of Indian Institute of Management, Ahmedabad (IIM-A).
"Targeted interventions, which aim to prevent spread among vulnerable and marginalised populations, involve IEC (information, education and communication) which helps reduce stigma and BCC (behavioural change and control) which helps in modifying risky behaviour," says the paper.
The paper titled Managerial Challenges in Addressing HIV/AIDS: Gujarat State AIDS Control Society (GSACS)' is written by professors KV Ramani, Dileep Mavalankar, Devanath Tirupati and Vijaya Sherry Chand.
Says Dr Rajesh Gopal, joint director of GSACS, "We are fighting two epidemics AIDS and the stigma attached to it. We have to come out of the institutional healthcare model and emphasis should be on communication. All four routes of transmission unsafe sex, infected needles and syringes, infected blood and parent-to-child transmission are preventable."
According to him, Gujarat is moving towards being a low-prevalence state with less than five per cent prevalence among high-risk groups and less than one per cent prevalence among general population.
Currently, there are six ART (antiretroviral therapy) centres in the state at Ahmedabad, Rajkot, Mehsana, Bhavnagar, and two in Surat. The seventh in Surendranagar just received a nod last week.
On Monday, World AIDS Day, three patients will get the second line of ART at Civil, Hospital, Ahmedabad, he reveals. The IIM-A paper stresses the need for behavioural surveillance of high-risk groups like commercial sex workers (CSWs) and their clients, men who have sex with men (MSMs), injecting drug users (IDUs), migrant workers, truck drivers and street children. Inadequate screening of blood and beating opportunistic infections, most commonly tuberculosis, are other problems.
Anjoo Sheth, director of suicide prevention centre Saath, says, "AIDS patients often contemplate suicide because of rejection from their families. When they are in the last stages, relatives are unwilling to care for them as they fear infection. There is urgent need for hospices in the state where those who are terminally ill can be given proper care."
Number of ICTCs (integrated counselling and testing centres):
Andhra Pradesh 752
Tamil Nadu 710
Total in country 4,155
* 2007 Naco figures
Referance:Times of India, December 01 2008