                |
||
 |
HIV/AIDS: Big Questions • Who determines the numbers, and how? In 2006, UNAIDS declared that India had 5.7 million HIV-positive people. NACO put the figure at 5.2 million. Simultaneously, others warn that by 2010 India will have 20 million positive people. Finally NFHS-3 comes along and puts the HIV burden at 2.5 million. Where do these multiple, conflicting estimates of HIV burden come from? Who has an interest in inflating -- or downplaying -- AIDS figures? What are the different methodologies used to arrive at these numbers? More... Is HIV/AIDS skewing the priorities of the public health system?The bulk of health problems facing Indian people are simple -- malnutrition, malaria, diarrhoeal diseases, etc – and they require simple solutions -- food, mosquito control and clean water. But the government’s approach to public health increasingly focuses on vertical programmes to tackle each disease instead of comprehensive healthcare. The AIDS control programme is another vertical programme that reinforces our misplaced priorities, and also puts more pressure on an already crumbling public health infrastructure More... What has changed for people living with HIV?Many experts feel that it’s time we moved beyond HIV/AIDS awareness campaigns and began seriously tackling the practical considerations of getting medicines to patients. Awareness is important, but it’s useless if we cannot provide the medicines More... Zarina: 'We need more than information'Zarina is just one of thousands of HIV-positive people caught between a government that cannot provide care and treatment to all, a private sector that is expensive and swarming with quacks, and NGOs that are driven by their own agendas More... Why do less than half of those who require ART get treatment?Despite the fact that India is a major producer of cheap generic HIV and AIDS drugs, India’s ART programme is poorly conceived, implemented and monitored, with a shortage of drugs, equipment and personnel in most states. An unprepared public health system with no transparency is in no position to handle such an intensive programme More... Transmission: Is it just about sex and drugs?Do we really know what the various forces driving India’s epidemic are? Some studies report that around 23% of medical injections could be using unsterile syringes or needles. WHO estimated that unsterile medical injections accounted for 24% of HIV transmission in India in 2000. But India has focused almost exclusively on the sexual route of transmission. Very little space is left for non-sexual routes of transmission. This has important implications for the prevention programme More... Criminalising high-risk groups such as MSMAll three core groups affected and infected in the HIV epidemic -- men having sex with men, sex workers and injecting drug users -- are criminalised in India. How can any intervention work amongst groups whose behaviour is criminalised? Basic structural changes are called for, including the deletion, or at least reading down, of Section 377 of the Indian Penal Code on sodomy, decriminalising sex work and curbing narcotics trafficking instead of punishing end-users More... Sex workers continue to be treated as vectors of diseaseFemale sex workers constitute less than 1% of the infected female population in India. Yet, they are seen as a high-risk group and are the target of various HIV-related interventions. Such targeted interventions only end up further alienating communities instead of empowering them to combat HIV More... Moving beyond detoxificationThe prevalence of HIV amongst injecting drug users in India could be more than 5%. But the only government intervention for these hidden, marginalised people is detoxification. Those who cannot obtain treatment and continue to inject drugs, or those who relapse, need other methods for reducing the risk of HIV transmission, including community outreach, the provision of new needles and syringes, condom provision and drug substitution therapy More... Why are AIDS drugs unaffordable in India?The big question facing HIV-positive people in India is access to affordable antiretroviral drugs. Already, second-line drugs cost over Rs 1 lakh per person per year in India, compared to approximately Rs 50,000 in 66 other developing countries More... Prevention of HIV transmission: Do we know what works and what doesn't?We know that HIV prevalence has stabilised or dropped in some parts of the country and amongst certain groups of the population. We know, for instance, that prevalence amongst female sex workers in Maharashtra has dropped from over 54% to 23%. And that prevalence in the general population in Tamil Nadu has dropped from 1% to .5%. But do we know why? An analysis of prevention efforts in India, the successes and failures, throws up more questions than answers More... Falling through the cracks: PPTCT in IndiaParent to child transmission of HIV in India infects 56,700 children every year. The third phase of the National AIDS Control Programme aims to reach 7.5 million women and give prophylactic treatment to 75,600 infected mother-baby pairs. The task is ambitious: in 2005, just 2.9 million women were reached, though the target was 6.9 million More... Do we need a separate law on HIV/AIDS?Stigma and discrimination lead to the most significant human rights violations for persons living with HIV/AIDS and are the greatest barriers to preventing further infection and providing care, support and treatment. But India has no existing legislation which would cover discrimination on the grounds of HIV. And the framework of public health legislation is too limited to adequately cover HIV issues More... Is premarital HIV testing feasible - or desirable?Three states are considering legislation on compulsory HIV testing before registration of marriage. Public health activists, however, point out that premarital counselling and life skills education, not compulsory testing, are more likely to ensure behavioural change. Such a law might end up increasing the social ostracisation of the HIV-positive, adversely affecting women, the very group the law sets out to protect More... Are we ready for provider-initiated HIV testing?At present, testing for HIV can only be done at the client’s request and with his/her consent. Recently, the WHO issued guidelines enabling a shift from client-initiated testing to HIV testing recommended by healthcare providers in any situation where they find it necessary. Does this make sense in India, which does not have the resources to test millions, and where care and treatment is not available even to the existing HIV-positive population? More... Vaccine development: Still a shot in the darkThere are more than 20 trials of HIV vaccine candidates across the world. But the most promising one has failed. We are far from achieving the goal of an HIV vaccine, says Dr Shahid Jameel of the International Centre for Genetic Engineering and Biotechnology More... What are the challenges in conducting clinical trials for an HIV vaccine?India recently completed its first clinical trial for an HIV candidate, a Phase 1 safety trial at the National AIDS Research Institute, Pune. A second Phase 1 trial is ongoing at the Tuberculosis Research Centre (TRC), Chennai. Sanjay Mehendale, Deputy Director of the National AIDS Research Institute (NARI), discusses the logistical and ethical issues involved in running a trial for an HIV vaccine More... |
| Microsites | ||||||||
|---|---|---|---|---|---|---|---|---|
|
| Newsletter |
|---|
| Syndicate |
|---|
 |