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HIV: Why low-prevalence Lanka should press panic buttons

by Vimukthi Fernando

When a high official involved in HIV prevention and containment located herself in a village to carry out her first assignment, her first stop was the local police station.

There she found out that the highest number of complaints lodged therein were based on extra-marital relations. It had been the most common factor for disputes, whether the complainant was male or female.

This is only one village in remote Sri Lanka. Now, multiply this by the number of villages in the country. So much for Sri Lanka's much vaunted 'immunity'' from HIV aids.

Whether we like to accept it or not, multiple sexual partners has been a norm, rather than the exception, in rural Sri Lanka before a values-based 'invasion' in the form of puritan Victorian values. History, tradition and folklore bear witness to various degrees of permissiveness that prevailed, remnants of which could still be seen in rural Sri Lanka. Therefore, 'vulnerability' to HIV is a challenge that needs a better response from us, Sri Lankans.

Sri Lanka's vulnerability to HIV/AIDS is high, noted many speakers. Proximity to high-prevalence countries, increased traffic between Sri Lanka and these countries, especially neighbouring India, increasing number of migrant communities and high numbers of internally displaced persons are pointed out as risk factors.

The spread of HIV/AIDS among young people is noted as a point of concern. Nimal Padmasiri, a youth representative from Gramiya Samaja Sanvardhana Ayathanay (Rural Social Development Institute) points out behavioural changes in the country's youth. There was a lack of knowledge and concern about HIV/AIDS.

But, fortuitously, despite the vocally played-up fears, the official HIV numbers (according to official records) have remained low. While the accumulated number of identified HIV positive persons is close to 750, with over 200 developing full blown AIDS, the estimated figure of HIV+ persons has risen from 3,500 in the 3rd quarter of 2005 to 5,000 as at end February 2006.

One significant factor is the number of newly identified HIV+ persons. The number has been rising, and has now reached between 30-35 new identifications per quarter.

Interestingly, "groups involved in risky behavioural practices'' were among those who launched the website for the 8th International Congress for AIDS in Asia and the Pacific (ICAAP) scheduled to be held in Sri Lanka in August 2007, was launched on Tuesday. People from various walks of life...representatives from government and non-government organizations, , those who are HIV positive from different countries in Asia and the Pacific, gathered to celebrate the event.

"Why such hype about an event that is scheduled to happen in more than a year's time?" one may ask. And yet, last week's event is but just the first tentative step, says Prof. A. H. Sherifdeen, Joint Chair of the Local Organizing Committee.

Sri Lanka is known as a low prevalence country. Does it mean that the country will stay 'low prevalent' forever? Whatever the warnings are from the AIDS/STD Centre or the NGOs focusing on the problem - the multitudes engaging in risky behavior seem to think that they are 'immune' to HIV/AIDS.

A point of particular concern at the forthcoming sessions will be the fast spreading rates of HIV/AIDS in Asia and the Pacific, especially in China. "If this continues, it is possible that the total number of HIV/AIDS infected people in the region will reach around 20 million in 2010, points out a congress media release.

At the last ICAAP meeting in Kobe, in 2005, it had been noted that "the epidemic which used to spread mainly through groups who practised high risk behaviours such as sex workers, IDUs (injecting drug users) and MSM (men who have sex with men) but had spread now increasingly among the broader population including young people.

"With every wave, comes the expectation of another. The waves keep coming, they are ceaseless. Thus progress initiates responsibility in people; simultaneously renewing hope. Hope is an intrinsic character of human life. It is inexhaustible," points out a congress media release.

Let us hope that the waves of change and hope expected in Colombo in 2007 will cover Asia and the Pacific bringing healing to the regions.

The forthcoming congress will also address a number of social, medical and political issues. It will take a multi-sectoral and comprehensive approach, promoting corporate responsibility, says Prof. Myung-Hwan Cho, President AIDS Society, of Asia and the Pacific (ASAP) and Chairman, International Advisory Committee of 8th ICAAP.

The congress plans to bring together, more than 3,500 delegates from over 60 countries in Asia and the Pacific. A mixed gathering of health care professors, social and community workers, NGO representatives, political leaders, researchers, interested communities and the media are expected.

The conference will look into changes such as providing a holistic response to HIV/AIDS with the participation of government, academics, civil society and private sector. With the government at the lead, it tries to promote equity measures such as gaining legal rights against stigma and discrimination, and changes in HIV/AIDS education to help raise awareness amongst youth - including how to protect themselves from HIV/AIDS.

Dispelling myths about HIV/AIDS, prevalence changes through behavioural changes among youth, information technology and its effect on commercial sex are a few other issues lined for the congress.

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