An HIV/AIDS-free future: Are we ready?

By Carol Aloysius

The World AIDS Day, observed today, is a time for retrospection. It is a time for reflection on a scourge that has inflicted itself on millions of persons, irrespective of age, gender, ethnicity, religion and culture.

AIDS (Acquired Immune Deficiency Syndrome), as we all know, is a killer disease. It is caused by the HIV (Human Immunodeficiency Virus) which destroys the immune system of the body, enabling various pathogens to enter the body and cause disease due to the vulnerability of the immune system.

While in most countries, including neighbouring India, Pakistan, Bangladesh and Thailand, the disease has spread to reach uncontrollable epidemic proportions, in Sri Lanka the prevalence rate is still very low at 0.1 percent.

However, local health authorities are anything but complacent about the low prevalence rate. They warn that unless some effective interventions are put in place, these rates could soar, reaching epidemic proportions in the future, largely on account of a surge in risk behaviour among Lankans, in particular the youth who are most vulnerable to HIV/AIDS.

Their risky habits include having sex with partners of the same gender, having unprotected sex with multiple partners, injecting themselves with drugs such as heroin using unwashed and unsterilised syringes and smoking and drinking alcohol, the latter two habits making them more vulnerable if they have already contracted the disease.

Homosexuality

Ryan White who contracted AIDS from a tainted blood transfusion became a poster boy for AIDS in the US and worldwide. He died of AIDS-related complications at the age of 18 in 1990.

A blood test will let you know if you have AIDS or other STDs

The Human Immunodeficiency Virus

In Sri Lanka, homosexual relationships between men is the main reason for the spread of HIV/AIDS; men having sex with other men accounts for over 12 percent of HIV transmissions. This is in spite of the fact that homosexuality is still officially banned by law in our country, unlike in the West.

So, where are these relationships forged? In night clubs, hotels and other places of entertainment where drugs and sex (both homosexual and heterosexual) are on offer for a fee to anyone interested.

These are also the lair for most foreign paedophiles. The real tragedy is that the young victims lured with baubles and cash to such risky behaviour, which could make them vulnerable to HIV/AIDS, are mostly children from underprivileged environments, with little parental control and low literacy levels.

Parallel with this rising trend is the increasing number of sexually abused children. Child Development and Women’s Affairs Minister Tissa Karaliyadda has been reported to have said in Parliament that there had been 7,400 offences against children this year - of whom 357 boys and 297 girls were children of parents working in the Middle East.

Which brings us to the question: How and why is it that the paedophile network that crisscrosses the globe, and the commercial sex trade continue to remain so active at a time when efforts to halt this trend have been stepped up both by the government and non-government sector? Many organisations, including the business sector as well as the government have now come forward with various schemes to wean those engaged in commercial sex by offering them alternative means of employment. Only time will tell if these schemes have any impact on Lankan youth.

A recent social mapping exercise (2010/2011) carried out by the World Bank estimates 235,000 female sex workers in the island. Findings of surveys on female workers in garment factories in the Free Trade Zones also reveal that there is a rising number of young female factory workers who are contracting Sexually Transmitted Diseases (STDs) as a result of living in unprotected environments, far from familiar surroundings, with little knowledge on how these diseases are caused and how they can be prevented. Some studies place the number of STD cases in Sri Lanka at 60,000 while other studies place this figure at 200,000.

According to the Health Ministry, only 10-15 percent of the reported cases are from government clinics.

“These diseases can lead to more serious diseases such as HIV and AIDS”, warned a health official, who said most cases of unreported STDs and HIV are largely due to the widespread prejudice and stigma attached to these diseases. “Somebody contracting an STD or AIDS would be made an outcast by his/her family, community and at the workplace. Their colleagues will have nothing to do with them and will refuse to work in the same room due to myths about how the disease is contracted. Removing this stigma is vital for any success in minimising the number of victims of HIV/AIDS in our country”, he said.

Using unclean syringes to inject drugs has contributed to the spread of AIDS

According to UNAIDS, Sri Lanka had around 3,000 persons living with HIV at the end of 2009. By December 2011, the number of reported cases was around 1,465 with 253 deaths. Sixty percent of the reported cases were males and more than half were from Colombo.

Emerging trends

A sinister trend that is emerging is that whereas in the past, the number of women contracting HIV/AIDs was lower than men, today the ratio is almost equal for both sexes.

Another trend is that many women who are in the Most At Risk group are married and have been infected by their husbands who had worked abroad and returned with the disease.

“If a woman has the slightest suspicion that her husband may have contracted a sexual disease, she has the right to protect herself and demand that he wears a condom. The same applies to a commercial sex worker”, a sociologist said.

While many interventions have already been put in place to control the spread of HIV/AIDS, such as sex education programs for schools, youth clubs and young persons most at risk and life skills training for young persons engaged in commercial sex so they can lead healthier lives, the task is too big for a single ministry such as the Health Ministry or a single private sector or voluntary organisation to tackle.

It should involve civil society organisations, line ministries, businesses, the entertainment industry, religious leaders, the medical community, the Police and the Forces, to work together to wipe out the negative feelings about HIV/AIDS which is still widespread.

It needs changes in the legal system, and labour laws where factory owners, managers and owners of businesses can have no prejudice against workers with HIV/AIDS. Counselling should be provided to AIDS victims, their families, their colleagues and managers.

Political commitment to sustain these efforts is vital. Above all, the focus should be shifted from simply maintaining clinical labs and treatment services to more meaningful ways of preventing the disease.

Society must, therefore, reach out to help the victims and the victimised. Only then can we begin our journey towards an HIV/AIDS-free nation.

Are Sri Lankans ready to face this challenge?