Combatting HIV/AIDS

President Mahinda Rajapaksa recently called on world leaders to unite in the relentless fight against HIV/AIDS when he inaugurated the eighth International Congress on AIDS in the Asia/Pacific region at the BMICH.

While reiterating the Government's commitment to combat the scourge of AIDS, he said that Sri Lanka was considered a low prevalent country in the region with only 0.1% of the total population infected.

It is gratifying to note that AIDS affects less than 0.1 per cent of Sri Lanka's population; among the high risk groups, it affects less than one per cent.

Nearly two decades since reporting its first HIV infection, Sri Lanka remains one of the few countries in the region with a low-level in AIDS cases.

There is considerable evidence that Sri Lanka is vulnerable to the development of concentrated AIDS epidemics The latest statistics show that up to May 2007, 872 persons had been diagnosed as HIV positive, of whom 220 had developed AIDS and 162 had died.

AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If a person is infected with HIV, his/her body will try to fight the infection. It will make "antibodies," special molecules to fight HIV.

Being tested positive for the HIV virus is not the same as having AIDS. Many people are HIV-positive but don't fall ill for many years. As the HIV disease worsens, it gradually wears down the immune system. Viruses, parasites, fungi and bacteria that usually don't cause any problems can make one sick if his/her immune system is damaged.

Having sex with an infected person is the most common way of becoming HIV positive. However, one could fall prey to that category by sharing a needle (injections) with someone infected or being born when the mother is infected, or by being breast fed by an infected woman.

Getting a transfusion of infected blood used to be a way people got AIDS, but now the blood is screened stringently and the risk is extremely low.

There are no reported cases of HIV being transmitted by tears or saliva, but it is possible to get infected with HIV through oral sex or in rare instances through deep kissing, especially if one has open sores in one's mouth or bleeding gums.

The number of HIV/AIDS positive cases in Sri Lanka is comparatively low. However, a rising commercial sex industry, high mobility from migration and non use of condoms makes Sri Lanka highly vulnerable to a large-scale epidemic.

Sri Lanka's first HIV infection case was reported in 1986 and the cumulative total reported at the end of 2004 was 614 - 363 males and 251 females. The reported number of deaths due to AIDS was 131 as at end 2004.

The estimated HIV prevalence between those in the age group 15-49 in 2003 was less than 0.1%. It is estimated that 5,000 persons had been living with HIV in Sri Lanka at the end of 2005. The current ratio of HIV-positive men to women in Sri Lanka is reportedly 1.4 to 1, although in reality, there may be more men than women infected as in the most early phase of HIV epidemics.

Sri Lanka initiated its HIV prevention and control efforts in 1992 under the National STD and AIDS Control Programme (NSACP) of the Ministry of Health and the Director General of Health Services. In addition, the National Blood Transfusion Services (NBTS) and the National Programme for Tuberculosis and Chest Diseases (NPTCD) strengthened their responses to check transmission and prevent the further spread of HIV.

These services are provided in collaboration with eight Provincial Directors of Health Services and the district staff.

Reducing the stigma associated with HIV and AIDS in our country needs greater involvement of civil society and business organisations, the entertainment industry, religious leaders and the medical community.

As respected opinion leaders, they can play an effective role to stop the harassment of groups promoting positive attitudes towards people with HIV and AIDS and creating a conducive environment for preventive efforts.

Training the police to deal with vulnerable groups and engage HIV-positive groups are central to these efforts.

The Government, the Ministry of Health or international organisations here alone cannot battle the threat of AIDS. Scaled-up prevention efforts require a multi-sectoral approach, involving other ministries and departments covering finance, education, agricultural extension, transportation, the police and the security forces, as well as partnering with NGOs, the private sector and civil society organisations, such as trade unions and other worker fora.

Sri Lanka has not been labelled a low risk country when it comes to positive AIDS/ HIV cases. But it is important that we take adequate steps and intensify our AIDS prevention programme so that we could maintain this position in the future too.