BANGALORE: For a year-and-a-half not a day passed without Jaya (name changed) thinking how good it would have been if there was an anti-retroviral treatment (ART) centre at the district hospital in Gulbarga.

Now, that the centre is functional, but it is a bit too late, at least for her.

The 39-year-old HIV positive requires the second line of treatment. But the Government does not provide it at any of its hospitals.

So, like she has for the past year Ms. Jaya continues to travel to Bangalore for treatment. But instead of going to the government hospital, she visits a private hospital.

The journey is tiring and the costs are huge. "It is not easy for me to come here for treatment. It is difficult to get leave," she says.

Ms. Jaya, who works as a secretary in a private office, spends more than Rs. 32,000 a month on medicines.

For the present, she is managing with the money she got by pawning her jewellery. "I have pawned the last of what I had. I do not know what I will do next," she says.

"I also don't like being away from my family for too long. My children get worried when I go out of town," she says.

A second line of treatment for HIV/AIDS is required when the first line of treatment fails either due to toxicity of the first line medicines or resistance to them.

The second line of treatment uses a different combination of medicines from the first line regimen. It is about 20 times more expensive than the first line and is not easily available.

The Karnataka Network of Positive Persons says that at least at least 2 per cent of persons living with HIV/AIDS in the State are in need of the second line of treatment.

Elango of the Network says that while access to treatment is difficult for such persons, it is worse for those who require the second line of treatment.

"The Government does not have any facility to check for HIV drug resistance. So, many times people find out about their resistance and change their medicines very late," says Mr. Elango.

He says in the past year, three people were found resistant to the first line of medicine. The HIV resistance test is mostly done in private laboratories. But the tests cost more than Rs. 20,000. According to the 2004 sentinel survey, 50,000 people in the State live with HIV/AIDS. Other agencies, however, put the figure at around five lakh.

N. Jangay, technical consultant, Karnataka State AIDS prevention Society (KSAPS), says it is not possible to provide the second line of treatment for HIV/AIDS at government hospitals as it is very expensive. "The National AIDS Control Society cannot afford the second line of medicines."

Even the first line of medicines is being provided only to 1 out of every 10 persons who need it.

At present, 3,000 persons living with HIV/AIDS in the State are on the government programme for ART. But access to treatment has been difficult. Since the start of ART in government hospitals in 2004, medicines were provided only by a few hospitals in the State such as Bowring and Lady Curzon Hospital, Bangalore, Mysore Medical College, Mysore, and Karnataka Institute of Medical Sciences, Hubli.

In the past one month, KSAPS has set up ART centres in Gulbarga, Bijapur, Raichur, Bagalkot, Belgaum, Davangere, Kolar and Mangalore. But the medicine has not reached most of these centres.

"We are trying to ramp up ART in the State. But it is difficult," says Mr. Jangay.

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