Kerala - Thiruvananthapuram   

Number of HIV-positive cases in State drops

Thiruvananthapuram: Kerala has managed to contain the prevalence of HIV in the general population to an all-time low of 0.13 per cent.

This latest estimate released by the National AIDS Control Organisation (NACO) puts the total number of HIV-infected persons in the State at 24,831 as against the previous figure of one lakh.

In fact, the last sentinel surveillance report (2006), conducted in 25 sites across the State, showed a drop in HIV prevalence from 0.32 per cent in 2005 to 0.21 per cent. The figure dropped further to 0.13 per cent after NACO announced that as per the new national estimates, there had been a sheer drop in the total HIV case load in the country.

The new estimates were arrived at by NACO with the help of international agencies, including the UN and the U.S. Agency for International Development, and then comparing it with the 3rd National Family Health Survey findings.

According to the revised national estimates, HIV prevalence in India is now 0.36 per cent and not 0.9 per cent as was perceived earlier. The total number of HIV-infected persons in India has thus dropped from 5.2 million to 2.5 million, resulting in a proportionate drop in the number of cases in Kerala.

Despite the drop in numbers, HIV and the stigma associated with it continue to be a big social problem in Kerala which no awareness or prevention programmes have been able to tackle effectively so far.

The growing population of injecting drug users (IDUs) and men having sex with men (MSM) and the high level of HIV positivity among them have also emerged as major challenges for the State’s HIV prevention and control strategies.

The increasing rate of HIV prevalence among IDUs in the State has now become a major concern for the State. In 2004 and ’05, the sentinel survey had identified only one IDU site at Kozhikode.

This year, when the Kerala State AIDS Control Society (KSACS) mapped drug users across the State, four districts emerged on top of the list — Kozhikode, Ernakulam, Thiruvananthapuram and Alappuzha.

“HIV positivity among IDUs at Kozhikode has gone up from 2.6 per cent to 5.2 per cent. But in Ernakulam, an alarming 23 per cent of the IDUs have been found to be HIV positive.

The average positivity among IDUs in the State is 9.59 per cent, which is the highest among any risk group,” S. Sreelatha, Programme Officer (Surveillance), KSACS, pointed out.

The sentinel survey has indicated that unlike in many other States, in Kerala, it is the MSM category which should be classified as the high risk group rather than female sex workers, amongst whom the HIV prevalence rate is comparable to that in the general population, at 0.32 per cent.

HIV positivity among the MSM group was found to be the highest at 1.6 per cent in Kannur and the average across the State, 0.64 per cent.

“The female sex workers in the State are a more aware group and most of them have adopted safe-sex practices. In contrast, use of safe methods is quite low among MSM and a large number of them – especially in the North Kerala belt – are bisexuals and could be spreading the infection within their families. We need to re-orient our strategies to organise more HIV risk reduction programmes among this group,” Dr. Sreelatha said.

KSACS has already started three HIV prevention and control programmes in three IDUI sites, at Kozhikode, Thiruvananthapuram and Ernakulam, where Buprenorphin Substitution Therapy (BST) has been launched. The idea is to shift drug users from injecting drugs to oral drugs first and thus wean them away slowly.

However, sustaining these programmes among IDUs is difficult because this is a fragmented group and continued family support is essential for a drug user to stick on to the programme.

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