i4donline.net ~ December 2005 Issue

“... millions of young people know too little about HIV to protect themselves.”

Red ribbon – the red alert
An Indian girl, daughter of a traditional rural family, having low level of education got married to a person working in different state. Marriage got fixed by the local priest, the janampatri (the astrological assessments of life) of both bride and bridegroom were verified, matched and it was astrologically supposed to be a happy marriage. But, after few months, the girl felt ill, blood test discovered she is a victim of AIDS (Acquired Immunodeficiency Syndrome), infected by her husband who already was infected by the same. This is not a story of single girl, such girls are in thousands around us, in the rural areas of developing countries, HIV (Human Immunodeficiency Virus) detection or detection of AIDS is still considered to be a ‘curse’. But is it? Neither any disease should be treated as a curse, nor the victims of it, the curse lies in our social system where knowledge sharing lacks, social traditions and blind customs overpower the scientific truth; so astrological assessments matter more in matrimonial alliances rather than medical tests! Therefore the symptoms and diseases like Thalassaemia, HIV/AIDS are carried on from one generation to another. Problem of HIV/AIDS persists everywhere in the world, but due to different reasons and at different extents. The red ribbon, an international symbol of AIDS awareness, is a knot to all the nations now. AIDS was first reported in the United States in 1981 and has now become a major worldwide epidemic. By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight infections and certain cancers. Since 1981, more than 25 million people have died of AIDS. Around half of all people who become infected with HIV do so before they are 25 and are killed by AIDS before they are 35. Young people (15-24 years old) account for half of all new HIV infections worldwide - more than 6,000 become infected with HIV every day.

Share knowledge to save others
In The Millennium Development Goals Report 2005, the following lines are mentioned which are most important: “Because there is no cure for AIDS, prevention is essential. But millions of young people know too little about HIV to protect themselves”. In the same report, it has been mentioned that surveys in sub-Saharan Africa have revealed that only 21 per cent of young women and 30 per cent of young men know the basics about how to avoid infection and surveys of young women in South-Eastern Asia show even lower levels of knowledge.

In this information age, when we talk about ‘knowledge sharing’, we ourselves sometimes create the ‘knowledge divide’. The people who know about the causes and effects of HIV/AIDS, ignore own social responsibility to enlighten the others. A person living with HIV, who is medically known as an HIV positive person, is one who has virus in his/her body. Such a person remains infected and is presumed infective for the rest of own life. But, s/he might appear to be perfectly normal and healthy and asymptomatic for many years. It must be revealed to all that an asymptomatic HIV infected person does not have AIDS. But when an HIV positive person's T lymphocytes, which are responsible for the immunity count falls to 200 or less, s/he starts developing symptoms. Therefore the most important aspect which needs to be emphasised and communicated more among the common people is that all persons with AIDS are infected with HIV, but not all persons with HIV infection have AIDS. AIDS is only the end stage of this infection.

When statistics threats
Around 95% of people with HIV/AIDS live in developing nations. By December 2005, women accounted for 46% of all adults living with HIV worldwide, and for 57% in sub-Saharan Africa. Africa has 12 million AIDS orphans. At the end of 2004, in the USA, of the adults and adolescents with AIDS, 77% were men. UNAIDS estimates that more than 2 million people were living with HIV in Europe at the end of December 2004. The figures of HIV and AIDS statistics and features, in 2005 for Asia are as follows:

The UNAIDS/WHO report has been launched in 19 cities worldwide on 21st November 2005. According to new UNAIDS/WHO report, there is new evidence that adult HIV infection rates have decreased in certain countries and that changes in behaviour to prevent infection have played a key part in these declines. But, it also indicates that overall trends in HIV transmission are still increasing, and that far greater HIV prevention efforts are needed to slow the epidemic.

Kenya, Zimbabwe and some countries in the Caribbean region show declines in HIV prevalence over the past few years with overall adult infection rates decreasing in Kenya and there is evidence of drops in HIV rates among pregnant women in Zimbabwe. Despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean. There were an additional five million new infections in 2005.

The number of people living with HIV globally has reached its highest level with an estimated 40.3 million people, up from an estimated 37.5 million in 2003. More than three million people died of AIDS-related illnesses in 2005; of these, more than 500000 were children. According to the report, the steepest increases in HIV infections have occurred in Eastern Europe and Central Asia (25% increase to 1.6 million) and East Asia. But sub-Saharan Africa continues to be the most affected globally – with 64% of new infections occurring here.

Aiding AIDS on each day
The most threatening fact is that the people with AIDS are surviving longer and are contributing to a steady increase in the number of people living with AIDS. This trend will continue as long as the number of new diagnoses exceeds the number of people dying each year. It is also remarkable that out of 6.5 million people in developing and transitional countries who need life-saving AIDS drugs, only 1 million are receiving them.

World AIDS Day, celebrated since 1988, is important in reminding people that HIV has not gone away, and that there are many things still to be done. For many years, World AIDS Day has been organised by UNAIDS, who have chosen the theme after consultation with other organisations. In 2005, UNAIDS handed over responsibility for World AIDS Day to an independent organisation known as The World AIDS Campaign (WAC). The WAC’s theme for their campaign is ‘Stop AIDS: Keep the Promise’. This theme is however not specific to World AIDS Day alone but to the work the WAC does throughout the year. It will also remain the focus until 2010. This change in the way that World AIDS Day is organised has caused some confusion among HIV and AIDS organisations. Some have chosen to adopt ‘Stop AIDS; Keep the Promise’ as their theme for World AIDS Day 2005. Others have, for the first time, picked their own topic for the events they’re holding this year on 1st December. Whatever one decides to do for World AIDS Day however, the fact remains that one should follow its basic principles by raising awareness and understanding where s/he lives and by remembering the millions living with HIV or suffering because of AIDS.

The UNGASS Declaration of Commitment was signed by all 189 members of the UN in June 2001. The governments of these countries committed themselves to taking action on HIV and AIDS in the fields of leadership, prevention, care and support, treatment, reducing vulnerability, and human rights. The 3 by 5 Initiative, launched by WHO and UNAIDS in December 2003, set the target, to provide access to antiretroviral treatment to 3 million people living with HIV in developing and transitional countries by the end of 2005. One of the Millennium Development Goals, to which all members of the UN have committed, is to have halted by 2015 and begun to reverse the spread of HIV/AIDS. Substantial progress must be made by the end of 2005 to ensure that our leaders will be able to keep this promise, too.

The new UNAIDS/WHO report recognises that access to HIV treatment has improved markedly over the past two years. More than one million people in low-and middle-income countries are now living longer and having better lives because they are on antiretroviral treatment and an estimated 250,000 to 350,000 deaths were averted this year because of expanded access to HIV treatment. The report notes that, without HIV prevention measures, about 35% of children born to HIVpositive women will contract the virus. While mother-to-child transmission has been virtually eliminated from industrialised countries and service coverage is improving in many other places, it still falls far short in most of sub-Saharan Africa.

According to a major survey carried out in the Philippines in 2003, more than 90% of respondents still believed that HIV could be transmitted by sharing a meal with an HIV-positive person. Despite the efforts made by the international and national organisations, governments, media and private initiatives, there are still numerous myths and blind believes regarding the HIV/AIDS which mostly affect the people having less education and social enlightenment. Levels of knowledge of safe sex and HIV remain low in many countries, even in countries with high and growing prevalence. In 24 sub-Saharan countries, two-thirds or more of young women (aged 15-24 years) lacked comprehensive knowledge of HIV transmission. Strong HIV surveillance with proper knowledge dissemination by right persons in the most suitable manner is the need of the hour. Let’s try to untie the red knot from the nations whichever we belong to and promise to coming generations to give them a knot-free world. Following the target of MDG 6, it is high time to join hands to ‘halt and begin to reverse the spread of HIV/AIDS’.

References:

Saswati Paik, saswati@csdms.in