MODULE 5

H.I.V infection is a major public health problem in India. The central government formed the organisation, NACO (National AIDS Control Organisation) in 1992 to control this epidemic. Statistical data by NACO shows that there are around 2.1 million H.I.V infected individuals presently in the country. Each state has state level organisations for H.I.V control. Let us have a look at the services provided by NACO in each state.

Ø Free of cost H.I.V laboratory tests and counselling sessions.

Ø Free H.I.V treatment and H.I.V drugs.

Ø Free treatment for H.I.V related illnesses.

Ø Support groups of people living with H.I.V and peer group meetings.

Ø Supervisions and aid to Blood banks to ensure safe blood donation.

Ø Clinics to treat sexually transmitted infections.

Ø Facilities to perform free CD4 tests and viral load tests.

Ø Preventive measures and programmes targeting commercial sex workers migrant labourers and homosexuals.

Ø Facilities to give in –patient treatment and short stay for people living with H.I.V.

The above said services are provided to H.I.V infected individuals through various government centres such as-

1.     ICTC (Jyothis)- Free of cost H.I.V testing and Counselling services at Taluk, district hospitals and medical colleges through ICTC Centres.

2.     ART Centres. (Anti Retroviral Treatment) _ USHUS

Drugs for H.I.V treatment are provided for free at this centre. An H.I.V positive result from an ICTC lab and an identity proof are required for registration at these centres. Expert services of doctors and Counsellors are provided here. USHUS centres function at all government medical colleges, Kasargod District Hospital and Ernakulam General Hospital. CD4 tests are also done here for free of cost.

3.     Vihaan. Organisation by people living with H.I.V

This organisation supported by government provides a platform for H.I.V positive individuals to meet and interact. They can share their anxieties and the social issues faced by the members discussed in the monthly meetings. Monitory benefits and provisions are provided by various Voluntary Organisations to this H.I.V infected individuals through Vihaan.

4.     STI Clinics.(Sexually Transmitted Diseases) Pulari.

STI clinics function in Taluk hospitals, district hospitals and government medical colleges in association with Dermatology, Venerology department.

5.     ART Plus Centres.

Second line H.I.V treatment is provided at ART plus Centres. H.I.V infected individuals who had 1^st line treatment failure are referred here for further treatment. After detailed assessments further treatment is decided by a panel of experts at this ART plus Centres. Drugs once decided at the centre are provided every month from their respective ART Centre.

6.     Link ART Centres.

Such centres function in districts where there are no ART centres in order to help those individuals who have to travel  long distances every month to collect their drugs. Once the drugs are started from an ART centre, and the individual remains stable for a long period of time on drugs, he may be transferred to Link ART centres for future drug collection. Wayanad and Malappuram districts have such centres.

There are a number of research projects going on in the field of H.I.V. The scientific world is on constant search to find a complete cure for H.I.V. The present drugs are highly effective in destroying active H.I.V particles in the body. These drugs target various enzymes and steps in H.I.V replication. But a small percentage of virus remains dormant a long period without replication. Since they do not replicate, the current drugs cannot destroy them. Such dormant viruses become active later and start replicating. This is the reason why H.I.V can only be effectively controlled but not completely cured by the existing drugs. This has inspired the researchers to think of a vaccine against H.I.V. The research is not on a preventive vaccine, but on a therapeutic vaccine which can boost human immune system so that the body itself can destroy the virus. Studies are conducted with H.I.V antibodies in this direction. If such vaccines are combined with existing drugs, both active and dormant viruses can be completely destroyed.

Another field in H.I.V treatment currently under research is the possibility of long lasting H.I.V drugs. Daily pills which are prescribed currently are not acceptable or convenient to many H.I.V infected individuals. Studies are going on to develop drugs which act for longer periods and which need to be administrated once in a week or month. Instead of pills, injectables, skin patches or implants for drug administration are also researched upon.

           Pre –exposure prophylaxis is the preventive method in which individuals at risk take drugs continuously to prevent H.I.V contraction from infected individuals. This is practised by many homosexuals who resist the use of condoms in some states of  USA.

            The good news is that many studies in the right direction are going on to find a complete cure for H.I.V in various parts of the world under the leadership of major researchers. Just like other deadly diseases of the past, we can hope that H.I.V infection will also be conquered by the modern scientific medicine in the near future.