Take HIV medications to stay healthy
ALTHOUGH HIV cases, during the last decade, have decreased by 0.7% per annum globally, the number of HIV cases in Pakistan has increased at an alarming rate of 9.1% per annum from 2005 to 2015.
Unfortunately, the coverage of antiretroviral medications, used to treat people with HIV has remained low.
While antiretroviral treatment (ART) that involves taking a combination of HIV medicines every day, cannot eliminate the virus, it can help people with HIV live longer and healthier lives.
The use of ART prevents the virus from multiplying in the body of an infected person – something that allows the immune system to sustain and stops progression to Acquired Immune Deficiency Syndrome (AIDS).
An additional benefit of ART adherence is that if the infected person maintains an undetectable viral load, it can reduce the chances of HIV transmission to others.
In the past three decades, the NACP, in collaboration with international and local partners, has been successful in creating awareness about HIV, testing high-risk people for it, and facilitating HIV treatment in Pakistan.
However, the scale of its success has been limited when it comes to ART adherence among people with HIV in Pakistan, as nearly half of the registered cases do not take it.
Not taking ART means that people with HIV may be at risk for AIDS and have a greater chance to transmit HIV to others.
While there is no evidence of why a significant number of people with HIV do not take ART, public health research from other countries indicates how poverty, low level of education, injection drug use, discrimination in healthcare settings, gender identity, and stigma associated with HIV impedes access to the life-saving ART.
Perhaps, the question about how societal beliefs about the relationship between HIV and morality contribute to stigma associated with HIV in Pakistan is outdated.
What actions have been taken to address HIV-related stigma, to scale up HIV diagnosis, to educate how ART saves lives and reduce HIV transmission, and to ensure its access to all the people with HIV in the country, are all difficult, but more relevant questions?
Perhaps, the NACP’s conventional approach to contain HIV spread and treat it is bringing less than promising results, as the number of HIV, at least among the high-risk population groups, notably the injection drug users is skyrocketing, with a prevalence of 37 %.
In recent years, researchers from the University of New South Wales, Australia, in their study with HIV-positive male injection drug users in Pakistan found that 45% of them were not adherent to ART.
They further explored the extent to which HIV-positive male injection drug users can affect the health of their spouses, and it turned out that unfortunately, the prevalence of HIV among spouses was 8.5%.
This is a reminder that the dynamics of HIV are far more complex than we assume, and HIV should be dealt with as such.
First, there is a dire need to explore the reasons behind the low utility of ART, as it can allow us to come up with solutions to address the problem.
Second, we need to create awareness about the benefits of ART, notably among people with HIV, and here, telemedicine can be of significant help.
Third, we need to scale up use of ART, as living longer and healthier lives is perhaps a fundamental right of people with HIV. Finally, ART should be considered not only a treatment for HIV but an effective mode of preventing others from it.
—The writer is Assistant Professor at Department of Pathology & Laboratory Medicine, the Aga Khan University.