Creating awareness about HIV holds the key to improving the quality of life of patients suffering from the virus. Associated stigma and discrimination make it even more challenging. The Government of India's seven-year plan ensures a treatment-to-care continuum of services that are effective, inclusive, equitable and adapted to the needs of the people living with HIV. Dr Ankita Baidya, Consultant- Infectious Disease, Manipal Hospital, Dwarka, New Delhi gives an outlook
It was in 1986 when India’s first case of HIV/AIDS was detected in Chennai. Since then, India has made remarkable progress in reducing the spread of the dangerous virus by creating awareness, improving the quality of healthcare, and ensuring access to treatment.
In 2024, India has successfully reduced the number of new infections by 44 per cent as compared to 2010.
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There is a decrease in annual new HIV infections in India by as much as 57 per cent, which is a reflection of prevention programmes implemented in the country along with efforts to increase awareness about the transmission of HIV.
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However, the journey for India being HIV/AIDS free isn’t over yet and we still have a long way to go. Let’s take a look at our journey so far, and the future roadmap for an HIV/Aids-free India.
Efforts and progress made to achieve zero transmission in India
There is a decrease in annual new HIV infections in India by as much as 57 per cent, which is a reflection of prevention programmes implemented in the country along with efforts to increase awareness about the transmission of HIV.
Additionally, the number of AIDS-related deaths has also reduced by 29 per cent between 2007 and 2011. This has been due to wider access to Anti-Retroviral Therapy (Therapy used to treat people infected with HIV using anti-HIV drugs) - as many as 1.5 lakh people have been saved thanks to ART till 2011. According to india.gov.in India is also the supplier of 70 per cent of the world’s ART machines.
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India's roadmap for an HIV/AIDS-free future focuses on prevention, treatment, and reducing the stigma of the dreaded disease
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Efforts to prevent the transmission of HIV from mothers to their children have been successful. By 2021, the rate of vertical pediatric HIV infections had dropped to 24 per 100,000 live births, reflecting the effectiveness of targeted interventions. The stigma and discrimination through the HIV and AIDS (Prevention and Control) Act of 2017, has also been addressed, which requires intermediaries in every state to handle grievances and ensure a supportive environment for people infected with HIV.
Ongoing challenges
Despite the progress in the reduction of HIV/AIDS infection, India continues to face several challenges.
One of the major barriers is the stigma and discrimination experienced by people living with HIV/AIDS and those at risk. This discrimination is majorly observed in families, communities, and law enforcement agencies as well. This stigma keeps individuals from seeking help and therefore makes it difficult to implement interventions or treatment programmes.
Another issue would be access to healthcare, which is particularly noticed in rural and marginalised communities. Many people lack the resources or infrastructure needed to receive proper medical care. There also is the issue of low rates of testing and diagnosis, and as a result, several people infected with HIV are unaware of their status.
Additionally, poor health-seeking behaviour, especially among HIV-positive women, aggravates the issue. They frequently face social and cultural barriers that keep them from getting the care they require, which leaves their illness untreated and raises the possibility of further transmission. These difficulties are made worse by the national HIV programme's financial limitations, which can make it more difficult to provide services and launch new projects.
New technologies underway for early detection and diagnosis
GQ-RCP Platform: Three researchers at Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR) have developed the GQ Topology-Targeted Reliable Conformational Polymorphism (GQ-RCP),
a platform for precise HIV detection. This innovative fluorometric test identifies unique G-Quadruplex (GQ) DNA structures from the HIV genome, helping to reduce false positives.
Rapid Diagnostic Tests (RDTs):
RDTs can detect HIV in just a few minutes without needing a lab. These tests are especially useful in areas with limited resources.
Self-Testing Kits:
Self-testing kits let people test for HIV at home, giving them privacy and control. These kits are easy to use and help reduce the fear of visiting a clinic.
Artificial Intelligence (AI) in Predictive Diagnostics:
AI helps improve HIV diagnosis by analysing health data for better risk assessments. This technology helps identify people who may need testing, especially in remote areas.
Point-of-Care Viral Load Testing:
Point-of-care devices offer fast and accurate viral load results at the clinic or community site. This helps doctors make quick treatment decisions without long waiting times.
CRISPR-Based Technologies:
CRISPR technology is being used to develop ultra-sensitive HIV tests. These tests can detect HIV even in very low amounts of the virus.
Innovative treatment modalities and therapies for HIV-AIDS under research A lot of research is undergoing to establish a cure for HIV. Among these, a few promising methods are:
1. One would be therapeutic vaccines. These vaccines not only prevent HIV but also limit its spread in those already infected and reduce the need for ongoing medication.
2. Gene therapy, current in research, might be an effective therapy, which uses tools like CRISPR-Cas9 to change the DNA of immune cells to resist HIV. Immunotherapy strengthens the immune system to help it fight HIV. Whereas latency-reversing agents (LRAs) activate dormant HIV to make it easier to target.
3. According to the National Library of Medicine there are combination therapies that combine treatments like gene therapy and immunotherapy to attack HIV in multiple ways. Such long-acting therapies reduce the need for frequent doses.
4. All the above methods are still in research and development and are yet not approved for common use.
Future roadmap
India's roadmap for an HIV/AIDS-free future focuses on prevention, treatment, and reducing the stigma of the dreaded disease. According to Press Information Bureau the NACP Phase-V (2021–26) aims to cut new HIV infections and AIDS-related deaths by 80 per cent by 2025-26. It also focuses on eliminating stigma and improving access to STI/RTI services.
Also, according to the Press Information Bureau, The National Strategic Plan, which is a seven-year plan that plans to ensure a “treatment to care continuum of services that are effective, inclusive, equitable and adapted to needs of the people living with HIV including pre-exposure prophylaxis for vulnerable populations. These strategies demonstrate India's commitment to an HIV/AIDS-free future through inclusive, targeted, and integrated efforts.