One life-threatening disease that has witnessed a sea change in medical diagnosis and treatment over the last two decades is Acquired Immunodeficiency Syndrome, or AIDS.
Thanks to the efforts by the National Aids Control Organisation (NACO) in reducing discrimination of HIV positive patients at home, workplace and public space, AIDS has largely been de-stigmatised.
Further, due to better medicines and non-discriminatory approach of the healthcare system, HIV positive persons can lead a normal life — their life span is not curtailed, they can have a healthy sexual relationship even with an HIV negative partner. But much needs to be done in the area of early detection of HIV in patients. The main reason: timely testing is a far cry. That people are not coming forward for HIV testing is the biggest impediment for early onset of treatment, say doctors.
“With early detection, we have a better chance of controlling the infection. There are several options in medicines so the treatment can be tailored to the needs of individual patients, but before that testing is a must,” says Dr Subramanian Swaminathan, Director, Infectious Diseases, BGS Gleneagles Global Hospital, Bengaluru.
Healthcare professionals insist that testing for HIV should be made routine, and more and more people should be encouraged to get it done. However, the fear of getting tested for HIV is still dominant. One reason is the sheer amount of preliminary paperwork required to get an HIV test. “We need to revisit the whole idea of consent and paperwork for HIV test, so as to de-stigmatise the whole process and encourage people to go for it. People should be more open to HIV testing so that they can get into treatment before they get into trouble. The paperwork involved with HIV testing is looked at suspiciously,” says Dr Swaminathan.
Doctors also say that HIV testing should be allowed without a doctor’s prescription. “You don’t need a prescription for a blood sugar test or kidney test done, why unnecessarily have a long-drawn procedure for HIV?” asks Dr Swaminathan.
“It can even be an Opt-Out strategy, just like we do HIV tests for pregnant women telling them it will rule out any infection for the baby. The woman has the option to say no to it. Similar thing can be done with all patients. Or like it happens in the US, we can do HIV tests for every in-patient,” he remarks.
Prevention: Your best option
Stating that in absence of any cure, prevention is the best way to keep the disease at bay, Dr Ranjana Becon, Gynecologist, Columbia Asia Hospital, Ghaziabad, cautions, “Always insist on using a disposable syringe if you need regular blood transfusion or other needs and use protection during sex.”
There are preventive medications too, like the pre-exposure prophylaxis (PrEP) medication, where a medicine is taken by an HIV negative individual who is at risk of HIV acquisition from sex or injection drug use. It is a single tablet to be taken daily.
PrEP works well for a sexually active HIV negative individual having an HIV positive partner. In case an HIV negative woman wants to have a baby with her HIV positive partner, PrEP can protect her and her baby.
“The HIV medications used as PrEP enter the blood and the genitals and block the enzyme — HIV reverse transcriptase —thus preventing HIV from making more copies of itself in the body and causing the disease,” says Dr Trupti Gilada, Infectious Disease Specialist, Masina Hospital, Mumbai.
“PrEP can decrease the risk of HIV acquisition via the sexual route by almost 99 per cent and by at least 74 per cent in people who inject drugs and share needles,” she adds.