Urgent and accelerated HIV service delivery with equity and rights is critical to end AIDS
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Bobby Ramakant (CNS)
Contd from last Saturday
How HIV impacts women
"It is important to understand how HIV impacts women in order to tailor our HIV responses in a gender-sensitive manner. There is a difference in frequency of cardiovascular and cerebrovascular diseases among women living with HIV. The way HIV impacts their bone density or issues related to HIV and menopause also need to be taken into account," said Dr Glory Alexander, Scientific Committee Co-Chairperson of ASICON 2025 and Founder-Director of ASHA Foundation Bengaluru. She is also among the recipients of the prestigious Dr BC Roy National Award. Dr Cristina Mussini from Italy said that risk of cardiovascular diseases is double and risk of stroke is two-three times among women with HIV.
"Women living with HIV have a six-fold greater risk of developing cancer of cervix (cervical cancer) compared to women who are not positive in general population. About 85% of all cervical cancers are caused by human papilloma virus (HPV). There are vaccines to prevent it but India till recently was dependent on imported vaccines which were very expensive. Now, Pune-based Serum Institute of India is making the vaccine (Cervavac) since 2023. So now our goal is to provide this vaccine to eligible women living with HIV so that they can protect themselves from acquiring cancer of the cervix. Our government too is considering it seriously to include vaccination in the national public programme. I am part of "Cancer Cervix Elimination Consortium India" which is complemen- ting the work of the government. In the private sector, many organisations are already providing the vaccine," said Dr Glory Alexander.
Antimicrobial resistance and HIV
When HIV virus becomes resistant to lifesaving antiretroviral medicines, then the person with HIV needs to be treated with a different set of medicines - and treatment options get limited. Antimicrobial resistance, which is fuelled by misuse and overuse of medicines, is among the top 10 global health threats today. Dr Kumarasamy said: "We have the latest antiretroviral regimen in our national programme as recommended by the WHO but antiviral resistance is also on an alarming rise. Drug resistance is also reported now against some of the newer antiretroviral medicines."
Progress made but challenges remain to end AIDS in India
New HIV infections surged by over 400% during 2010-2023 in few Indian states like Tripura and Arunachal Pradesh and doubled in Punjab and Meghalaya. Despite a lower national prevalence (0.20%), HIV rates in Mizoram (2.73%), Naga-land (1.37%), and Manipur (0.87%) significantly exceed the national average. In 2023-2024, injecting drug use was the main transmission route in some states (Assam, Arunachal Pradesh, Punjab, and Tripura) accounting for 61-77% of newly diagnosed people with HIV.
HIV prevalence remains very high among key populations such as migrants, truckers, female sex workers, prison inmates, men who have sex with men, transgender people and people who inject drugs. These groups experience HIV rates 9-43 times higher than the general adult population. According to a 2021 report by the National Centre for Disease Control (Directorate General of Health Services) based on HIV sentinel surveillance, Hepatitis B Virus (HBV) seroprevalence ranges from 0.95% in female sex workers to 3.09% in people who inject drugs, whereas Hepatitis C Virus (HCV) seroprevalence varies from 0.67% in migrants to 33.41% in people who inject drugs. HCV rates among people who inject drugs and are HIV positive is very high at 82.23%.
Co-infections management is a critical need to reduce morbidities and mortalities among people with HIV. The population is aging with around 37% of total people with HIV in India estimated to be aged 50 years or more. Around 4% of people with HIV were screened as those with presumptive TB, out of which 4-6% were diagnosed with active TB disease (and over 99% of them started TB treatment).
India has made significant stride towards the goal of eliminating vertical transmission of HIV and syphilis.
Contd from last Saturday
How HIV impacts women
"It is important to understand how HIV impacts women in order to tailor our HIV responses in a gender-sensitive manner. There is a difference in frequency of cardiovascular and cerebrovascular diseases among women living with HIV. The way HIV impacts their bone density or issues related to HIV and menopause also need to be taken into account," said Dr Glory Alexander, Scientific Committee Co-Chairperson of ASICON 2025 and Founder-Director of ASHA Foundation Bengaluru. She is also among the recipients of the prestigious Dr BC Roy National Award. Dr Cristina Mussini from Italy said that risk of cardiovascular diseases is double and risk of stroke is two-three times among women with HIV.
"Women living with HIV have a six-fold greater risk of developing cancer of cervix (cervical cancer) compared to women who are not positive in general population. About 85% of all cervical cancers are caused by human papilloma virus (HPV). There are vaccines to prevent it but India till recently was dependent on imported vaccines which were very expensive. Now, Pune-based Serum Institute of India is making the vaccine (Cervavac) since 2023. So now our goal is to provide this vaccine to eligible women living with HIV so that they can protect themselves from acquiring cancer of the cervix. Our government too is considering it seriously to include vaccination in the national public programme. I am part of "Cancer Cervix Elimination Consortium India" which is complemen- ting the work of the government. In the private sector, many organisations are already providing the vaccine," said Dr Glory Alexander.
Antimicrobial resistance and HIV
When HIV virus becomes resistant to lifesaving antiretroviral medicines, then the person with HIV needs to be treated with a different set of medicines - and treatment options get limited. Antimicrobial resistance, which is fuelled by misuse and overuse of medicines, is among the top 10 global health threats today. Dr Kumarasamy said: "We have the latest antiretroviral regimen in our national programme as recommended by the WHO but antiviral resistance is also on an alarming rise. Drug resistance is also reported now against some of the newer antiretroviral medicines."
Progress made but challenges remain to end AIDS in India
New HIV infections surged by over 400% during 2010-2023 in few Indian states like Tripura and Arunachal Pradesh and doubled in Punjab and Meghalaya. Despite a lower national prevalence (0.20%), HIV rates in Mizoram (2.73%), Naga-land (1.37%), and Manipur (0.87%) significantly exceed the national average. In 2023-2024, injecting drug use was the main transmission route in some states (Assam, Arunachal Pradesh, Punjab, and Tripura) accounting for 61-77% of newly diagnosed people with HIV.
HIV prevalence remains very high among key populations such as migrants, truckers, female sex workers, prison inmates, men who have sex with men, transgender people and people who inject drugs. These groups experience HIV rates 9-43 times higher than the general adult population. According to a 2021 report by the National Centre for Disease Control (Directorate General of Health Services) based on HIV sentinel surveillance, Hepatitis B Virus (HBV) seroprevalence ranges from 0.95% in female sex workers to 3.09% in people who inject drugs, whereas Hepatitis C Virus (HCV) seroprevalence varies from 0.67% in migrants to 33.41% in people who inject drugs. HCV rates among people who inject drugs and are HIV positive is very high at 82.23%.
Co-infections management is a critical need to reduce morbidities and mortalities among people with HIV. The population is aging with around 37% of total people with HIV in India estimated to be aged 50 years or more. Around 4% of people with HIV were screened as those with presumptive TB, out of which 4-6% were diagnosed with active TB disease (and over 99% of them started TB treatment).
India has made significant stride towards the goal of eliminating vertical transmission of HIV and syphilis.