Themed ‘Right to Health’, the World AIDS Day falls today and the World Health Organization is sending a strong message across borders, advocating for the rights of the 36.7 million people living and affected with HIV/AIDS and their right to enjoy universal health coverage. Sri Lanka being a very low prevalence country for HIV and AIDS, nevertheless has an equal responsible role to play in this regard. Speaking to Health Capsule, Director of National STD/AIDS Control Programme, Sri Lanka, Dr. Sisira Liyanage explained why it’s important to bring this rate of low prevalence to the point of elimination while stressing on the health risks involved with contracting HIV/AIDS.
According to Dr. Liyanage, Sri Lanka in addition to being a low prevalence country, also has a 0.1% prevalence rate for HIV/AIDS. He said that plans were afoot to test more than two million people. This is to detect if they are diagnosed with the disease this year. He also noted that people living with the HIV disease were already being provided with the antiretroviral treatment. “We are doing this with the assistance of the Government and patients are receiving the antiretroviral treatment free of charge” he said.
Mode of HIV/AIDS transmission
According to Dr. Liyanage, the HIV transmission occurs mainly due to unsafe sex. Especially MSM (Men who have sex with men/homosexual men) who practise unsafe sexual intercourse, without the use of a condom, are prone to HIV. “Only 56% are using condoms among MSM, but female sex workers also can be categorized as a risk group who are vulnerable to contract the disease. However, it should be noted that 93% of the female sex workers are using condoms compared to their male counterparts.
Throughout the past five years we haven’t witnessed an increase in HIV cases among females, but among the males, this rate is increasing due to their homosexual behaviour.We have now identified the cause for HIV/ AIDS transmission and have managed to bring the transmission of the disease through blood from mother to child under control. If we detect pregnant mothers with HIV, early, we can give them treatment and stop the disease from being transmitted to the child,” he said.
He stated that in 2016, nearly 44, 000 pregnant mothers had been tested for HIV and no baby was born with the disease. According to Dr. Liyanage, there had been sixteen deliveries by HIV contracted mothers last year, but all the babies have been tested HIV negative. “We have already taken the initiative to eliminate the risk of mother to child transmission of HIV. On the other hand, blood transmission through needles aren’t very common in Sri Lanka. Such cases haven’t been reported for the past five years. There is potential to contract the disease if unsterilised cylinders and needles are shared among individuals. Very often such cases are reported among drug addicts who inject themselves with drugs such as heroine. These people share the same needles, thereby contracting the disease through an infected person” Dr. Liyanage added.
How HIV and AIDS weaken the immune system
HIV (Human Immunodeficiency Virus) is a RNA virus that multiplies after entering the human body. The virus attacks a type of white blood cell known as Lymphocytes. According to Dr. Liyanage, the type of Lymphocytes thus attacked are known as CD4 cells. He said that the virus multiplies within these cells, thereby gradually destroying the patient’s immune system.
“An individual infected with the disease will be recognized as a HIV positive patient. When patients diagnosed with HIV are left untreated for years, they develop AIDS at a later stage in life perhaps after a period of ten to fifteen years approximately. Also known as the Acquired Immunodeficiency Syndrome, AIDS affects the immune system permanently.
If left untreated even at this stage, it will gradually start suppressing the immune system further. This will also pose the risk of being infected by germs which aren’t simply limited to the pathological varieties of germs. These germs can further multiply within the body and make an individual vulnerable to diseases due to the low immunity level” Dr. Liyanage warned. AIDS patients would be prone to develop weight loss, continuous fever, pneumonia, tuberculosis, cancer and many other diseases. Since a collection of diseases may affect the health and deteriorate the immunity of a patient, in the overall the disease is commonly known as Acquired Immune Deficiency Virus, he explained.
“If we can detect such people at an early stage we can treat them and prevent them from transmitting HIV to others. Also, the viral concentration in the blood can be remarkably reduced through antiretroviral therapy. Therefore, it’s very important to identify patients diagnosed with the disease at an early stage,” he said.
Eliminating the disease by 2025
Stating that UNAIDS plans to initiate a programme where a fast tracking initiative would be adopted in future to eliminate AIDS prevalence in the country, Dr. Liyanage informed that this fast tracking programme is known as 90-90-90. Explaining the programme further, he said that the initiative would help eliminate the risk of new cases of HIV/AIDS being reported in Sri Lanka by 2025.
“For instance, if the estimated number of patients in Sri Lanka is 4, 000 we have to identify ninety percent of this population who are diagnosed with HIV/AIDS. We should administer antiretroviral treatment to a ninety percent from the ninety percent of patients thus identified. Our aim for the third ninety percent who have received antiretroviral treatment is to ensure that they contain a low concentration of the virus. When tested for HIV, these patients should be undetectable. Our aim is to eliminate the risk of AIDS by 2025, meaning that there shouldn’t be any opportunity created for an individual to be newly affected by the disease. We have to conduct more awareness programmes, more tests to detect patients suffering from the disease and work diligently within the next few years in order to achieve this goal,” Dr. Liyanage added.
“Since unsafe sex is the main risk factor leading to the contraction of HIV, it is important to raise sufficient awareness among these vulnerable groups about the need to practise safe sex. We are already promoting various health education programmes and distributing leaflets. We also distribute free condoms and encourage people to visit the clinic to get themselves tested for HIV. We do this together with the help of non governmental organizations and the community. In the event an individual is tested HIV positive, we give them the necessary treatment to help control the disease. These are very important preventive measures that have to be carried out within a community,” he concluded.