Latest published data says that there were only 28000 new cases in 2004 compared to 520,000 in 2003. From where did they get these figures? As far as I know there was no systemic HIV Testing program's in India in 2003 or 2004. As a matter of fact you cant do HIV testing without permission of the concerned person nor can you reveal the result to anyone. All these numbers given out are very crude estimates.Pevelance of HIV infection in High Risk group is extrapolated to get national figures !! Govt. will take lower figure to take credit for excellent work done and NGO will give out higher one to sensationalise and to get more funds and trips abroad to HIV conferences.
Whatever may be the figure, but there is no denying the fact that the HIV infection is spreading and spreading pretty fast.Problem is, that there is no concensus on how to control this.So far we have tried out various awareness programmes and free distribution of Condoms. In Andhra Pradesh they want to recruit Milkmen to distribute condoms(Isnt it like bolting the door after....).But this approach is not working as evident from the increase in number of cases.Awareness is pathetic.Well educated Boys and Girls are unaware about how the HIV infection is transmitted and have unprotected Sex with multiple partners. Girls are more worried about getting pregnant than getting HIV or Hepatitis B infection.From this one can imagine level of awareness in Truck and long distance Bus drivers.Besides awareness programe has only limited effect.Awareness level for harmful effect of Nicotine and Drugs is high but it has not reduced its use. Significant percentage of doctors and even oncologist are heavy smokers !!!.
To start with, fight against HIV should be on WAR footing.That means we must know the extent of the problem.This can be done by doing HIV testing of all the person who seek medical help in Hospitals or Blood tests in Laboratory.All the Blood samples should be coded and have only demographic information. Samples should be tested by advanced tests only, which has short window period.If tested Positive then the person should be informed of his/her HIV status only by Doctor/Medical counselor. Known HIV Positive person should be excluded from the survey. This approach will help us understand the extent of the problem,nature of problem, profile of newly infected cases and also counsel the infected person so that he does not spread the infection inadvertently to the spouse and children.All those who had sexual contact with Positive person should be advised discreetly to undergo HIV testing and thus break the chain.
This will also help medical personnel to take adequate precaution while treating Positive person.Present practice of taking Universal precaution is waste of resources.If prevalence is 0.9% then spending meager resources on 90% unaffected persons is criminal. Resources should be used to identify newly infected cases. Such a well directed measure will help us to reduce new cases and spread of this dreaded disease.
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