On World AIDS day

Today is World AIDS Day.Once again its a day to take a hard look at the year gone by and reflect on what we have been able to accomplish. In this battle against one of the most unusual Infectious disease,are we Winning or Loosing? Well, the answer is loud and clear. Right now AIDS has upper hand.We simply have no clue how to handle this epidemic.There are as many solutions as the stakeholders.Poor HIV positive person is bewildered, frightened,helpless person, who has no idea about the disease,and prognosis.Today he is in good health.there are no apparent symptoms to indicate that he is harboring a deadly Virus which is rapidly multiplying in his body and is annihilating his immune system.He knows that he is HIV +ve, but is not aware of what he should do.He has been told that this disease is not curable.He has no knowledge about ARTreatment,and even if he knew, he cant afford it.Large chunk of the funds to fight AIDS is spent on awareness programme.There is little money for subsidizing tests and treatment.He will work today and will wait for the day when Virus will decimate the Immune system and opportunistic infection will strike to begin the end.Then he will be shunned by friends and relatives.But will it matter? He will be already isolated in his mind, waiting for the end to come.
There is no solution in sight.We have to change the approach but what should be the new approach to tackle AIDS?.Awareness can go only this far.There is urgent need to define AIDS as "Infectious Viral Disease" which is not curable.( All Viral diseases are not curable -they can be prevented by Vaccines).This epidemic should be tackled like any other Infectious disease epidemic.There is need to bring change in our Sexual Behaviour.There should be more emphasis on "Safe Sex".These days there is more promiscuity and matching ignorance about STD and 'Safe sex'. Girls- even well educated ones- dont practice safe sex, have unprotected sexual intercourse,and are more worried about getting pregnant than contracting killer diseases like AIDS or Hepatitis B or C !!
In today's TOI there is article about HIV testing done without consent.Why this privileged status for HIV testing? Do you need specific consent for Hepatitis B, Diabetes,Kidney disease, cancer testing ? Should we take special consent for X-ray chest for T.B. and ECG for heart disease. Two years ago when SARS virus hit the S E Asia, anyone transiting through these regions were quarantined on airport.Did anyone take permission to test?
Till last year Blood Banks were collecting blood from donors and then testing it for HIV and other tests. If +ve the blood was simply destroyed after disinfection. Donor was not made aware of HIV status as it was legally forbidden to do so.He would infect his wife,children and donate Blood twice a year which was never used.!Thank God this absurd rule is now removed.TOI article goes on to add that this clandestine testing has actually reduced the spread of infection.Doctors can also act as counselor and HIV +ve person can spread message of awareness better than anybody.
Surprisingly HIV +ve person is treated by Dermatologist and not by Physician!!Its throwback to the time when AIDS was cosidered as part of venereal disease!If there are complications than Physician is called in.In US HIV +ve person is looked after by Physician.Obstetrician - the most vulnerable medical practitioner in contracting disease from patient- has no role in any AIDS programme.This sunday there is a conference on AIDS, arranged by IMA-Mumbai.In the speakers list Obstetrician is missing! Lets hope that in 2006 we may find new, more effective way to contain this epidemic.Amen.