AIDS claim 40 million worldwide since 1981

By Dr Sujatha Samarakoon
Consultant Venereologist
President AIDS Foundation Lanka

First recognized in 1988, World AIDS Day falls on December 1 each year. On this day, people around the world unite to show support for people living with and affected by HIV and to remember those who lost their lives due to AIDS.

An estimated 40 million people worldwide have died of AIDS since 1981, and an estimated 38 million are living with HIV by end 2019 (1) and 1.7 million became newly infected in 2019 (1) making it one of the most important global public health issues in recorded history. Despite recent improvements in treatment, the AIDS epidemic still claims an estimated two million lives each year, of which more than 250,000 are children1.

Since 1988, Sri Lanka has been commemorating World AIDS day which is dedicated to spreading awareness of the AIDS pandemic and the need to prevent and control of HIV in the country and to remember those who have died of the disease.

The red ribbon has become an internationally recognized symbol for AIDS awareness, worn by people throughout the year in support of people living with HIV and in remembrance of those who have died.

Sri Lanka is categorized as a country with a low prevalence of HIV infection as the HIV prevalence among adults above 15 years of age was 0.1% as of end 2019 (2). At the end of 2019, it is estimated that around 3600 people are living with HIV in the country2. The main mode of transmission is through unprotected sex (2). The National STD/AIDS Control Programme (NSACP) of the Ministry of Health, which spearheads the national response to HIV/AIDS commenced interventions even before the first HIV infection was diagnosed in the country in 1986. The initial programmes were mainly to create awareness among the general population especially the youth and women on methods of prevention. Concomitantly HIV testing services were introduced free of charge in the government sector where people were able to get the HIV test done to know their status maintaining confidentiality. A policy decision was made to screen all donated blood for HIV infection in the public sector and also the private sector. The outcome of this timely decision was that since year 2000 no blood transfusion associated HIV infections have been reported to the national programme. This was a great achievement for the health sector and the people of Sri Lanka. Awareness programmes were then expanded to involve the key population groups or populations most at risk to HIV infection due to a variety of reasons including high risk sexual behaviours. The highest prevalence of HIV is reported among men who have sex with men (MSM) at 1.5%2. HIV prevalence is also reported among trans-gender women (TGW), female sex workers (FSW), beach boys (BB) and injecting drug users (PWID). Other high-risk groups include prisoners, drug users and migrant workers. Between 2011 and 2019, new HIV infections among adult males have been increasing exponentially from 78 cases to 359 cases, which is a 460% increase (2). Currently, the national programme is reaching out to key population groups using several approaches especially to reach the hidden high risk populations.

In 2004, a policy decision was made to provide anti-retroviral therapy (ART) to people living with HIV (PLHIV) through the national programme. As of end 2019, a total of 2 302 (64%) (2) knew their HIV status and 1 845 (51%) (2) registered for treatment which is offered free of charge.

AIDS Foundation Lanka (AFL) was established in 2008 after the 8th International Conference on AIDS in Asia & Pacific (ICAAP) was held in Sri Lanka. The objectives of the AFL is to support the National STD/AIDS Control Programme in conducting awareness programmes to educate the general population and key population groups on basic facts of HIV/AIDS, access and availability of services and support people living with HIV.

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Through-out the years, AIDS Foundation Lanka has reached out to several population groups such as out-of school youth, formal and informal sector workers and healthcare workers in educating them on basic facts of HIV which includes the methods of transmission and prevention, availability of services and the need to dispel stigma and discrimination. Several awareness programs were held at workplaces, hospitals and communities. These programmes are conducted to support prevention efforts and also the “test and treat” policy of the national programmes by encouraging those who are living with HIV and do not know their status to get them tested for HIV. People with HIV who are aware of their status, take ART daily as prescribed which helps to control the replication of the virus and keep an undetectable viral load which enables to live healthy lives and have effectively no risk of sexually transmitting HIV to their HIV-negative partners.

Every year, AFL commemorates the World AIDS Day by conducting awareness programmes for the general public including women and youth.

Although a non-profit organization, AIDS Foundation Lanka, continuously supports people living with HIV by providing them a nutrition food package monthly, educational grants, book vouchers, school bags and shoes, tuition and transport fees for children infected and affected by HIV. Some are supported in initiating self-employment income generating projects and by paying overdue housing loans. One objective of these support schemes is to strengthen the link of PLHIV with the national programme as around 10-20% of patients registered with the national program defaults attending services.

During the COVID-19 period, the national programme has made every effort to provide HIV testing services, treatment and care. The AFL has supported these endeavours by increasing the nutrition food package allowances, transport allowances to travel to HIV service providing clinics, on-line tuition fees for students.

AIDS Foundation Lanka is supported by several well-wishers who have undertaken to look after an individual or a family. The well-wisher provides the nutrition package or tuition fees to AFL and AFL handles all donations maintaining confidentiality. Some schoolchildren through their social clubs, interact clubs have come forward to donate nutrition packages, school books and other utilities. HIV positive pregnant women are provided with additional nutrition support and a maternity kit which contains baby clothes and other utilities for mother and baby worth SLR 8000/=. All PLHIV related support activities are carried out maintaining confidentiality of donors and recipients. AFL is located at the 1st Floor of Sri Lanka Medical Association (SLMA), No 6, Wijerama Mawatha Colombo 7. Phone number 011-2690230.

Reference

1.UNAIDS: Global HIV & AIDS Fact Sheet 2020. www.unaids.org/en/resources/fact-sheet

2. National STD/AIDS Control Programme, Sri Lanka. Annual Report 2019.