World AIDS day

by Dr. Sujatha Samarakoon

First recognized in 1988, World AIDS Day falls on December 1 each year. Every year, on December 1, the world commemorates World AIDS Day. 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 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 20191 and 1.7 million became newly infected in 20191 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 20192. At the end of 2019, it is estimated that around 3,600 people are living with HIV in the country2. The main mode of transmission is through unprotected sex2. The National STD/AIDS Control Program (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 programs 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 programs 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 behaviors. 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)2. 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% increase2. 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 Eigth 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.

Throughout 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 programs are conducted to support prevention efforts and also the “test and treat” policy of the national program by encouraging those who are living with HIV and do not know their status to get themselves 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 programs 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 nutritious 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 program has made every effort to provide HIV testing services, treatment and care. The AFL has supported these endeavors by increasing the food package allowances, transport allowances to travel to HIV service providing clinics and 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 school children 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 8,000/=. All PLHIV related support activities are carried out maintaining confidentiality of donors and recipients. AFL is located at the first Floor of Sri Lanka Medical Association (SLMA), No 6, Wijerama Mawatha Colombo 7. Phone number 011-2690230.

(The writer is a Consultant Venereologist and President AIDS Foundation Lanka)