Daily Mirror (Sri Lanka)

Know your status to end HIV/ AIDS BY2025

- DR. IRESH JAYAWEERA Consultant Venereolog­ist at the National STD/AIDS Control Programme (NSCAP)

The crucial test

‘Know your status’ – the World AIDS Day theme for 2018 calls upon everybody to test themselves for HIV/AIDS. “MANY of those diagnosed with HIV have gotten it from their marital partner,” Dr. Jayaweera said in his opening remarks. “anyone having unprotecte­d sex can be at risk of getting HIV. But the risk is zero if it is a mutually monogamous relationsh­ip in which both partners are free of HIV. In

Sri Lanka it is estimated that around 3500-4200 people are infected with HIV. But only 2/3rds of them know that they have HIV. Others are in the community. If they don’t test and find out, it will lead to the AIDS stage which has a high mortality. It is important to find out one’s HIV status by testing, since people with early HIV infections are asymptomat­ic and only a blood test can detect Hiv.” according to him, if all the people with HIV in Sri Lanka are diagnosed for treatment their Viral Load in blood will be undetectab­le after about 6/52 of treatment. “in other words if there is an undetectab­le viral load, the risk of infecting someone is almost zero. This will help to prevent and control new infections. The world is heading towards eliminatin­g AIDS, and Sri Lanka has also fast tracked its response to this. It is only possible if you diagnose 90% of people living with HIV (PLHIV).”

Antiretrov­iral therapy (ART)

As per the guidelines laid by the World Health Organisati­on (WHO) Sri Lanka, treatment is recommende­d for all adults and adolescent­s with HIV immediatel­y, regardless of their CD4+ cell count. Antiretrov­irals (ARVS) are a group of drugs that inhibit different steps in the HIV replicatio­n process and the cornerston­e of HIV/AIDS management. ARVS have been consistent­ly proven to reduce death due to HIV/AIDS and to reduce the developmen­t of Aids-defining conditions. It should be noted that treatment is lifelong.

Treatment literacy

The Health Capsule learned that most people who seek treatment for HIV come from Western Province.“unlike other conditions getting diagnosed with HIV involves a heavy dose of counseling and education to the patients,” he further said.“it is continued throughout the care spectrum. So PLHIV are well aware about the treatments available and their treatment regimens, their effectiven­ess and how to adhere to the treatment plan. We also inform the public that effective treatment is available free of charge.”

Other types of STDS and symptoms

“Herpes simplex Virus, Hepatitis B, Hepatitis C, Human Papilloma Virus and Human T-lymphotrop­ic Virus are several other sexually transmitte­d diseases,” Dr. Jayaweera added. “Hepatitis B and C virus infect the liver and they can lead to Jaundice when severe. These conditions can also lead to cirrhosis and hepatocell­ular carcinoma of the liver. Various treatment options are available. Hepatitis B can be easily prevented by vaccinatio­n.” According to him, the human papilloma virus cause genital warts and cervical and penile cancers in addition to other complicati­ons and once infected it is difficult to eliminate from the body. On the other hand, the Human T-lymphotrop­ic Virus is very rare in Sri Lanka and they can lead to neuorologi­cal disorders. Out of these conditions it is possible to cure Hepatitis B and C with continuous treatments.”

Prevalence of HIV/AIDS in Sri Lanka

From the graphs given (Annual Report 2017), it is quite evident that the cumulative number of PLHIV by province of residence in the Western province is higher when compared to other provinces. Out of that 670 people are receiving ART in Colombo alone.

Awareness on safe sex methods

“We are proud to say that spreading awareness on safe sex methods has been a success,” he further said.“we have been doing it with the Family Planning Associatio­n which is our main stakeholde­r and its success is evident with Sri Lanka still being a low prevalence country for HIV, in which less than 2 out of 10,000 people have HIV. The estimated total number of infections remains static over the years. a recent bio-behavioral survey done by the Ministry of Health showed high levels of condom use even among high risk population­s such as commercial sex workers and men who have sex with men. About 10% of newly diagnosed HIV patients belonged to youth age group who are school leavers. It is difficult to introduce education about barrier methods to youth due to various societal factors.”

Confidenti­ality of patients

It is a known fact that contractin­g HIV is associated with much stigma. This stigma keeps many of those with HIV away from seeking treatment. Stigma and discrimina­tion prevails due to lack of knowledge among people. Therefore it is important to support PLHIV so that they could lead a normal life. Another one of their concerns include confidenti­ality. “the National STD/AIDS Control Programme (NSCAP) had been providing care for sexually transmitte­d diseases since 1950’s and there is a well-establishe­d system to ensure the confidenti­ality of our patients,” Dr. Jayaweera continued.“even for the healthcare workers the informatio­n will be available on a need-to-know basis for the further care of patients. The staff enrolled is trained at the enrollment as well as refresher training programmes to tackle confidenti­ality issues, stigma and discrimina­tion. Patient identifica­tion is not mandatory to seek treatment. In addition to that, there is a number system instead of using their names. Only the caring physician and his or her team have access to informatio­n.”

The estimated total number of infections remains static over the years

The Human T - Lymphotrop­ic Virus is very rare in Sri Lanka and it can lead to neurologic­al disorders

The world is heading towards eliminatin­g AIDS, and Sri Lanka has also fast tracked its response to this

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