Dr Shrikala Acharya outlined MDACS plan to fight HIV and eradicate AIDS by 2020. Edited excerpts from a conversation with Manasi Tahalani
What is the current scenario of HIV in the city?
Today, we have 44000 registered HIV patients under our 14 antiretroviral therapy (ART) centres in the city, of which, 30000 are on ART treatment. According to the data received from 2007 to 2015, the number of general clients diagnosed with HIV Sero-positivity has declined consistently from 17,159 to 8593. Further, the number of pregnant women diagnosed with HIV Sero-positivity has declined from 953 to 251. However, our focus is to completely eradicate the new HIV cases in the city which are more prevalent among the bridge population which includes migrants and workers and injecting drug users.
Why has the HIV prevalence become more prominent among bridge population and drug users as compared to other high-risk groups?
Bridge population and drug users have a high-risk behaviour wherein they believe that they cannot get the infection and therefore do not come forward to get themselves tested for the virus. Meanwhile, drug users may not practice safe behaviour and have high probability of indulging in unsafe sexual relations. Lack of awareness, no safety measures adopted during sex and half knowledge about the virus is the biggest reason for the rise in the cases among these groups. Further, these groups transmit the virus to their spouses which is passed on to their children. Therefore, in order to control the transmission of virus, we have to start diagnosing the virus at the initial stage so that treatment is provided at the earliest.
Can you elaborate on the transmission virus from mother to child and give us insight into what measures are taken on this front?
There was a case wherein a woman who was four-months pregnant came to one of our ART centres and we tested her for HIV which turned out to be positive. Following this, we test the husband as well and we found out that the he was HIV positive and had transmitted the virus to his wife. Majority of the mothers get HIV infection from their husbands who themselves are not aware about it which is a huge cause of concern. Therefore, we decided to sign Memorandum of Understanding (MOUs) with private maternity and nursing homes wherein free HIV kits are provided to these hospitals and would-be-mothers are tested for HIV.
What is the line of treatment provided to the mothers after they are tested positive for HIV?
Earlier when we were following National AIDS Control Organisation (NACO) guidelines, then single-drug treatment was provided to the mothers. But since 2014, we are following World Health Organisation (WHO) and multi-drug ART treatment is provided wherein a combination of three drugs in a single table throughout their life is to be consumed by the mothers. With this dosage, the virus gets killed from 33percent to 0.5percent. Further, it is necessary that the mothers come at the initial stage of their pregnancy to ensure that treatment is started on time. Those who come late or at the time of delivery, we have lost the golden period and therefore owing to this, of 244 positive HIV mothers, 22 babies were born HIV positive in 2015. Majority of these mothers belong to Mankhurd, Govandi, Kurla and Malad to Dahisar areas.
