Human Immunodeficiency Virus (HIV) transmission through unsafe sex today has become one of the major challenges in the effort to eliminate HIV from Manipur which once witnessed high HIV transmission through intravenous injection among drugs users as the major cause of the spread in the infection.
“The cases of HIV transmission among injecting drugs users or through sharing of needles may decrease. Unfortunately, HIV transmission through unsafe sex has been gradually increasing,” said Kangabam Anandi, who is an HIV survivor and general secretary of Imphal East Network for Positive People (IENP+) in an exclusive interview to the Imphal Free Press.
In the efforts to check the spread of HIV/AIDS in India, the National AIDS Control Organization (NACO) introduced various policies and programmes to end HIV epidemic by 2030 in line with the sustainable development goal. The first National AIDS Control Programme was launched in 1992, which focused on the national HIV surveillance system, prevention activities among High Risk Groups (HRGs) including information on HIV and the blood safety programme. Several other programmes followed since.
However, there is a growing concern among the people of Manipur who are working in the field of HIV treatment over unrelenting transmission of HIV through unsafe sex. It has now become one of the major challenges to eliminate HIV from the state, while majority of the people living with HIV (PLHIV) are still reluctant to disclose their identity with the perceived stigma and discrimination against HIV.
Amid the challenging concern, the Imphal Free Press contacted Kangabam Anandi to know more about the present scenario considering her long journey in the field of HIV and AIDS in the state.
Forty-year-old Anandi has a different story to tell the world – of courage, strength and an overcoming life.
The courage that she possessed to introduce herself to the world as an HIV survivor with no fear enabled her to get the right support and extend the much-needed support and care to fellow PLHIV since the year 2000, she said.
Anandi has been helping over 3,000 people living with HIV who are registered at Imphal East Network for Positive People which is providing related services given under NACO, she said. Many of them are being infected through sexual route and report of the case is increasing, she added.
It may be pointed out that there are various means of HIV transmission such as through unprotected sex with an HIV infected person, transfusion of HIV infected blood or blood products, sharing of needles contaminated with HIV infected blood and from HIV infected mother to her baby – during pregnancy, during birth or after delivery through breast milk.
“Out of various routes, transmission through unsafe sex has been gradually increasing and the other mode of transmission has been controlled to a great extent… We are still receiving the report of many men and woman being infected with HIV from their partner or spouse. The very reason of this problem is due to having multiple partners or keeping extra-marital affair,” Anandi said.
Citing poverty as one of the main causes of increasing HIV transmission through sex, Anandi said that out of poverty, many women, particularly widow or divorced women, land up in sex work as a profession to meet their ends.
Manipur being one of the states with high prevalence rate of HIV and Acquired Immuno Deficiency Syndrome (AIDS), the widow rate is also considerably high. Besides this, many men are losing their life due to addiction with several intoxicant items. In search of their livelihood, they are compelled to become sex workers knowing or unknowingly about health risk involved in it of it, Anandi said.
She further said that NACO has taken up various activities like Anti-Retroviral Therapy (ART), Opiod Substitute Therapy (OST), Prevention of Parents to Child Transmission (PPTCT) program, Isoniazed Preventive Therapy, promotion of condom, distribution of syringe etc. Even after implementing numerous programmes, the state still getting report of HIV transmission through unsafe sex is unfortunate. If the situation is not control effectively, serious consequences will surface after a decade or sooner.
Anandi got infected from her first husband in 2001, she said. Since then, she battled the scourge and overcame it all. Today, she is a mother of two daughters and endures all odds to lead a dignified life by engaging in several income generating activities like tailoring, embroidery, pala singer, etc, she said.
Many consider her as a role model in the society for her successful efforts in preventing HIV transmission to her two daughters and husband (still they are HIV negative) though she got infected when she was 21 years of age. Born and raised in a remote place called Thanga, Anandi studied till 10th standard.
Until and unless some initiative for the welfare of widows or separated women are taken up, the problem of HIV in the state cannot be fought successfully. Besides this, the authority concerned should enhanced condom promotion programme in the state, she added.
“It is high time the government identify number of widows and separated women who have no one to support them. Along with this, long term policies and programme for widow and separated women should be formulated so that they can stand on own their own feet," she suggested.
She also suugested local MLAs to take up steps to help widows staying in their respective constituencies from their local area development funds.
It may be mentioned that according to the ‘National strategic Plan for HIV/AIDS and STI (2017 to 2024) released by the Union Ministry of Health and Family Welfare, Government of India, on December 1, 2016, HIV and AIDS were first reported in India in 1986. Since then, the Ministry of Health and Family Welfare, Government of India, has led the HIV/AIDS response, inclusive of advocacy, policy, strategic guidance, funding, and service provision for HIV prevention, treatment and care for both, people at risk of or living with HIV.
Three decades on, the national response resulted in significant achievements of 66 per cent reduction in new infections since 2004 and 54 per cent reduction in AIDS-related deaths since 2007. The history of the HIV response in India is based on an exceptional dialogue and collaboration between government, communities, people living with and affected by HIV, civil society organisations (CSOs), academics and researchers, development partners, private sector, and parliamentarians, it stated.
In June 2016, the Minister of Health and Family Welfare reiterated the country’s commitment at the United Nations’ High-Level Meeting on AIDS towards the goal of ‘ending the AIDS epidemic as a public health threat by 2030’, inclusive of the Joint United Nations Programme on HIV/AIDS (UNAIDS) Fast Track targets for 2020 as well as in line with the Sustainable Development Goals (SDGs) for 2030.
