Vast distances a barrier to combating HIV/AIDS in India

[Guest guest]

Vast distances are a major hurdle to India's efforts to curb its

soaring HIV rate.

By Tan Ee Lyn. Reuters. NEW DELHI (Reuters) -

India, which has the world's third largest HIV-positive caseload,

gives drugs for free to HIV/AIDS patients. But doctors say this is

not enough to stop the spread of HIV which is making inroads in rural

India, especially among women infected by itinerant husbands, and

also children.

For three days a month, Sambit squeezes into a crowded and often

filthy train for a three hour journey to Delhi to receive HIV

treatment.

" There's no seat and I am very weak, " said the 30-year-old former

tailor, who asked that his full name not be revealed. He can't afford

lodging in Delhi and can barely afford the train tickets.

" I need to borrow money from my family for all these trips, " he said.

Many patients in the same position simply give up treatment, an

anathema in HIV therapy as it gives rise to drug resistance. These

patients may then need more powerful second line treatment, which is

not freely available in India.

" Travel can affect drug compliance. Patients who don't get family

support, women who may not like to travel alone will just give up, "

said a doctor at a New Delhi hospital, who spoke on condition of

anonymity because he did not have permission to speak to reporters.

There are 147 " antiretroviral therapy " or ART centres in the country,

part of a government drive that has been encouraged by the World

Health Organisation in a bid to prevent HIV from becoming a major

health problem.

Delhi has nine such centres and is far better served than many other

states. Up to 6,000 patients receive treatment in Delhi, nearly half

of these live outside the capital.

The government now plans to build " link centres " , small facilities

that are closer to where patients live so people like Sambit can

obtain their medications more easily.

" They just come to pick up the drugs if they have no side effects and

they go home ... that saves transport and other costs, " Rao said,

adding that the plan was to have as many as 500 such centres all over

India.

INFECTION FIGURES AREN'T GOING DOWN

India has 2.47 million HIV cases, according to the latest figures,

but health workers say the number is rising rapidly and spreading to

new population groups.

" Our numbers are going up, " said Loon Gangte, South Asia coordinator

of the Collaborative Fund for HIV Treatment Preparedness.

" It's not confined to high risk groups, it's going into the general

population. It's not a problem of sex workers, drug users or truck

drivers. These people have wives and children at home and the disease

is making its way into the general population. "

Sujatha Rao, director-general of the government's National AIDS

Control Organisation, says doctors are increasingly seeing women

infected by their husbands.

In some clinics, 1 out of 100 women who come for ante-natal care

checkups are HIV positive, she said.

" It is a generalised epidemic, " she said. " We have pockets where the

prevalence is more than 1 percent among ante-natal care mothers, so

we need to intensify our work. "

Out of India's 611 districts, HIV prevalence is more than 1 percent

of the population in 156 districts.

" The epidemic is getting deeper into (certain) rural, general areas

of the country ... it is migrant-related. They go to work and then

they take back the infection to their homes, " she said.

Even though HIV drugs are free, only about 155,000 people have access

to retroviral drugs, up from 20,000 just two years ago.

Health expert say there are many people who do not know they are

infected or who do not know that treatment is available.

Some health professionals believe India's HIV problem is closely

intertwined with poverty and that the government must tackle poverty

if it seeks to curb the spread of HIV.

" Many of these people are very poor, they worry about food, shelter.

So they may not think their HIV status is a problem because they

don't even know where their next meal is coming from, " said Errol

Arnette of the help group Sahara.

" A lot of AIDS patients die of TB because it's hard for hospitals to

keep them (in hospital). HIV patients are just thrown in a corner

because of heavy stigma. "

(Editing by Goldin)

http://uk.news./rtrs/20080603/thl-uk-india-aids-acc9995.html