HIV Epidemic Fast Spreads in Orissa

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HIV Epidemic Fast Spreads in Orissa Monday, April 05, 2010

By Kishore Kumar Dash; PLHA continues to face Social Stigma

With 2.5 million HIV/AIDS cases ,India, at this level, continues to be the third

largest contributor to the global HIV burden after South Africa and Nigeria. It

remains one of the most significant problems haunting India over the past

decade. The killer disease is more severe in the southern half of the country

and the far north-east.

As per the recent stastics ,the highest of 479.866 lakhs HIV prevalence rates

are found in Andhra Pradesh, followed by 436.679 in Maharashtra and 255.881 in

Karnataka in the south; and Manipur and Nagaland in the north-east.

The joint report prepared by NIMS, ICMR, NACO and AIIMS in March last year

reveals the urgent attention of the policy and programme managers in view of

increasing epidemic trend in seven States including Orissa. Orissa was among

seven low prevalence States, where increasing epidemic trend was noticed by

various agencies during the five-year period.

The reports of five folds increase in terms of HIV prevalence among adults in

the State between 2002 and 2006 is a matter of serious concern. More importantly

number of people living with HIV/AIDS (PLHA) in all ages had seen a dramatic

increase in Orissa.

As per the study, there was a rise of nearly five folds among numbers of PLHA

from 2002 to 2006. Estimates said 8,248 people living with HIV were detected in

2002 in the State that went up to 9,717 in 2006 in the State. Further, this

number went up to 16,082 by the end of January,2010.

According to the Health & Family Welfare Department sources of Government of

Orissa, Ganjam district tops the lists of both HIV

positive cases and AIDS death cases, followed by Cuttack and Koraput.

With the number of people living with HIV/AIDS stands at 921 by February 2010,

Koraput stands second in the state. This apart, a total of 133 deaths have been

reported in Koraput during the same period. In fact, Ganjam district happened to

be the major hub of this killer virus.Ganjam again topped the list having 5920

in the category. Cuttack follows it with 2083 persons affected by HIV positive.

Though Orissa is not one of the high risk states, Ganjam is one of the high risk

districts in the country. While 3,359 HIV positive cases were reported last year

in the district, this year the number has reached at 3,635 till November last

year.

According to latest figures released by the Orissa State AIDS Control Society

(OSACS), OSACS on the occasion of World AIDS Day,December 2009, as many as 1,083

persons were so far died due to AIDS in the State while Ganjam suffered highest

number of casualties with 349 deaths, followed by Koraput with 145 deaths.

The deaths on account of AIDS are rising in the State where 714 people lost

their lives this year compared to 133 last year and 28 in 2006. This year's

death roll is estimated to be the highest during the past seven years. Situation

is slowly becoming grim in other districts of Orissa like Puri, Kendrapara,

Angul, Bargarh, Rayagada and Jajpur.

The report published in the Indian Journal of Medical Research revealed that an

increasing epidemic trend has been noticed in seven of the low-prevalence States

such as Pudduchery, Jammu and Kashmir, Jharkhand, Bihar, Orissa, Rajasthan and

West Bengal. The assessment showed that HIV prevalence among the adults was 0.36

per cent while the rate in high prevalence States stood at an alarming 0.8 per

cent.

In the low and moderate epidemic states like Orissa, the rate of infection stood

at 0.2 per cent. As per the data, Odisha's adult HIV prevalence rate has seen a

rise from the 0.06 per cent level in 2002 to 0.22 per cent in 2006.

This also explains why the number of people living with HIV/AIDS (PLHA) has

increased over the same time--from 9,717 to 48,248 — a 400 per cent growth. The

report further points out that Tamil Nadu is one among the high-prevalence

States to have recorded a decline in the rate, while it remained stable in

Andhra Pradesh and Karnataka.

Social Stigma Makes HIV/AIDS People Ostracized:

Ostracism, humiliation and mistreatment at the hands of family members,

community and the medical fraternity are increasing in Orissa.Stigma remains the

single most important barrier to public action.

It is a main reason why too many people are afraid to see a doctor to determine

whether they have the disease, or to seek treatment if so. It helps make AIDS

the silent killer, because people fear the social disgrace of speaking about it,

or taking easily available precautions.

Stigma is a chief reason why the AIDS epidemic continues to devastate society

across the state. Fear of contagion coupled with negative, value-based

assumptions about people who are infected leads to high levels of stigma

surrounding HIV and AIDS. The epidemic of fear, stigmatization and

discrimination has undermined the ability of individuals, families and societies

to protect themselves and provide support and reassurance to those affected.

This hinders, in no small way, efforts at stemming the epidemic. It complicates

decisions about testing, disclosure of status, and ability to negotiate

prevention behaviours, including use of family planning services.

Latest report reveals, that more than 40% of people living with HIV in India,

particularly Orissa had been refused medical treatment on the basis of their

HIV-positive status. It also found strong evidence of stigma in the workplace,

with 74% of employees not disclosing their status to their employees for fear of

discrimination.

Of the 26% who did disclose their status, 10% reported having faced prejudice as

a result. The case of one Madhab of Padmavati village under Purushottampur block

in Orissa's Ganjam district best illustrates the story.

Two years ago, dreaming of a better future he had left for Mumbai. Son of a

daily labour, the twenty seven year old Madhab hadn't had the luxury of

education. Soon after his arrival, he could get to work as a daily labour. " I

felt I was lucky. I was very happy, " he says.

However, his happiness didn't last long as ill fate struck him a bad blow. Back

in home since over six months, Madhab is fighting for life and against social

stigma as he has been detected with HIV positive.

Madhab is not an isolated case. Hundreds like him from Ganjam district are

unsure about their life. Their dreams have turned into nightmares. And they have

forced their near and dear ones to undergo the tragedy. In rural Ganjam stories

like this are not difficult to find. " It's a sad story. The situation is grim.

Unless care is taken, it will go out of hand, " said a health department

official.

" I wish I had died immediately after testing positive for HIV/AIDS rather than

have to undergo such disgrace, pain and trauma. This is much worse than death, "

weeps Malati , recalling her ordeal at the hands of her family and community

members.

When 33-year-old Malati, who lives in a village near Aska in the Ganjam district

of Orissa, tested HIV-positive she was driven out of the house, locked up in the

family goatshed, denied adequate food and basic amenities. She was finally

rescued by a local NGO working with HIV/AIDS. By then, she was delirious, and

infested with ticks and worms.

HIV infection is on rise now in Orissa; exactly what the prevalence is, is not

really known, but it can be stated without any fear of being wrong that

infection is widespread… it is spreading rapidly into those segments that

society in the state.

Sadly though, the emerging face of the HIV epidemic is increasingly turning

younger, rural and feminine. Prevailing gender stereotypes and early marriage

ensure that women remain ignorant and unable to protect themselves, making them

especially vulnerable to infection from husbands.

One of the most debilitating impacts of this epidemic is the stigma and

discrimination resulting from disclosure of status. And AIDS widows, in

particular, bear the brunt of inhuman social ostracism.

Their situation exacerbates due to loss of the earlier social support system and

source of earnings, dependent children and denial of healthcare.

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