Editorial: About HIV and AIDS

Talk about HIV and AIDS has become so routine and commonplace that many groups do not even blink when someone suggests that World AIDS Day be ‘celebrated’. There is nothing celebratory about HIV or AIDS, but people get inured too easily nowadays and this Virus, although it is still as lethal and communicable as it was in 1986, when the first case in the world was detected, the statistics or the conditions of the HIV+ve or AIDS patients do not seem to evoke much genuine response. It appears that before any genuine understanding on the challenge, its impact and risks could be fully understood, AIDS awareness in the country has taken a backseat, the concerned agencies preferring to gloat over the fact that the number of new infections has started scaling down. Neither the nation as a whole or Sikkim can afford to let its guard down on HIV. And it is no longer only about first generation infections, there is also now the issue of children being born HIV+ve. A quick primer of HIV in Sikkim is perhaps required here. The first HIV+ve case in Sikkim was detected in the year 1995, nearly a decade after the Virus arrive in India. It broke the 3-figure mark sometime in the year 2008, and as of now, there are 271 confirmed HIV+ve cases in the State. The numbers might appear inconsequentially low when compared to what other parts of the country and the world are suffering, but one must bear in mind that these detection are from the voluntary testing centres and the compulsory HIV screening of expecting mothers. This is a very small pool, and one must add that given the small size of the State, many people fearing that they might have contracted the virus would prefer to get themselves tested in the more assured anonymity of testing centres outside Sikkim. Should their tests come back positive, they will get counted in States where they got themselves tested and not here. That said, the snow-balling effect of the Virus is already palpable. Against the 6 cases where people living with HIV collapsed into full-blown AIDS between 1995 and 2006, in 2007, 12 HIV+ve people developed AIDS. The first case of AIDS in Sikkim was detected in 2005. This figure stands at 67 now.
The reason why these figures are detailed here is to drive home the point that AIDS Awareness demands fresh direction in Sikkim. The still low numbers can be misleading and that is because of the national policy on how “official” data is collected and confirmed. Then, the pool from which these cases have been detected might not be as inclusive of segments at high risk as required. These are the limitations of operating in a small state with models drafted for larger states. What Sikkim has to realise is that HIV prevalence can explode if awareness and education is not delivered coherently. This can happen only if the national models are customised for local target groups, local developments and future situations. The fact that the 271 HIV+ve figure includes teenagers demands that awareness in schools in among teen peers groups be more than token processions on World AIDS Day. The Red Ribbon Clubs were a positive effort towards addressing this target audience. It is time that their impact is studied in deeper detail and fine-tuned to ensure even more effectiveness. The entire awareness exercise has to be more earnest, more involved.
HIV and AIDS are no longer dirty little secrets Sikkim can afford to sweep under the carpet and ignore. A generation which has lived ignoring issues like substance abuse cannot afford to ignore this disease which has the propensity to grow into an epidemic before a community has realised it is in its midst. Look at India. The first case was detected in 1986 and we are already clocking 4 million HIV+ve people. In Manipur, the AIDS bomb has already exploded and this even before the State had come to terms with the presence of the disease in its streets. Why we say the problem can no longer be ignored in Sikkim is because now it has started surfacing in the coming generation. Newborns have arrived in this world with the virus we passed on to them. Why? Because Sikkim still, in many ways, refuses to believe that the laid back climes of the State could provide the breeding ground for the Virus.