World AIDS Day is commemorated on 1 December every year. We use this opportunity to spread awareness about how this disease is spread and how to prevent its transmission. On this day, the world unites to fight against HIV and to show support for people living with HIV. It is a tribute to the work of all the scientists that what was once considered an incurable disease that spelled sure death, with the right diagnosis, treatment and follow up, HIV is now considered a chronic disease – very much like hypertension and diabetes. In this interview, Dr. Meher Rizvi, Associate Professor, Department of Microbiology & Immunology at Sultan Qaboos University, speaks about HIV, AIDS and other infectious diseases and the ways to prevent them.
How is HIV transmitted?
Human immunodeficiency virus (HIV) which causes the dreaded AIDS remains one of today’s most challenging public health concerns. According to UNAIDS there were approximately 37.9 million people worldwide with HIV/AIDS in 2018. Over the years, a decline in the number of new cases has been noticed thanks to an unprecedented global commitment to curbing new HIV infections and ensuring that everyone with HIV has access to HIV treatment. It is important to spread awareness about how this disease is spread and what measures can be taken to prevent it. Although HIV is spreads predominantly by sexual transmission, it can also be spread by sharing razers, blades and tattoo needles. Intravenous drug abusers are at an increased risk of acquiring HIV due to sharing of needles and syringes. Health care centres have a great responsibility of disposing off their sharps correctly so that no accidental exposure occurs or illicit and nefarious re-use of needles and syringes occurs. This is a problem of great magnitude in developing countries like India.
How can HIV be prevented?
Monogamous relationships should be encouraged. Safe practices like using condoms play a big role in stopping the transmission of HIV. IV drug abusers should be actively engaged, weaned away from addiction and rehabilitated into constructive members of the society. Instilling a sense of greater purpose in the young people will not only help in community building but also in keeping them away from drugs. Many of them are unemployed. It will be a good idea to introduce them into constructive activism like becoming proponents of climate change or waste management. Their interests should be explored and efforts made to involve them in activities meaningful to them. We need to spread general awareness among all categories of people. Shaking hands, sharing utensils, towels do not lead to transmission of HIV.
Prevention of other infectious diseases is also important. What are the strategies that you would suggest to prevent the spread of other infectious diseases?
While discussing how HIV transmission can be curtailed, we can also spread awareness about preventing other infectious diseases as well. It is essential to target the marginalized sections of the society and encourage them to access healthcare. The society has to be sensitized and a person living with HIV should be treated with empathy and care. Numerous studies have amply shown that STI increases the chances of acquisition of HIV. In the quest to reduce HIV transmission, we need to spearhead awareness about other sexually transmitted infections and to encourage the people suffering from them to approach the local health centres and get not only themselves treated but also their partners. Abstinence during the treatment is essential. Only in this way will we effectively control both STI and HIV. Any person with a STD should be tested for HIV, HBV and HCV as the latter two can also be spread by the sexual route.
Those with HIV are at risk for developing tuberculosis and other opportunistic infectious diseases. They should strictly adhere to their treatment and go on regular follow ups where their viral loads and CD4 counts will be reviewed and treatment tailored to their needs
Unfortunately, despite advances in our scientific understanding of HIV and its prevention and treatment far too many people with HIV or at risk for HIV still do not have access to prevention, care, and treatment, and there is still no cure. Since there is no effective vaccine, behavioral change is the most effective intervention which can contain the spread of this virus. Let us together build a more supportive, empathetic and a more aware and a safer society together.