Sudipto Mondal/The Hindu
Mangalore, Nov 7: In 2006, 72 people died of AIDS in Dakshina Kannada district. In 2007, 87 people have died in the first eight months of the year. With 534 HIV positive cases reported till August this year, the district has once again retained its top spot in the prevalence of HIV.
But what makes the district top the charts more often than not? If statistics are anything to go by, a whopping 88 per cent of the people, who tested HIV positive in the district this year, have contracted the virus through heterosexual activity.
"A lot of people from this region tend to leave their families behind and go out in search of employment. Because most of these people are still in their reproductive prime, they tend to indulge in high risk activity," says Bhakta Vatsalam, deputy director of Karnataka State AIDS Prevention Society. Seventy-nine per cent of the people who tested positive this year have been between 16 and 45 years of age.
"Awareness and precaution are still the only way to curb the disease from spreading," says the medical officer of the Anti-Retroviral Therapy (ART) Centre in Mangalore, N. Kiran Kumar.
The Government has been sustaining a massive Information, Education and Communication (IEC) drive and the message is being taken to every village with the help of NGOs, and regular awareness camps are being conducted. The fact that patients at the ART Centre showed no inhibition about the disease reveals that the stigma the disease carries is slowly disappearing. Dr. Kiran and his colleague, who attend to more than 40 patients a day, say: "Most of them discuss their HIV status openly. Many of these people have dedicated themselves back to the community and help creating awareness programmes. It is a very positive sign."
None of the Government-run ART centres in the country administers second line drugs to patients who have, over time, developed resistance to the first set of anti-retroviral drugs. "This is something that the Government-run ART centres must have as soon as possible because second line drugs are prohibitively expensive," says Arthi Aranha, a councillor, working for Freedom Foundation. The foundation administers ART at half the market price.
She says that a policy decision should be taken by the Government to curb the prices of anti-retroviral drugs.
Dearth of ART centres
There is an acute shortage of these centres in the region. The ART centre at the Wenlock Hospital is the only centre in the region, serving patients from three districts of Dakshina Kannada, Udupi and Chikmagalur. The centre is bursting with people from as far as Honavar, Karwar in Uttara Kannada and Kanoor in Kerala. People who come from Karwar have to travel for close to two days for their monthly doses of medicine.
Dr. Kiram concedes, "A small minority of people are still worried about being seen in an ART centre and get recognised. That is why they travel long distances for their monthly treatment".
Side effects
The doctors who spoke to The Hindu agreed that the medicines administered for AIDS have some level of toxicity. Arthi, who has worked with scores of patients over the years, says, "For the patient, it is ultimately a choice between the benefits of the therapy and its side effects; it is a personal choice."
A health official in Bangalore says: "Unless there is a proven alternative, we have to continue with the current medication. But a nutritious diet is an insurance against the side-effects."
Dietary support:
Dr. Kiran, however, laments that most of the people who come to the centre cannot even afford the travelling expenses. As a matter of professional routine, he counsels patients to have a nutritious, high protein diet. "How can we realistically expect these poor patients to have a healthy diet?"