News
Hundreds of males falling prey to AIDS, disease under-reported
AIDS (Acquired Immune Deficiency Syndrome) may be a term that is seldom talked about today but the silent killer is spreading among males who are biologically inclined to be sexually active with other males. 
According to the latest figures from the Ministry of Health, STD/AIDS control programme designed to contain AIDS and sexually transmitted diseases (STD), 285 males have been diagnosed with the disease in 2018. Of this 60% are reported are from males who have had sex with males (MSM).
The 2018 report said that HIV (Human Immunodeficiency Virus) spread among adult males has increased by 265% in the last nine years.
In 2011, there were 78 men who were infected, but in 2018 the figure spiralled to 285, of which 161, or 57%, were MSMs.
Many of these men are married and occupy high positions in their professional careers.
Their behaviour has helped in spreading the disease to wives and female partners. The cumulative figures for six years from 2013 to 2018 for infection in males to females has been fluctuating recording a high of 55% in 2014 and a low of 143 cases – 41% in 2018.
However, statistics among adult females has been stable with 60 cases reported each year in the last eight years, between 2011 to 2018.
Studies show that female sex workers are well informed of the risk of infection and most often insist on safe sex. Around 76% of 30,000 estimated female sex workers insist on using condoms.
On the contrary, only 67% of the estimated 40,000 male sex workers use condoms.
The STD/AIDS Control Programme has found that with the increase in tourist arrivals, the disease has become prevalent among the 2,200 TGM (transgender males), 4,500 beach boys and 900 people who inject drugs, although at a lesser scale.
HIV tests done under the STD/AIDS programme on 1.18 million suspected cases in 2018 has revealed 350 including two children (mother to child transmission) in 2018. This is a 23% increase from 2017.
Director Dr. Rasanjali Hettiarachchi, said the figures are under reported and several bisexual men are carrying the disease. Most of them are young, are in the 25 to 40 year old group.
They are vulnerable because of their lifestyle of having multiple partners and not using condoms.
The predominant mode of transmission among males has been found to be oral and anal sex performed without protection.
In Sri Lanka, unlike in the West, bisexual men do not openly admit their sexual preferences and lead a double life. Most often they have a wife and children and enjoy high social status and hold important positions at work. They infect their wives and other male/female partners they come into contact with.
The 10 to 15 year incubation period is another reason for the subtle spread of the disease. Infected persons become carriers of the disease unaware of their status and indulge in unsafe sex for years before they become an AIDS patient.
The STD/AIDS Programme revealed that one fifth of infections were in late stage and were fully blown aids patients. They had reported to a clinic because of illnesses related to the disease.
The percentage of patients who have fully blown AIDS is around 18% in 2017 and 2018.
In 2013, the number of fully blown AIDS patients stood at 30%, however it has gradually scaled down because of early detection and treatment.
The programme estimates around 200 deaths since 1987 to date, but said there may be several others, for they die of other illnesses due to AIDS and go undetected.
Global studies reveal that 1% of the world’s population, men and women, are biologically inclined towards their own sex. However, women are not greatly affected by the disease as there is no penetration during sex.
The cumulative figure since 1987 for people living with HIV is 3,500 of which 10% are young adults (between 15 to 24 years). Also little less than 100 children, below 15 years have been detected.
The programme employs peer educators and field supervisors among female and male sex workers, beach boys and drug users to encourage condom use and inform them of the availability of detection and treatment. These persons, also afflicted and on treatment, have been trained to educate their peers on the importance of using condoms and safe sex.
Also they direct persons to the STD/AIDS clinics for testing. Most tested have been reported with venereal diseases including syphilis, hepatitis and herpes.
Three peer educators and 44 field supervisors work among male sex workers operating in 164 secret hives in Colombo, Galle, Kandy, Matale and Anuradhapura. in addition 308 fsw who are peer educators work in 10 hotspots including Colombo, Polonnaruwa, Anuradhapura, Gampaha, Galle and Kurunegala.
Also, around 2,200 male transgenders in 55 hideouts have been given free condoms and 4,500 beach boys operating in 31 hives and drug users have been included.
The programme distributes condoms in the hotspots frequented by these persons and 14 STD clinics have distributed 391,099 free condoms in 2018. Adult HIV prevalence in Sri Lanka is <0.1% and the infection which was concentrated in the western and north western provinces of the country has expanded to the southern province in recent times. Also to some districts in the north central and northern provinces.
District wise, western province reported cases in all districts while the north western, southern and central provinces have shown higher rates of infection in 2018. In Colombo, Gampaha, Puttalam and Kegalle districts the numbers have increased in all four years between 2015 to 2018.
Between 2016 to 2018, Colombo and Gampaha districts were badly affected with three males infected for every 100,000 people in 2017.
Female infection in Colombo, Polonnaruwa and Vavuniya were three for every 100,000 people in 2017 and 2018.
In addition, in 2018, Gampaha, Galle, Matara and Vavuniya had reported three females infected for for 100,000 people.
The report said that in 2017, most districts of the northern province reported high rates of HIV infection among females, the trend slowing down in 2018 because of education on adopting safety precautions in sexual activities and the distribution of condoms.
A cumulative 3,500 patients are estimated to be living with HIV with only 77% (2,709) aware of their status and 1,574 (45%) on a treatment plan.
The programme says its target is to have 90% of HIV patients know their status and receive treatment on time.