AIDS Congress to showcase Lanka

Surveys indicate that Sri Lanka has a low prevalence of HIV/AIDS even though the country has been facing a conflict. "But this should not make us complacent," Dr. K.A.M. Ariyaratne of the National STD/AIDS Campaign warns, calling for strengthening of measures towards prevention and also treatment and care of those living with HIV.

He was speaking at a media conference on the theme 'Conflict, HIV/AIDS and Low Prevalence' last Wednesday, at which details of the 8th International Congress on AIDS in Asia and the Pacific (ICAAP) to be held in Colombo in August 2007, were announced.

ICAAP local organizing committee co-chair Bradman Weerakoon said the biennial event would be the largest international conference the country has ever hosted, bringing together an interesting collection of more than 3000 participants - politicians, government officials, medical experts, academics, social workers, people living with HIV and the media.

"HIV is more than a health issue as it pertains to development and human rights," Mr. Weerakoon said on the need for an international conference on the issue. It affects the young and the most productive of adults and hence needs all of us to be involved to prevent the spread of the dreaded disease and dispel myths about it being contagious.

The media briefing also dealt at length with the question of how Sri Lanka had managed to keep a low prevalence of HIV, despite the conflict.

How has the conflict made the country more vulnerable? On the one hand with the numerous killings taking place, less importance is, naturally, given to HIV. On the other hand, Dr. Ariyaratne said the conflict had made people vulnerable and willing to take risks. Take the case of internally displaced persons whose privacy is restricted in camps, making them vulnerable to abuse and exploitation. Further, refugees travelling to countries such as India may return with an infection. Added to this, are the large numbers of vulnerable groups who contribute to the spread of HIV infection.

Presenting a global view on HIV infections, he said of the 65 million infected, 25 million had died, leaving 40 million living with HIV. "Our Southeast Asian region (which includes Thailand, India, Myanmar, Indonesia and Nepal) ranks second in terms of numbers of those living with HIV," he said pointing out that in Sri Lanka, however, the prevalence is less than 0.1%.

"We cannot guarantee that our figures will remain low. Our situation can change as has happened in other countries," Dr. Ariyaratne warned, discussing how the HIV virus present in blood and genital fluids was passed mainly through unprotected sex, blood transfusions, sharing of needles and from mother to baby.

Quoting the statistics in Sri Lanka, Dr. Ariyaratne said the reported cumulative HIV cases at the end of the third quarter of 2006 were 815, while the cumulative AIDS deaths reported in the country were 153. Fifty-six percent of reported cases are from the Western Province, understandably, since 30% of the country's population lives in this area which also has all the required testing facilities, he said.

Explaining that the figures are arrived at through annual HIV sentinel surveys conducted in 25 centres across all the provinces, including the north and the east, he said those who were surveyed included highly vulnerable populations.

The possible reasons for low prevalence could be low injecting drug use, a relatively high literacy rate, a well-established health infrastructure, screening of donated blood, positive cultural and religious practices and the committed work of government institutions and civil society organizations, according to him.

On the other hand, negative factors that could promote an epidemic are the presence of vulnerable populations (such as sex workers, migrant workers, drug users, a large population of youth); a low level of condom use, external and internal migration for employment; and close proximity to high HIV prevalence areas in India.

Senior Researcher Bhavani Fonseka from the Centre for Policy Alternatives (CPA) talked about the rights of people living with HIV and the stigma associated with the illness. "Why is information about AIDS being withheld?" she asked. "It is because of the discrimination they will face." She called for a change in the mindset and awareness amongst health workers and the general public with regard to patients' rights - to medication and information. "They too need to have access to health, employment and education facilities."

"Low prevalence does not mean low priority. We need to create an enabling environment with legal and administrative structures that have sound policies in place," she added.