AIDS - A Social Plague

While the world is preoccupied fighting the COVID-19 pandemic, let’s all take a moment to acknowledge another pandemic that has been going on for nearly 40 years now, with no vaccine or cure yet. World AIDS Day has been commemorated every year since 1988 on December 1, to raise awareness of HIV/AIDS, and to mourn the victims of the disease. 38 million people worldwide are living with HIV, the virus that causes AIDS, and 32 million people have died from AIDS related causes so far (compared with 1.5 million from Covid-19.)

AIDS is the disease caused by the HIV virus. It typically happens when your body’s T-cells, which fight pathogens, fall below a certain threshold, thus leaving you susceptible to opportunistic infections. AIDS has disproportionately affected the LGBT community, due to a higher risk of transmission from certain sexual acts such as anal sex. An entire generation of gay men was lost in the 1980s and early 1990s, when much wasn’t known about the disease, and there were no effective treatments available. People were dying of opportunistic infections caused by the weakening of the body’s immune system. The early drugs used to treat AIDS, such as AZT worked only in a limited manner, were toxic and had many side effects. The advent of protease inhibitors in the mid 1990s, and even more effective ART (anti-retroviral therapy) in the 2000s meant that it became a manageable chronic disease. Now, most HIV positive persons take as little as one pill a day to keep the virus in check, and most HIV positive people do not progress to getting AIDS.

However all this does not mean that people should get complacent. The greatest threat HIV poses is due to the stigma associated with it. Many people who know they are HIV positive do not disclose their status due to stigma or fear of rejection. Some people are reluctant to get tested, as they do not want to find out their status due to the stigma associated with being HIV positive. And those that are not on treatment are of greatest risk since they could be having a very high viral load... the amount of the virus in your blood... which makes transmission to others easier. The least risky persons are those who are undetectable... who regularly take their medications that keep the level of the virus in their blood to undetectable levels, and thus are untransmittable. These days, the recommendation is to get started on ART as soon as you test positive for HIV, as that has the best outcome for both you and others. ART is available for free in India through government hospitals, or you can also get it through private doctors. The HumSafar Trust, an NGO in Mumbai that provides HIV/AIDS services, runs an LGBT sexual health clinic, and this can also be a great resource.

Nowadays you also get what is known as PrEP (Pre Exposure Prophylaxis), where you can take a pill a day if you are HIV negative. While this has reduced HIV transmission rates, PrEP is still not widely available in India, and is not covered by government programs. And just as masks, when worn properly, greatly reduce your chances of getting Covid-19, condoms, when used properly are still among the best protections against HIV. Also, PrEP will also not protect you against other STIs such as syphilis, gonorrhea and chlamydia.

The other thing to keep in mind if you are HIV positive is to lead a healthier lifestyle. As HIV positive people live longer and get older, they suffer from other conditions, which can interfere with the HIV. A healthy diet that is rich in fruits/vegetables and low in refined/processed products such as sugar or maida, and regular exercise are a must. Avoid smoking at all costs; if you do smoke, join a smoking cessation program. If you drink, do so in moderation, and avoid recreational drugs (in India known as HF or High Fun), which are very popular in the gay community, as the harms caused by then far outweigh the temporary pleasure that they provide. And addiction can be a deadly downward spiral.

With a proper lifestyle, HIV is no longer the scourge that it used to be, and one can live one’s life normally just like with any other chronic condition. However prevention is still best, and so try to take proper precautions to not get it in the first place. And do not stigmatize HIV positive folks; they deserve the same dignity and respect as anyone else.

P.S. on that note, the insti dance club In-Sync has an annual event that is unfortunately named “AIDS”. Just as you wouldn’t name an event “Covid-19”, it is tasteless and demeaning to name one “AIDS”. I request InSync to correct this mistake made years ago, and rename their event to something more appropriate.