Post Mortem

HIV thriving in the shadow of Covid-19 pandemic

By Nagaland Post | Publish Date: 1/16/2021 12:38:59 PM IST

 It is indeed very interesting to see history repeating itself in a very unique way as far as HIV and Covid-19 pandemics are concerned and still a very interesting part is to take a look at people’s reactions with complete pack of anticipated hatred and condemnation with just a half-cooked knowledge through social media circulation rather than searching deep enough to know the exact nature and character of the disease in question. The classic contradiction seen here was our people’s initial reaction to the new diseases with massive contempt attached with pre-calculated discrimination and stigmatization against HIV and Covid-19 pandemics and at the same time, on the other hand, exhibiting self-discipline-deficit behaviors and showing obvious lack of will to uphold behavioral restraints to keep ourselves protected from these dreaded diseases. Unfortunately and very sadly, common observations during such pandemic situations were that most of the talking and discussion were simply unscientific, baseless and cooked-up stories rather than knowledge with scientific truth discourses. Another contradiction being observed here even during the recent Covid-19 pandemic was that our people as a whole have sadly behaved badly, and have become popular for wrong reasons, at breaching or breaking the authority’s guidelines and Standard of Operation (SOP) that had been laid down for the safety and interest of the state and the general public. HIV/AIDS and novel corona virus (Covid-19) have been classic examples of repetition of history especially in our state if not across the world.

In the early 1980s, when the HIV was first detected in the USA, the news rapidly flooded the entire world like wild fire with so much negativity which subsequently reached our state in early 1990s. As expected, along the universal wave, our people’s response and reaction to the new arrival of the HIV/AIDS disease was exceptionally worse than the reception of covid-19 pandemic and is still lingering. HIV pandemic news created an extraordinary wave with much contempt and anticipated hatred associated with disproportionate reaction without realizing that this very same disease will one day find our home and be part of our very own families uninvited. Regrettably, countless unfortunate incidences of discrimination and stigmatization were subjected towards the unfortunate victims of the HIV/AIDS at schools, jobs, renting houses, even at the very funeral point, and the most tragic and unfortunate part is that the manifested action was totally devoid of knowledge and blindly acted. Such an abominable reaction of the people towards new pandemic was understood and perceived to be a good sign of preparedness of our people to face or challenge any threatening situations: the disgusting posture exhibited by the public had been interpreted as a sign that people would definitely protect themselves by all means and avoid such discrimination and stigmatization laden disease at any cost. There was great anticipation and hope that HIV/AIDS would come to its dead end. 

However, slowly the intensity and flame of disgusting hatred towards HIV/AIDS cooled down and now, within 30 years time, Nagaland state stands at top-3 nationally in HIV prevalence (1.15%) only next to our neighboring NE States of Mizoram and Manipur. As per ANC (Ante Natal Care) HIV Sentinel Surveillance (HSS-2018-19) report, Nagaland with 1.66% of HSS stands at top-1 nationally which is interpreted as “HIV transmission is no longer confined only to a high risk group (Drug users or Sex workers) of population but rather has now reached the general population and household level” which is indeed a grave concern for all of us. ANC (Pregnant) population represents general population. ANC HSS research being more reliable, more consistent because pregnant women population are more homogeneous (similar/uniform) in nature so if ANC HSS reading becomes greater than 1%, it indicates HIV transmission has already taken its root at community and general population level. The implication of HIV positive pregnant women is that the risk of HIV transmission is higher in a family circle (wife, husband and children) and the cycle goes on. Family by definition being a unit of society, cyclic cascade like snowballing slowly leads to massive avalanche like momentum that might ultimately threaten the very existence of the entire society and community and endanger it if concerted effort of damage control is not initiated on war footing by all collective stakeholders of the state.

By and large, observation shows that the root causes of unabated rapid spread and transmission of HIV in the community were mainly our people’s habits of casualness, attitude of carelessness, lack of ownership of one’s own health, complacency behaviors and indifferent attitude, total lack of self restraints, and lack of healthy life style and self-discipline. Report shows that 94% of overall HIV transmission in Nagaland is through sexual route alone such as casual sex and sexual immoralities and unprotected sexual behaviors. HIV is no more confined only among the distance groups such as high risk group (HRG) like Injecting Drug User (IDU), Female Sex Worker (FSW), Men Sex with Men (MSM), Transgender/Hijras (TG/H) and bridge population such as migrants, long distance truckers, but rather it is now already very much within the family line and transmission cascades are getting its momentum faster than expected or anticipated. 

First of all, every stakeholder and individuals concerned need to know the peculiarity of HIV (Human Immunodeficiency Virus) that causes AIDS (Acquired Immunodeficiency Syndrome) and deaths. Peculiarity about HIV is that there is no cure yet for HIV, no vaccine has been successful so far. Drugs available right now for HIV infected people are very effective but not for cure and if discontinued, drug resistant variants of virus will develop soon and outcome scenario will not be pleasant at all for treatment defaulters. There is no drug so far that kills HIV virus directly. ARV drugs are mainly for the suppression of viral multiplication inside the infected host thereby preventing further transmission from infected individuals to non-infected individuals, to help improve quality living, improve longevity by warding off opportunistic infections by maintaining host immune capacity. Unfortunately, the treatment for HIV is painfully life-long. The scientific dynamics for HIV researches across the world through concerted collaboration and co-operational efforts of scientists community had had tremendous progression to tackle this invincible HIV and sees dawn with great hope that a day will come when HIV will be no longer be a formidable disease. New development of technologies have contributed vigorously in handling HIV pandemic and has indeed impacted countless positive changes on the lives of HIV infected people as well as improved quality of service delivery systems for people living with HIV (PLHIV). 

Classic difference between HIV and Covid-19 is that HIV does not come in wave through the air route like covid-19 which is air-borne, but HIV rather creeps in unnoticed through behavioral and life style routes. HIV does not show symptoms quickly like covid-19 or other common diseases but its symptoms appear only after HIV virus had thoroughly destroyed the host’s immune system. HIV deaths are not instant or quick like covid-19 virus but it kills its victims very slowly and inflicts a slow torturing death associated with painful deprivation of victim as well as family in terms of mental, physical, emotional, psychological, economic suffering accompanied by painful social discrimination and stigmatization. Unlike other diseases, there is no vaccine for HIV or cure for HIV. Once infected with HIV, the host remains infected for life. There is no natural healing or recovery from HIV unlike covid-19 or any other disease. For example, in the case of measles, the host’s immunity acts as magic bullet. Once vaccinated or once infected by measles and recovered, the host’s immunity remains permanent for life in normal conditions whereas, in the case of HIV infection, HIV virus attacks the host’s immune defense system, infects defense cells which is very typical of HIV, and produces surpluses of fake immune system which has no power at all against HIV. Unlike Covid-19 or other diseases, HIV does not kill its victim or prey directly but it kills its host through proxy killers (opportunistic infections) by thoroughly suppressing its host’s immune system thus the killing becomes slower, painful and torturous. 

Arrival of new Covid-19 pandemic has inflicted untold difficulties and complicated the management system of the HIV pandemic control program all over the world. Covid-19 lockdown and movement restrictions has played havoc and really created difficult situations for State AIDS Control Society and aggrieved People Living with HIV (PLHIV) in particular. Naga tribal societies and village administrative systems from time immemorial have been sovereign which has transcended from ancient tradition and culture practiced by our forefathers. Each village has its own set of sovereign rules to follow and no outsider, even the government, cannot interfere or challenge it. Almost every village and tribal towns locked themselves out simultaneously by erecting walls and secured gates immediately after the government announced lockdown and restriction of all forms of movement. The tribal bodies, village councils, town’s colony councils all instituted their own set of rules as accepted local SOP and the rules were so strong that even the villages’ own people or relatives were prohibited from entering or going out where even the authority’s SOP or guidelines had nothing to do with local sovereign authority and rules. 

The consequence of this pandemic emergency of clamping down all movements was that HIV silently but rapidly thrived in the shadow of covid-19 pandemic. To make the current situation of HIV burden worse, countless returnees flooded the state from other states and from abroad who could not be screened and tested for HIV for obvious known reasons of covid-19 situation. Hardest part in management was the conversion and declaration of all District hospital facilities, where all HIV control programs are co-located, as Covid-19 hospital and sealed off. Moreover, almost entire critical manpower employed in the HIV control program was deployed for Covid-19 duty as well. The cycle of Covid-19 duty, followed by facility quarantine, followed by home quarantine and then back to covid-19 duty, so on and so forth, was one of the most challenging circumstances being faced by HIV Control Program staffs across the state as they are compelled to carry out dual responsibilities simultaneously for both covid-19 duty as well as HIV control program’s duty. At times, ARV drugs for PLHIV, who desperately needed drugs for survival, were able to reach them by climbing up the village gates and walls. 

For instance, internationally and nationally, flagship programs such as WHO (World Health Organization), NACO (National AIDS Control Organization) and State AIDS Control Society along with international development partners as well as national development partners have been relentlessly working so hard to achieve the target of eliminating HIV by 2030 where HIV would be no more considered as public health threat and is still working very hard and pursuing continuously and consistently, even going harder and tougher, to achieve its prime objectives. Every effort and plan has been strategized to suit the dynamic nature of the disease and constantly working hard to create new innovative strategies to counter-check or pre-empt and possibly, to eliminate HIV transmission if not eradicate altogether from the surface of planet earth.

Launched on December 3,1990. Nagaland Post is the first and highest circulated newspaper of Nagaland state. Nagaland Post is also the first newspaper in Nagaland to be published in multi-colour.

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