World AIDS Day is celebrated on December 1 every year since 1988. It is dedicated to raise awareness, educate and improve the understanding of HIV as a global public health problem. It provides an opportunity to understand the interdependence between progress in ending Acquired Immunodeficiency Syndrome (AIDS) and progress towards universal health coverage and the right to health.

Everyone, regardless of who they are or where they live, has a right to health, which is also dependent on adequate sanitation and housing, nutritious food, healthy working conditions and access to justice. This year’s World AIDS Day campaign promotes the concept of "Right to health".

World AIDS Day 2017 theme is “My health, my right”. The World Health Organization (WHO) highlights the need for all 36.7 million people living with HIV and those who are vulnerable and affected by the epidemic, to reach the goal of universal health coverage.

Universal health coverage in HIV means:

• Leaving no one behind
• Integrated care for HIV,TB, and broader health
• Access to good quality services
• Affordable and long term care for people living with HIV
• Building stronger HIV response for stronger health system.

Remarkable progress is being made on HIV treatment. According to a report from UNAIDS (Joint United Nations Programme on HIV/AIDS) in June 2017, nearly 21 million people living with HIV are now on treatment. In 2000, just 685000 people living with HIV had access to antiretroviral therapy.

In India, there are 2.1 million people living with HIV (2015 report). According to National AIDS Control Programme, the annual AIDS-related deaths have declined by 54 percent and new HIV infections dropped by 32 percent between 2007 and 2015.

What is HIV/AIDS?

Infection caused by the Human Immunodeficiency Virus (HIV) in the human body results into weakening of people’s immune system ( defense system) against infections and some types of cancer. This immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off.

The most advanced stage of HIV infection is called as Acquired Immunodeficiency Syndrome (AIDS). It is defined by the occurrence of any of more than 20 opportunistic infections or HIV-related cancers.

Signs and symptoms:

• The symptoms of HIV vary depending on the stage of infection. The first few weeks after initial infection, individuals may experience no symptoms or an influenza-like illness including fever, headache, rash, or sore throat.
• As the infection progresses, an individual can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough.
• Without treatment, they could develop severe illnesses such as tuberculosis, meningitis, severe bacterial infections and cancers.

How is HIV transmitted?

• Sexual Contact: The most frequent mode of transmission of HIV is through sexual contact with an infected person.
• Sharing needles or syringes: HIV can be transmitted through needles and syringes contaminated with HIV infected blood.
• Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV can result into HIV infection.
• From mother to child: A pregnant woman infected with HIV virus can transmit the virus to child during pregnancy, birth, or breastfeeding.

High Risk groups (HRGs)- Female sex workers (FSW), men who have sex with men (MSM), transgender (TG)/Hijra and injecting drug users (IDUs) belong to high risk groups. 

Bridge Populations- Individuals who have sexual partners in the high risk groups as well as other partners of lower risk (general population) are called a “bridge population”, because they form a transmission bridge from the HRGs to the general population. Truckers and Migrant workers are named as bridge population due to their close proximity  with high risk groups and are at the risk of contracting HIV.

HIV is not transmitted:

• By hugging, shaking hands, sharing toilets, sharing dishes, or closed-mouth or “social” kissing with someone who is HIV-positive.
• By mosquitoes, ticks or other blood-sucking insects.

Prevention and control of HIV/AIDS:

National Aids control programme (NACP) is a 100% centrally sponsored scheme by Ministry of Health and Family Welfare, Government of India. The programme is being implemented through the State AIDS Control Societies (SACS) and District AIDS Prevention and Control Units (DAPCUs) in the country to reduce new infections by 50% (2007 Baseline of NACP III) and to provide comprehensive care, support and treatment to all persons living with HIV/AIDS.

Components of NACP IV:

1.Preventive services

• awareness generation,
• condom promotion,
• prevention of parent to child transmission,
• Integrated Counseling and Testing Centres (ICTCs)(to provide HIV counseling & testing services), 
• promotion of voluntary blood donation and access to safe blood and
• targeted interventions for high risk groups and bridge groups.

2.Comprehensive care, support and treatment

3.Strengthening institutional capacities

4.Strategic information management systems (SIMS)

Even though the prevalence of HIV is decreasing over the last decade, following activities under the NACP would provide essential support in arresting new infections and thereby achieving the target of "Ending the epidemic by 2030" for Sustainable Development Goals.

• Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Disease (AIDS) Prevention and Control Bill to ensure equal rights to the people infected with HIV and AIDS in getting treatment and prevent discrimination of any kind.
• ‘Test and Treat Policy’ for HIV with the objective of “as soon as a person is tested and found to be positive, he will be provided with ART irrespective of his CD count or clinical stage.”
• The life-saving third line ART treatment for HIV patients free of cost
• 90–90–90 strategy will identify 90% of people living with HIV, place 90% of people identified as living with HIV on treatment and ensure that 90% of people on treatment have sustained viral load suppression by 2020.

Red Ribbon Express- It travels across the country through a specified route chart to spread awareness on HIV/AIDS, promote safe behavioural practices, strengthen people's knowledge about the measures to be taken to prevent this epidemic and develop an understanding about the disease to reduce stigma and discrimination against People Living with HIV/AIDS. 

Key ways to prevent HIV transmission

• Practice  safe sexual behaviours such as condoms
• Get tested and treated for sexually transmitted diseases.
• Never share needles or other injecting equipment, including syringes, spoons and swabs (injecting drug users).
• All pregnant women should be tested for HIV as a part of routine antenatal screening, and start HIV treatment immediately if found positive for HIV.
• Post-exposure prophylaxis (PEP): It is short-term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure, either occupationally or through sexual intercourse.

Key messages-

• Awareness is the best prevention for AIDS.
• There is no cure for HIV infection. However, effective antiretroviral (ARV) drugs can control the virus and help prevent transmission.
• With antiretroviral (ARV) therapy, people with HIV, and those at substantial risk, can enjoy healthy, long and productive lives.

FAQs- http://naco.gov.in/faqs

For more information-www.nhp.gov.in

References-

* naco.gov.in/sites/default/files/NACO%20ANNUAL%20REPORT%202016-17.pdf

www.un.org/en/events/aidsday/