War may trigger AIDS epidemic: UN official

An estimated 5000 Sri Lankans may be infected with HIV, an official disclosed yesterday and warned that the war situation might lead to an epidemic of this killer disease, Joint United Nations Programme HIV/AIDS (UNAIDS) for Sri Lanka Country Coordinator David Bridger said as verified by the National STD/AIDS Control Programme’s HIV/AIDS Surveillance Data, since the first case of HIV/AIDS in Sri Lanka was reported in 1987, only 886 patients were confirmed as HIV positive cases. However, these test results did not show the number of HIV positive cases identified by private clinics around the country.

“According to the estimate made every two years by UNAIDS and the Government of Sri Lanka in recognition of potential under-documentation, somewhere between 3000 and 8000 Sri Lankans may be infected with the disease,” Mr. Bridger said.

In the first half of the year, 48 HIV victims have been identified and approximately 80 patients are currently being treated with free anti-retroviral drugs provided by the Government. 60% of the HIV positive cases were reported from the Western Province, although some of the reported cases are believed to reside in other provinces.

“While a large amount of testing is documented in Colombo, the Government has 26 STI (Sexually Transmitted Infection) clinics around the country. Although the disease affects only a small portion of the general population, every part in the country is now recognized to be having HIV positive cases. Yet this is not alarming and not in clusters that we can discern,” he said. However AIDS activists were concerned that the chaotic situation created by Sri Lanka’s ongoing ethnic conflict may create an ideal environment for an HIV epidemic. Official figures show that Sri Lanka is still maintaining its low-prevalence status. Many factors that can cause a pandemic are present in Sri Lanka, such as the rise in militarization within societies, internal displacement of civilians and refugees travelling to the southern region of neighbouring India, where the density of HIV/AIDS positive cases is significantly high.

Comparable situations in other countries have shown a substantial increase in the number of victims who succumbed to the disease. Yet, evidence shows that Sri Lanka has not been similarly affected.

“Research shows that factors such as resettlement cause post-conflict times to be more dangerous than the actual time of the conflict,” Mr. Bridger said. He said Sri Lanka’s low-prevalence status was based on its good healthcare and education systems, lack of injecting drug users and the better social position of women.

“These factors may not counterbalance the factors that can cause an epidemic in Sri Lanka. Additionally, as we have seen in countries like Vietnam and Thailand, the number of injecting drug users has the potential to increase very rapidly, thus creating a more favourable environment for the disease to spread,” he said.

He said humanitarian groups’ lack of access to people living in the conflict areas especially in the northern region may lead to further under-documentation of HIV positive cases.

“The situation in conflict areas inhibits the civilians from gaining access to services made available by the UN and other organizations. Meanwhile, the severe shortage of staff in hospitals and the closing down of schools work against preventing the spread of the disease. We must work to ensure targeted protection, which is increasingly difficult due to the constant shift of people as the war continues to progress,” Mr. Bridger said.

High risk sexual behaviour that is prevalent in the country such as low condom use is recognised to be a prominent factor that threatens the low incidence of the disease. Meanwhile, groups that practice other high risk behaviour in relevance to HIV/AIDS are also present here, such as drug users, men who have sex with men, and commercial sex workers.

“Instead of further stigmatising these groups, our goal should be to protect them against the disease and to minimize risk by working against unprotected sex and promoting safe injection,” Mr. Bridger added.

“Sri Lanka needs to focus on implementing effective prevention of the disease while offering the best healthcare available to the infected. While Sri Lankans are generally well-informed about the disease, there are many misconceptions about its transmission that need to be eliminated. Furthermore, there is concerning attitude towards those who are infected with the disease and reservations about being tested for HIV/AIDS,” he further told The Sunday Times.

According to Mr. Bridger, in the absence of these misconceptions and stigma, people would be more likely to be open to the notion of being tested for HIV. In view of the current situation in the country, the National STD/AIDS Control Programme of the Health Services Department has devised a new national strategic plan which will act as a blueprint for the Government to respond to the epidemic potential. “The plan, of which the overall goals are to keep the prevalence of the disease low and to improve the quality of life of those infected, extends from 2007 to 2011. It is to be presented to the National AIDS committee on July 31 and on its approval, is to be launched during the time of the ICAAP (8th International Congress on AIDS in Asia and the Pacific),” he concluded.