Manipur in Northeast India despite having a high prevalence of people living with HIV/AIDS is progressing towards “zero transmission” of HIV/AIDS from mother to child. This was informed by the joint director, Manipur AIDS Control Society (MACS), Abhiram Mongjam during an exclusive interview with the Imphal Free Press.
Abhiram said that at one time, Manipur, with a high number of injecting drug users (IDUs), faced a big health issue of high HIV transmission from mother to child. But today, with the effective implementation of Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) programme, the problem is being addressed gradually to reach the stage of “zero transmission” from mother to child, he said.
The PPTCT programme was launched by the National AIDS Control Organisation (NACO) under the Union Health and Family Welfare Ministry in 2002 to eliminate transmission of HIV/AIDS from mother to child by the target the year 2020.
Recalling the period where transmission was high, Abhiram said, “In the late 1990s, injecting drug users faced serious warnings from several organisations in the effort to control the drug menace in the state. The situation made many IDUs to get married for the sake of hiding their status and to avoid serious actions against them. This became one of the major reasons for HIV/AIDS transmission from mother to children in the state during the early 2000’s”.
During this period, it was estimated that every day, at least one of the babies born every day was infected with HIV/AIDS. However, with the launching of the PPTCT programme, the number of newborn babies with HIV/AIDS infection reduced steadily, he added.
In 2019, the Social Justice and Empowerment Ministry report recorded as many as 34,000 IDUs in Manipur with a population of over 27 lakhs.
Abhiram said that Manipur has been implementing the PPTCT programme, keeping in view the target year 2020 as set by NACO, by focussing on scaling up of testing services in the state.
Highlighting the progress made in the last eight years, the MACS joint director said that before 2011, the HIV/AIDS testing facilities were available only in a few hospitals like the Regional Institute of Medical Sciences (RIMS), the Jawaharlal Nehru Institute of Medical Sciences (JNIMS) and some primary health centres.
But from 2011 onwards, test facilities were increased and now the state has 64 testing facilities, including private and government hospitals in all districts of the state.
Of these 64 testing centres, 54 are Standalone Integrated Counselling and Testing Facilities (SA-ICTC), six Mobile Integrated Counselling and Testing Facilities (MICTC), three are Facility Integrated Counselling and Testing Centre (FICTC) and one Public-Private Partner (PPP ICTC), Abhiram informed. Besides these, six ICTC each in Primary Health Centre and Urban Health Centre and five in a private clinic and one in prison will be set up soon, he said.
“With the enhancing of testing facilities during these last eight years, the number of people coming for HIV testing is also increasing,” Abhiram said, adding, “This is the main factor that helps to prevent transmission to the stage of elimination”.
Explaining the functioning of the PPTCT programme, Abhiram said, “Pregnant women who are tested HIV positive undergo lifelong Anti-Retroviral Therapy (ART) and their newborn babies (HIV exposed) are provided six weeks of Nevirapine syrup immediately after birth. The syrup is extended up to 12 weeks in case the child’s mother does not complete its ART course for 24 weeks.”
“MACS could execute this service effectively with the increase of HIV testing during these last eight years,” he added.
The joint director also informed that the number of general clients tested during 2011-2012 was 48,681 and pregnant women were 46,291. But from March 31, 2020, till date, the number reached 97,761 among the general population and 50,948 pregnant women.
Of the number of HIV incidence during 2011-2012, the total number of the population tested for the general client was 4.26 per cent i.e. 2074. But in 2019-2020 it was reduced to 0.99 per cent with the figure of 973, he added.
In the case of pregnant women, the infection rate was 0.37 per cent (i.e. 173) 2011-2012. However, the infection rate has declined to 0.13 per cent (i.e. 64 cases) in 2019-2020.
Under the PPTCT programme, six-week-old new-born children of HIV-infected mothers are sent for HIV-DNA-PCR testing for which dry blood spot (DBS) samples are collected. If the sample is tested HIV positive, then again the sample is tested for the second time. The HIV-exposed baby will start lifelong ART if it is tested positive in the second test.
“Fortunately, nowadays, all the DBS record came with negative test results for the state. This also shows that HIV transmission from mother to child is almost negligible,” he added.
While stating the significance of eliminating HIV transmission from mother to child, Abhiram said that prevention of this the transmission would help to prevent disease burden resulting out of HIV and AIDS in the state, such as discrimination and stigmatisation.
“People know that children being infected by HIV are not their fault. But they are always stigmatised and discriminated that has made them face various challenges in life such as depression and mental trauma. Such consequences may spoil their life even if they have many talents,” the joint director added.
Appealing to the people of the state to get HIV tested, Abhiram said that government alone cannot fight this health issue without the support and cooperation from the people of the state. Only through early detection, transmission can be prevented. As such, people should not hesitate to undergo HIV testing, he added.