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Tide has yet to turn in South Asian church's struggle against AIDS

Despite advances made in tackling HIV, old challenges still remain
Tide has yet to turn in South Asian church's struggle against AIDS

Indian school students hold posters as they pose for a photograph while taking part in an awareness campaign to mark World AIDS Day at a school in Amritsar on Dec. 1, 2014. (Photo by Narinder Nanu/AFP)

Published: December 01, 2015 04:04 AM GMT
Updated: November 17, 2022 08:48 AM GMT

Despite significant advances over the last decade in science, medicines and the dissemination of information on HIV/AIDS, people in South Asia, one of the world's poorest regions and home to a quarter of the population, remain particularly vulnerable to the epidemic.

Christians, a small minority in South Asia, are battling HIV with limited resources while poverty, discrimination and lack of funding remain major challenges for church caregivers.

Muslim-majority Pakistan is home to 97,400 HIV patients, according to the government's National Aids Control Program.

Meanwhile, the nation has seen an 11 percent increase in HIV-related deaths over the last few years, according to local media reports.

More effort is needed to provide treatment and also to overcome discrimination against those infected with HIV in Pakistan, experts say.

 

Stigma still holds strong

"The stigma still holds strong. Much work needs to be done with regard to awareness about HIV patients," says Dr. Nabeel Saqib, former Caritas Pakistan national coordinator on health and a World Health Organization official.

Nazir Masih, 52, a Christian, was the first person to be diagnosed with HIV in Pakistan in 1999.

He founded the New Lights AIDS Control Society (NLCS) in 2001 with support from the Global Fund for Aids.

Currently, the NLCS runs three centers in Punjab province, which offer testing and counseling services to 1,200 HIV patients, including 110 children. It also supports the education of 28 children of HIV-affected families.

"Our teams visit each patient every three months to make sure their families are looking after them and that they are taking their pills regularly," Masih said.

He decried what he called a serious lack of government HIV services and facilities.

The government only has 18 HIV treatment facilities nationwide where just over 5,000 people are receiving vital antiretroviral (ARV) drug therapy, Masih said.

"Untrained doctors have been put in charge of these centers. In one Punjab city, the doctor attends HIV patients only once a week. Hundreds are still waiting", he told ucanews.com.

Very little is being done to break down the social stigma and prejudices associated with the disease, he said.

"Personally I feel the stigma won't end. People still call it the disease of bad people and think victims are involved in immoral activities and do not deserve any kind of help. As a result HIV positive people in our country do not admit to having the disease and continue spreading the virus which is dangerous," Masih said.

Predominantly Hindu India has 2.1 million HIV cases, the third highest in the world, according to a 2014 UNAIDS report.

 

Caritas sensitizes people about AIDS

Caritas India, the social arm of the Catholic Church in India, is offering services to sensitize people about AIDS in nine districts of the western state of Gujarat. The project is a partnership with the AIDS Control Society of the Gujarat state government under the country's National AIDS Control Program.

"We counsel people about the causes of the disease and how to prevent it," Caritas India spokesman Amrit Sangma, told ucanews.com.

He said Caritas has made a special effort in targeting high-risk groups such as sex workers.

Sangma says their efforts have reaped some levels of success.

In Amreli district, sex workers now insist on having safe sex. Also, some believe the risk is too great and have given up sex work, he said.

In Gujarat's Bhavnagar and Bhanaskantha districts, Caritas was able to reach out to the gay community who, due to social stigma are not easy to approach.

"We had a breakthrough when we counseled one gay man who in turn started counseling other men about the risks of the disease. Hopefully, the risk of contracting the virus has decreased among these men as they have been educated about the dangers of the disease," he said.

Buddhist-majority Sri Lanka, however, remains a low prevalence country where monogamy is promoted religiously and culturally. The nation has 0.1 percent HIV prevalence rate among its total population of 20 million with 167 new cases being detected this year.

 

Bangladeshi NGO activists in this 2006 file photo take part in a rally to mark World AIDS Day in Dhaka. The World Health Organisation has called on Asia-Pacific leaders to make a greater effort in the fight against HIV/AIDS as the number of people with the virus continues to grow. (Photo by Shafiq Alam/AFP)

 

Since the first case was registered only 357 people have died as a result of the disease, according to official figures.

However organizations trying to monitor the disease believe there could well be a high number of undetected cases.

Laws against prostitution and social discrimination are major challenges in diagnosing HIV, says Dr. Sisira Liyanage, director of the National STD/AIDS Program.

"I am personally for legalizing prostitution and making sure sex workers are tested periodically," said Liyanage.

The large number of migrant workers is also a major concern. It's difficult to gauge how many are being exposed to the disease while working abroad, Liyanage told ucanews.com.

Nonetheless, “HIV risk factors are among younger people but they are less aware of their risk,” Father Tony Martyn, assistant secretary general of the Sri Lankan Catholic bishops’ conference told ucanews.com. “We don’t work directly with people living with HIV but educate our Catholics on the infection. We discuss concerns with catechists to educate children on this particular issue,” he added.

 

Change in infection trends

Muslim-majority Bangladesh recorded its first HIV case in 1989. According to the Bangladesh Ministry of Health, 3,664 people were living with HIV in the country in 2014. However, the United Nations Program on HIV/AIDS (UNAIDS) estimates the figure at around 9,500. Until now, 472 people have died as a result of the disease.

Despite its low prevalence, Bangladesh remains highly vulnerable to an epidemic due to a change in infection trends and concerns over funding for HIV programs in the future, according to a U.N. expert.

"Over the last 15 years, most cases were among traditional high-risk groups — drug users, male and female sex workers. But in last three-to-four years, we have been observing a transition to what we call low-risk women such as the wives of migrant workers. Most of these infections are from the migrant population either directly or through their spouses," Dr. Ziya Uddin, an HIV/AIDS specialist with UNICEF told ucanews.com.

Experts find this trend alarming since Bangladesh has about 8 million migrant workers living abroad.

The government runs 20 HIV testing centers where people can be tested for HIV and get drugs easily. However, many people are afraid of using the services because they fear social ostracism.

The Catholic Church has provided services for HIV patients since 2007. Social stigma and discrimination against HIV patients are major challenges, says Dr. Edward Pallab Rozario, head of Caritas Bangladesh Health Project.

"Although HIV positive patients are fewer in Bangladesh, they face stigma and discrimination ... Most patients often can't find jobs," said Rozario, secretary of Catholic bishops' Health Commission.

"They [HIV patients] fear that if their friends and relatives know about their disease, they would stop mixing with them and cast them out ... They might not get employment, their children might not be allowed to enroll in schools and colleges and they might not be able to marry off their sons and daughters. So, these factors force them to hide the disease," he said.

Currently, Caritas offers spiritual, financial and counseling support to some 50 Christian HIV patients and their children. The agency also arranges gatherings for Christian HIV patients and runs HIV/AIDS advocacy programs across seven Caritas regional areas in the country.

"We could do many things to tackle HIV, but we don't have enough funds. At present, Caritas runs a small HIV project and it gets funding from Caritas Bangladesh's own sources," Rozario said.

"Twice a year we sit with them to offer spiritual guidelines, counseling and offer a stipend to children of poor patients. We have trained some in handicrafts and running small businesses, so they can survive by utilizing their skills," he added.

Additional reporting by Kamran Chaudhry in Lahore, Ritu Sharma in New Delhi, Quintus Colombage in Colombo and Stephan Uttom in Dhaka.

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