World AIDS Awareness Day is observed on December 1st  every year, is emblematically a call to increase social security mechanism for HIV infectious, alert governments in setting up effective policies for susceptible population so that they delight equal status in the society.

This article going over the state of HIV around the India, takes a look at a part of the world hit very hard by the HIV epidemic.

AIDS, or acquired immune deficiency syndrome, is a disorder that is caused by infection with the human immunodeficiency virus (HIV). This virus attaches to the surface of specific white blood cells called T cells and is therefore able to reproduce and continue production of the virus. As more and more of the body's healthy T cells become infected with HIV, the bodys immune system becomes compromised.

The spread of HIV and AIDS has affected millions of people worldwide; AIDS is considered a pandemic. In 2009, the World Health Organization (WHO) estimated that there are 33.4 million people worldwide living with HIV/AIDS, with 2.7 million new HIV infections per year and 2.0 million annual deaths due to AIDS. In 2007, UNAIDS estimated: 33.2 million people worldwide had AIDS that year; AIDS killed 2.1 million people in the course of that year, including 330,000 children, and 76% of those deaths occurred in sub-Saharan Africa. According to the UNAIDS 2009 report, some 60 million people worldwide have been infected with HIV, resulting in approximately 25 million deaths and 14 million orphaned children in southern Africa alone since the epidemic began decades ago.

India – Demographics

Here are some facts about India:

• Located in South Asia
• 7th largest country geographically, and the 2nd most populous country in the world
• While India has the 4th -largest and the 2nd -fastest growing economy in the world, the country still has very high levels of poverty, environmental pollution, disease, and malnutrition.

In some of the urban and more populous areas, there are some primary health care centers that offer quality health care and research. However, the population growth of India has outpaced the growth of the health care industry, resulting in shortages of health care facilities and qualified health care professionals, especially in rural areas. India’s health care system is overseen by the Ministry of Health and Family Welfare.

The Status of HIV and HIV Care in India

A country of more than a billion people with millions living with HIV.

Here are some facts about HIV in India:

• HIV emerged as a problem in India almost a decade later than the rest of the world.
• HIV rates skyrocketed in the 1990’s and continues today. In fact, India has the highest population of people living with HIV anywhere in the world.
•  At first, HIV was isolated to high-risk populations such as sex workers and the country’s huge truck driver force. Today, all sectors of India’s population is affected.
•  It is estimated that in 1990 there were approximately 200,000 people infected with HIV in India. By 2003 that number had climbed to 5.1 million. it's estimated that around 2.4 million people are currently living with HIV. In 2006 UNAIDS estimated that there were 5.6 million people living with HIV in India, which indicated that there were more people with HIV in India than in any other country in the world. In 2007, following the first survey of HIV among the general population, UNAIDS and NACO agreed on a new estimate – between 2 million and 3.1 million people living with HIV.  In 2008 the figure was estimated to be 2.31 million.
• According to a recent study in the British Medical Journal, India has an HIV/AIDS population of approximately 1.4-1.6 million people. The estimated number of human immunodeficiency virus (HIV) infections in India has declined in recent years—from 5.5 million in 2005 to below 2.5 million in 2007. In 2009, 2.4 million people was estimated to be infected with HIV in India. which equates to a prevalence of 0.3%.22 While this may seem low, because India's population is so large, it is third in the world in terms of greatest number of people living with HIV. With a population of around a billion, a mere 0.1% increase in HIV prevalence would increase the estimated number of people living with HIV by over half a million. These new figures are supported by the World Health Organization and UNAIDS. According to the United Nations 2011 AIDS report, there has been a 50% decline in the number of new HIV infections in the last 10 years in India.
• In a country where poverty, illiteracy and poor health are rife, the spread of HIV presents a daunting challenge.

In spite of over two plus decades of research and science, there is still a lot of misinformation about HIV.  Some of these will be :

HIV (human immunodeficiency virus) is a virus that attacks the immune system, the body's natural defense system. Without a strong immune system, the body has trouble fighting off disease. Both the virus and the infection it causes are called HIV.

White blood cells are an important part of the immune system. HIV invades and destroys certain white blood cells called CD4+ cells. If too many CD4+ cells are destroyed, the body can no longer defend itself against infection.

The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). People with AIDS have a low number of CD4+ cells and get infections or cancers that rarely occur in healthy people. These can be deadly.

But having HIV does not mean you have AIDS. Even without treatment, it takes a long time for HIV to progress to AIDS—usually 10 to 12 years. If HIV is diagnosed before it becomes AIDS, medicines can slow or stop the damage to the immune system. With treatment, many people with HIV are able to live long and active lives.

HIV Causes

HIV infection is caused by the human immunodeficiency virus. People can get HIV from contact with infected blood, semen, or vaginal fluids.

• Most people get the virus by having unprotected sex with someone who has HIV.
• Another common way of getting the virus is by sharing drug needles with someone who is infected with HIV.
• The virus can also be passed from a mother to her baby during pregnancy, birth, or breast-feeding.

After HIV is in the body, it attacks and destroys CD4+ cells, which are the part of the body's immune system that fights infection and disease. When HIV weakens or destroys the immune cells, it may lead to certain illnesses or diseases, such as some types of pneumonia or cancer that are more likely to develop in someone who has a weakened immune system. These conditions are a sign that HIV has progressed to AIDS.

HIV is spread when blood, semen, or vaginal fluids from an infected person enter another person's body, usually through sexual contact, from sharing needles when injecting drugs, or from mother to baby during birth.

HIV is spread by blood transfusions or organ transplants.

HIV doesn't survive well outside the body. So it cannot be spread by casual contact such as kissing or sharing drinking glasses with an infected person.

Symptoms

HIV infection progresses in stages. These stages are based on symptoms and the amount of the virus in blood. Most people go through the following stages after being infected with HIV:

Initial stage (acute retroviral syndrome)

Acute retroviral syndrome is an illness with symptoms like mononucleosis. It often develops within a few days of infection, but it may occur several weeks after the person is infected.

Symptoms may include:

• Abdominal cramps, nausea, or vomiting
• Diarrhea
• Enlarged lymph nodes in the neck, armpits, and groin.
• Fever
• Headache
• Muscle aches and joint pain
• Skin rash
• Sore throat
• Weight loss.

These first symptoms can range from mild to severe and usually disappear on their own after 2 to 3 weeks.

Chronic stage

It may take years for HIV symptoms to develop. But even though no symptoms are present, the virus is multiplying (or making copies of itself) in the body during this time. HIV multiplies so quickly that the immune system cannot destroy the virus. After years of fighting HIV, the immune system starts to weaken.

A doctor may suspect HIV if symptoms persist or if a cause of the symptoms (such as the flu) cannot be identified. HIV may also be suspected when several of the following symptoms are present:

• Diarrhea or other bowel changes
• Fatigue
• Fever
• Loss of appetite or unexplained weight loss
• Dry cough or shortness of breath
• Nail changes
• Night sweats
• Swollen lymph nodes in the neck, armpits, and groin
• Pain when swallowing
• Confusion, difficulty concentrating, or personality changes
• Repeated outbreaks of cold sores or genital herpes sores
• Tingling, numbness, and weakness in the limbs
• Mouth sores or a yeast infection of the mouth (thrush)

Also, HIV may be suspected when a woman has at least one of the following:

• More than 3 vaginal yeast infections in one year that are not related to the use of antibiotics
• Recurrent pelvic inflammatory disease (PID)
• Abnormal Pap test or cervical cancer

Children with HIV often have different symptoms (for example, delayed growth or an enlarged spleen) than teens or adults.

Late stage

AIDS occurs during the last stage of infection with HIV. If HIV goes untreated, AIDS develops in most people within 12 to 13 years after the initial infection. With treatment for HIV, the progression to AIDS may be delayed or prevented.

After immune system starts to weaken, the persons are more likely to develop certain infections or illnesses, called opportunistic infections. Examples include some types of pneumonia or cancer that are more common when a weakened immune system.

A small number of people who are infected with HIV are rapid progressors. They develop AIDS within a few years if they do not receive treatment. It is not known why the infection progresses faster in these people.

How is HIV diagnosed?

The U.S. Food and Drug Administration (FDA) has approved tests that detect HIV antibodies in urine, fluid from the mouth (oral fluid), or blood. If a test on urine or oral fluid shows that they are infected with HIV, those people will probably need a blood test to confirm the results. If any one have been exposed to HIV, their immune system will make antibodies to try to destroy the virus. Blood tests can find these antibodies in their blood.

Most doctors use two blood tests, called the ELISA and the Western blot assay. If the first ELISA is positive (meaning that HIV antibodies are found), the blood sample is tested again. If the second test is positive, the doctor will do a Western blot to be sure.

It may take as long as 6 months for HIV antibodies to show up in a blood sample. If you think you have been exposed to HIV but you test negative for it:

• Get tested again in 6 months to be sure you are not infected
• Meanwhile, take steps to prevent the spread of the virus. If you are infected, you can still pass HIV to another person during this time.

How it is treated?

The standard treatment for HIV is a combination of medicines is called “Highly Active Antiretroviral  Therapy (HAART)”. Antiretroviral drugs slow the rate at which the virus multiplies. Taking these medicines can reduce the amount of virus in body and help stay healthy.

It may not be easy to decide the best time to start treatment. There are pros and cons to starting HAART before CD4+ cell count gets too low. Consult with doctor to understand therapy choices.

To monitor the HIV infection and its effect on immune system, a doctor will do two tests:

• Viral load, which shows the amount of virus in blood.
• CD4+ cell count, which shows how well of immune system is working.

If test sample have no symptoms and CD4+ cell count is at a healthy level, the persons may not need treatment yet. Doctor will repeat the tests on a regular basis to see how the persons are doing. If symptoms or some other health problems occur, should start treatment, whatever CD4+ count is.

Once treatment is started, it is important to take medicines exactly as directed by Physician. When treatment doesn't work, it is often because HIV has become resistant to the medicine. This can happen if patient don't take medicines correctly.

Treatment has become much easier to follow over the past few years. New combination medicines include two or three different medicines in one pill. Many people with HIV get the treatment they need by taking just one or two pills a day.

To stay as healthy as possible during treatment:

• Don't smoke. People with HIV are more likely to have a heart attack or get lung cancer.1, 2 Smoking can increase these risks even more.
• Eat a healthy, balanced diet to keep immune system strong.
• Get regular exercise to reduce stress and improve the quality of life.
• Don't use illegal drugs, and limit use of alcohol.

Learn all can about HIV so one can take an active role in treatment. Doctor can help to understand HIV and how best to treat it. Also, consider joining an HIV support group. Support groups can be a great place to share information and emotions about HIV infection.

How can you prevent HIV?

HIV can be spread by people who don't know they are infected. To protect yourself and others:

• Practice safe sex. Use a condom every time you have sex (including oral sex) until you are sure you and your partner are not infected with HIV.
• Don't have more than one sex partner at a time. The safest sex is with one partner who has sex only with you.
• Talk to your partner before you have sex the first time. Find out if he or she is at risk for HIV. Get tested together and retested 6 months later. Use condoms in the meantime.
•  Don't drink a lot of alcohol or use illegal drugs before sex. You might let down your guard and not practice safe sex.
• Don't share personal items, such as toothbrushes or razors.
• Never share needles or syringes with anyone.

Conclusion:

In spite of being home to the world's 2nd largest population suffering from HIV/AIDS, the AIDS prevalence rate in India is lower than in many other countries. In a country where poverty, illiteracy and poor health are rife, the spread of HIV presents a daunting challenge.

The Indian government should concentrate more to bring up policies, take initiatives to educate people, society and develop Health infrastructure to over come challenges in order to control disease.

In addition to government, an good efforts are putting from several bodies such as social welfare, voluntary organizations are always endeavoring, aiming on AIDS awareness to reach maximum people in the country.

A continuous research, discoveries are happening over two plus decades, to figure out how to completely eradicate the problem, Still there is no succeed has been happened in medication to cure HIV/AIDS, Researchers are working toward prolonging the life of a patient with the help of newer ways of medications. How ever, with the support of World AIDS Day to battle against of this pernicious disease is still on endorsing the people to live a normal life.

Lets not kill the victims by showing discrimination; Lets pledge against discrimination and help the battle against AIDS.

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