Syllabus: GS-II – Health, Social Justice, Government Policies

Why in the News?

World AIDS Day is observed every year on 1 December, and India marks the day amid progress, emerging challenges, and a renewed commitment to eliminate AIDS as a public health threat by 2030.
The 2025 theme — “Overcoming disruption, transforming the AIDS response”— highlights the need to strengthen systems, reduce inequalities, and protect vulnerable groups.
India, home to 25.44 lakh people living with HIV (PLHIV)—the third highest globally—has made substantial progress, particularly in slowing down new infections.

India’s Major Achievements

1. Significant Decline in New Infections

• New HIV infections ↓ 46% between 2010–2021.
• AIDS-related deaths ↓ 79% since 2010.
• Adult HIV prevalence: 0.2% (below global average).

2. Strong Legal and Policy Framework

• NACP-V (2021–26) strengthens prevention, testing, ART, and social protection.
• HIV/AIDS Prevention and Control Act, 2017 prohibits discrimination in healthcare, workplaces, housing, and education.

3. Improved Treatment Access

• 18.15 lakh PLHIV on Antiretroviral Therapy (ART) (72% coverage).
• Viral load testing has expanded; 12.75 lakh tests conducted by Oct 2024.

Key Terms Explained

• HIV: Virus that weakens the immune system.
• AIDS: Advanced stage of HIV infection.
• ART: Drugs that suppress HIV and prevent disease progression.
• Viral Load Suppression: HIV becomes undetectable → prevents transmission.
• IDU: Injecting Drug Use — major driver of infections in NE India.
• Key Populations: Sex workers, MSM, transgender persons, IDUs.

Changing Face of the HIV Epidemic in India

While national prevalence is decreasing, certain States show alarming trends:

High Prevalence States

• Mizoram – 2.73%
• Nagaland – 1.37%
• Manipur – 0.87%
• Meghalaya – 0.43%

These States struggle with stigma, drug use, and gaps in health access.

The Alarming Situation in Assam

• Adult prevalence: 0.13%
• Estimated PLHIV: 32,031
• 2023–24: 7,274 positives out of 10.8 lakh tested
• 64.6% infections due to injecting drug use — overtaking heterosexual transmission
• High-burden districts: Kamrup Metro, Nagaon, Cachar

India’s Persistent Challenges

1. Gap in HIV Status Awareness

• Rural and remote areas under-tested.
• Stigma prevents testing.
• Low awareness among adolescents and women.

2. Treatment Dropouts

• Only 70% of diagnosed remain on ART (Assam: 70%, India: 72%).
• Migration, distance, and stock-outs cause ART discontinuation.

3. Transmission Among Key Populations

• 87% — unprotected heterosexual contact
• 5% — parent-to-child
• 2% — injecting drug use & homosexual contact

4. Co-Infections

• TB remains the leading cause of death among PLHIV.
• Hepatitis B & C common among IDUs.

5. Regional Inequality

NE India and parts of southern India continue to face higher prevalence.

What Needs to Change – The Way Forward

• Expand community-based testing (mobile vans, outreach).
• Strengthen ART access for migrants and rural areas.
• Integrate HIV services with TB, Hepatitis, mental health care.
• Scale up harm reduction: clean needles, opioid substitution therapy.
• Combat stigma through awareness campaigns.
• Youth-focused interventions in NE India.

Conclusion

India has made remarkable gains — reduced infections, strong legal protections, improved ART coverage.
However, new vulnerabilities such as rising drug-linked infections and treatment gaps threaten progress.
Achieving the 2030 AIDS-free goal requires stronger public health systems, community partnerships, and stigma-free, science-driven interventions.

Exam Hook (One Line)

India targets ending AIDS by 2030 under NACP-V and the HIV/AIDS Act 2017 but faces major gaps in testing, treatment, and regional inequality.

Mains Question

“Evaluate India’s progress and challenges in achieving the goal of ending AIDS by 2030. How can national programmes and State-level interventions be strengthened to address emerging vulnerabilities?”