Lauding India's efforts in providing treatment to HIV affected people, UNAIDS on Thursday urged the country to scale up its healthcare services for the benefit of HIV positive mothers and children.

"If we want zero AIDS–related deaths, India needs massive scale up of treatment and care services. By 2015, we need at least 15 million people on treatment world–wide," Charles Gilks, country coordinator for UNAIDS, said.

Gilks was speaking at the summit on good practices, innovations and impact of National AIDS Control Programme–III organised by National AIDS Control Organisation (NACO).

The second day of the three–day Summit brought together experts and community leaders who stressed on concrete strategies that are required to strengthen care, support and treatment in the next phase of the National HIV programme.

"We have an unfinished agenda. Stigma, discrimination and denial faced by HIV positive people is still very high," Aradhana Johri, Additional Secretary, Department of AIDS, said.

While Gilks said India should focus to improve services for pregnant mothers, Mohammed Shaukat, Deputy Director General of NACO, said though the number of Antiretroviral Therapy (ART) centres increased from 107 in 2007 to 355 in 2012, HIV positive people are accessing them at a very late stage.

"It is important for HIV positive people to start ART soon to improve the quality of life," he said.

NACO has directed all ART centres to provide ART for anyone who has a CD4 count of 350 from 250 earlier. The CD4 count determines the immunity levels of a person living with HIV.

Manoj Paradesi, living with HIV for 18 years, said there is an urgent need to listen to voices of the community.

For the past few years, Geeta (name changed to protect identity), an HIV+ commercial sex worker (CSW) in the city’s red light area of Budhwar Peth has been living mostly on fast food, as her daily dabba meal delivered from NGO Saheli’s community kitchen is taken away forcibly by the brothel owner. The lack of protein in her diet has meant that Geeta and 55 other HIV+ patients, including 16 children of CSWs, are not responding to the crucial Antiretroviral Therapy (ART). In a bid to bring their diet back on track, Saheli has now decided to stop delivering meals to doorsteps and has instead asked these HIVaffected CSWs and their children to drop in to the community kitchen and pick up their meals, while giving them additional protein–rich food like milk and eggs.

NGO director Tejaswi Sevekari told Mirror that of the 850 CSWs registered with Saheli, 52 women are HIV+ as well as their 16 children. “Out of these total, 12 patients have dropped out of the ART regime but the remaining 40 women and 16 children are on ART. It was found that they were suffering a lot of side effects due to the ART, like nausea, dizziness and indigestion, which was unusual,” Sevekari said.

Saheli workers then decided to study the diets of those showing side effects to ART and consulted doctors, following which they realised that these HIV patients were not getting enough of protein in their food.

Dr Sanjay Pujari, an expert in infectious diseases, said that due to improper dietary balance, the women might not be maintaining the correct Body Mass Index (BMI) and this could be causing side effects. “Otherwise, there shouldn’t be any side effects of ART. Sometimes, due to improper food habits, there is lack in haemoglobin which can also give rise to side effects,” Pujari said.

The government has drafted some path-breaking provisions in the longpending HIV-AIDS (Prevention and Control) bill which lays down inviolable rights for the stigmatized group.

Among the provisions drafted in are a person can be jailed for up to two years if his/her spoken or written word leads to hostility or hatred towards an HIV patient and an AIDS-hit person cannot be denied employment or sacked except with a written assessment from an independent healthcare provider saying that there is a risk of transmission of the virus to others at the workplace. Soon, jail for targeting HIV patients

Siphiwe Maloyi* and his wife, Vuyo* had been married for only a short while when he filed for divorce after his wife revealed that she was HIV-positive – something she had known for years.

Siphiwe alleged his wife concealed her status until after they were married.

Vuyo had previously dated a famous local singer who died of an AIDS-related illness, and discovered her own HIV status shortly after his death. Now the couple is preparing for a messy divorce, and if he felt he wanted to, Siphiwe could criminally charge the woman he loved.

Siphiwe chose not to disclose his status to The Star, but said his marriage to Vuyo had changed his life forever. He had also not decided if criminal prosecution was the right way to deal with an already terrible situation.

The couple’s story is tragic, but the criminalisation of HIV transmission has been a topic of major debate in SA since 2001.

DA leader Helen Zille revived the debate last year when she called for a more monogamous sexual culture.

“It is fair to require everyone to know their status, and to avoid situations that involve the direct exchange of bodily fluids with others…

“While this precaution applies to everyone, people who are HIV-positive have a particular duty to disclose their status in situations where others could be at risk. No one can be assumed to have had consensual sex in a situation of non-disclosure,” Zille said last November.

According to current legislation, those who deliberately transmit the virus are liable to be charged with murder, assault, assault with the intent to do grievous bodily harm, rape and indecent assault. If the victim dies as a result of the transmission, family members may also sue the person responsible for the infection for negligent conduct.