The National AIDS Control Organisation’s (NACO) six-month index testing campaign, aimed at bolstering the identification of new HIV cases, has put some patients in a spot. While officials said the campaign will help scale up HIV testing and counselling, people living with the disease are worried that their privacy is at risk, as index testing may actually reveal their HIV status to their family members who may be unaware of it.
Launched in April, the campaign entails a voluntary case-finding approach where counsellors, with the consent of HIV-positive index clients, focus on identifying sexual and/or needle-sharing partners, as well as biological children who are at risk of vertical transmission of HlV.
Fear of stigma
However, most people living with HIV (PLHIV) are finding it embarrassing to get their family members and children tested, as they fear their relationship may be affected if their HIV status comes out in the open.
“I have a 17-year-old son. I contracted the infection after his birth and so far my son is unaware of my disease. Will he have the same respect for me if he gets to know my HIV status,” asked a 49-year-old person living with the disease.
Sources at Integrated Counselling and Testing Centres (ICTCs) said there are a lot of challenges in implementing the campaign. “Counsellors are finding it hard to convince the index cases to give their partner’s information. Even if they share, the partners refuse to get tested fearing societal stigma. We are worried that the patients may stop coming to the ART centres for medicine and drop out of treatment if they are pressured to share details,” sources said.
NACO’s letter
While index testing (similar to contact tracing) is not new, it is being taken up on a campaign mode following NACO’s directions.
On April 2, V. Hekali Zhimomi, Additional Secretary and Director-General, NACO, wrote to project directors of AIDS Control Societies of all States and Union Territories, stating that India is committed to achieving the 95-95-95 targets by 2025-2026. The 95-95-95 targets are aimed at achieving 95% of PLHIV knowing their status, 95% of diagnosed individuals on ART, and 95% of those on ART achieving viral suppression by 2025.
“This necessitates a significant scaling up of HIV testing and counselling services, particularly in priority populations utilising the high-yielding, innovative and effective strategies. One such strategy to bolster the identification of new HIV cases under the National AIDS Control Programme (NACP-V) is index testing,” the letter stated.
Acknowledging the challenges, Nagaraja N.M., project director, Karnataka State AIDS Prevention Society (KSAPS), said index testing is a voluntary exercise that will help identify hidden cases and check the spread of the disease.
“We have told the counsellors not to force anyone to reveal their partner/children details. Their decision will be respected,” he said.
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