Updated: December 2, 2021 12:44:46 pm
Considering the mental health impact of HIV (human immunodeficiency virus) on children, especially orphans, and the concerns over low viral load suppression (reduction of a person’s viral load to an undetectable level through antiretroviral treatment) among adolescents, Maharashtra State AIDS Control Society (MSACS) has decided to set up adolescent/child corners at antiretroviral treatment (ART) centres in major cities.
An adolescent/child corner was set up jointly by the MSACS and Armed Forces Medical College at the ART centre in Pune in September. Plans are now underway to provide similar spaces at ART centres in Thane, Navi Mumbai and Aurangabad. There are 72 ART centres in the state.
Apart from counselling and engaging the children in leisure activities, health officials plan to raise awareness about the need to adhere to treatment.
Across the state (excluding Mumbai), there are 13,388 registered children with HIV in the age group (0-14). Adolescents remain vulnerable to HIV infection and mental health challenges can be barriers to treatment and prevention efforts, MSACS project director Chandrakant Dange said.
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Some studies have shown that factors associated with low viral suppression were lack of knowledge and wrong perception about anti-retroviral treatment and poor pill-taking practice. Virologic suppression was significantly lower among adolescents in Maharashtra, a high HIV burden state, than the UNAIDS global target of 95 per cent, according to recent studies and a need was felt for a comprehensive and holistic adolescent-centric programme.
“There are several orphans who are brought to ART centres by their grandparents. At these spaces – adolescent/child corners we can provide informative videos/books and make them understand in simple language the need to adhere to treatment,” Dange said.
MSACS officials said that they were trying to understand why viral load suppression is less among adolescents. “Do they feel isolated? Is there an unwillingness to take medicines? Are there other influences like tobacco or alcohol consumption? These are some of the issues that have to be addressed and the counsellors will also explain the need to take medicines regularly,” officials said.
Focus on viral load testing
Currently, 2.17 lakh patients are on ART in Maharashtra. Among them, 2.10 lakh are eligible for viral load testing. So far, viral load testing has been done for 1.95 lakh persons with HIV – and there has been viral load suppression in at least 94 per cent (1.76 lakh patients). Viral load testing is used to confirm suspected treatment failure owing to the clinical or immunological failure of the patient. There are 13 viral load testing laboratories in the state. According to officials, the viral load in an HIV-positive person should be less than 1,000 copies of viral particles/microlitre. While the machines were underutilised in the last six months owing to the Covid-19 pandemic, efforts are on to scale up the process. There are 20,470 persons with HIV on second-line treatment of drugs and 937 on third-line treatment.
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