- National AIDS Committee to convene
The National AIDS Committee is due to convene within the next two months as Sri Lanka records 824 new diagnoses of HIV in 2024.
Consultant Venereologist and National STD/AIDS Control Programme (NSACP) Coordinator Dr. Vino Dharmakulasinghe told The Sunday Morning that they had diagnosed 824 new cases of HIV in 2024. They have further observed a slight increase in cases among the 15-24 years age group with 115 new diagnoses – 14% of the total new infections in the past year.
Dr. Dharmakulasinghe emphasised the importance of differentiating between HIV and AIDS. According to the World Health Organization (WHO), HIV is a virus that attacks the immune system of the body. AIDS occurs at the most advanced stage of this infection.
“With antiretrovirals for HIV treatment, people can lead a normal life. AIDS is the last stage,” said Dr. Dharmakulasinghe. During treatment, the viral load of a person living with HIV is monitored, ensuring that it is kept at undetectable levels so that it remains untransmittable during sexual activity.
“In this way, treatment is prevention. The numbers could be increasing because treatment is available and people come forward and do the testing. When we do treatment, ongoing transmission decreases and therefore treatment itself is a prevention method,” said Dr. Dharmakulasinghe.
However, the NSACP is still analysing the data and attempting to understand the real reasons behind the increase. According to the National HIV/AIDS Policy, district and provincial committees are convened each year. Last year, the programme had convened committees in 16 districts and the nine provinces, according to Dr. Dharmakulasinghe.
The recommendations collected at these committees will be taken to the National AIDS Committee chaired by the Health Ministry Secretary with the participation of the Director General of Health Services.
“The forum will include stakeholders from many areas and therefore it should give us a clearer picture of the situation,” said Dr. Dharmakulasinghe.
The National AIDS Committee will be convened after a hiatus of three years due to the Covid-19 pandemic and the other crises that followed in the country.
Behavioural and social changes
Consultant Community Physician and NSACP Coordinator Dr. Sathya Herath told The Sunday Morning that the increase in new diagnoses could be due to two reasons: changes in social and behavioural patterns.
According to her, behaviour has changed in two directions: sexual behaviour itself and health-seeking behaviour.
“Sexual activity has changed due to social changes such as dating apps and online platforms. There is an increase in condomless anal sex among young people. Unsafe sexual behaviour also happens under the influence of substances,” she said.
However, she said that the health-seeking behaviour of young people had also taken a positive turn, where they were more prone to get tested faster. “We observe late-stage infections among middle-aged and older people,” said Dr. Herath.
Lack of awareness and stigma
Sri Lanka’s first HIV infection was detected in 1987, but the country has maintained a low-level HIV epidemic since then. The NSACP has continuously attempted to engage with at-risk population groups to spread awareness.
In the latest of its efforts, the Know4Sure mobile application was introduced about three years ago in a bid to connect people with services more efficiently. It connects people with the nearest clinics and delivers contraception and self-test kits to their homes.
Know4Sure Coordinator Hiran Hemantha told The Sunday Morning that despite these efforts, many in rural areas were still not properly aware of HIV and Sexually-Transmitted Diseases (STDs).
The hotline receives about 100 calls a month with inquiries.
“These are especially from those in rural areas and migrant workers in Romania. They ask whether HIV gets transmitted when cutting onions. We do a lot of prevention programmes. People don’t like the topic and there is stigma, so they don’t even follow our social media pages. Instead they give us calls to protect their identity. The topic should be normalised,” said Hemantha.
According to the programme, in 2024, 187 new HIV cases were reported in the first quarter, 215 new cases in the second quarter, 205 new cases in the third quarter, and 217 new cases in the fourth quarter. Among 15-24-year-olds, 99 cases were reported among males, 13 cases were reported among females, and three cases among transgender people.
In 2023, 695 new HIV cases were reported – a 14% increase compared to the numbers reported in 2022, with most cases being reported from males between the ages of 20 and 30 years.