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U=U Finds a Home in India

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With just over half of the country’s HIV-positive population on treatment, India taps technology to underscore the importance of adherence and undetectability.

India’s government offers free antiretroviral treatment to all people living with HIV, but still just over half are on meds, and not all of them are sticking to their regimen, even though that’s key to maintaining their own health and assuring they won’t transmit the virus to others. So health care providers in Chennai, the nation’s fifth-largest city, are tapping into the power of entertainment and social media to spread the message of undetectable equals untransmittable. 

Voluntary Health Services, a hospital in Chennai, and Sahodaran, an organization focusing on men’s sexual health, have partnered for the U=U campaign, which features Aarthi Ganeshkar, a popular actress and comedian. The campaign, launched in September, includes posters and videos on Facebook, Twitter, and YouTube, and in WhatsApp groups, The Times of India reports. Other celebrities and activists will help promote it.

“We received a grant from Gilead Rainbow Grants and have tied up with Sahodaran to carry it out, as we want to have active participation and engagement with community members,” Arumugam Vijayaraman, director of programs at Voluntary Health Services, told the Times.

India has 2.1 million people living with HIV, according to the latest UNAIDS figures. That ranks it third in the world for sheer numbers, after South Africa and Nigeria. Prevalence is relatively low — 0.2 percent among adults — but because India has a huge overall population, 1.3 billion, the number of people with HIV is likewise large. However, only 56 percent of those with HIV are on treatment, and a recent study estimated that about three-quarters of those receiving treatment are adhering to it.

Reasons for not getting or staying on treatment include discrimination and stigma. The epidemic in India is concentrated among a few populations, such as sex workers, gay and bisexual men, transgender women, and injection drug users, notes All of these groups face prejudice and marginalization, despite some legal changes, like the decriminalization of homosexuality, so they are sometimes reluctant to seek health care.

But the new campaign will remind everyone how important health care is to those living with HIV, as adhering to antiretroviral treatment will keep them healthy and suppress the amount of virus in their body to the point that it is undetectable — and therefore untransmittable to others during sex. That’s a message that shouldn’t get lost even when the world is grappling with a new pandemic, health professionals note.

“In the last few months, the entire focus has been on containing the spread of COVID-19,” Suresh Seshadri, honorary secretary of Voluntary Health Services, told the Times. But there’s also a need to focus on HIV, as many people don’t understand the power of antiretrovirals or even know what treatment options are available, Seshadri added.

The campaign also includes messages about the importance of nutrition, exercise, mental health, and having a supportive circle of friends. “Health, happiness, energy, and rest are essential to improve the quality of life of HIV positive people,” project manager Sharan Karthik Raj told the newspaper. “But for that, they have to suppress the virus so that it cannot be detected and spread to other people.”

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