HIV on the decline, syphilis cases up

Health
When a 30-year-old came to him with an unhealed sore and swelling in his armpits and groin, Dr M Balasubramanian, a physician in Tambaram, had a hunch. He had become familiar with the symptoms while undertaking a survey in the Western Ghats in the late 70s. Two tests later, he was proved right. The man had syphilis, a sexually-transmitted disease the septuagenarian white-coat thought he wouldn’t see again.

A once common STD in the pre-antibiotic era, the prevalence of syphilis was brought down from 8% of the population to less than 1%. In 2011, the National Aids Control Organsiation (NACO) had announced that the country is on the verge of eliminating the bacterial infection. However, six years on, doctors say they are seeing a rise in those testing positive for syphilis among other sexually transmitted diseases, even as the prevalence of HIV is on the decline.

Data accessed by TOI from Tamil Nadu State Aids Control Society (TANSACS) has shown that from 2014 to 2016, the number of those who tested positive for HIV went down from 16,708 to 11,395 – a 30% decline, with the number of new cases detected decreasing by half from around 2,700. The second most common STD was Herpes genetalis -marked by genital pain and sores in some, and no symptoms in most –which, too, went down by close to 40% from 2014-2016. The biggest surprise for officials was the increase in syphilis cases from around 1,300 in 2014 to 1,700 the following year.

“This could be because of better awareness and surveillance,” said Dr K Senthil Raj, TANSACS director, adding that many of these cases were picked up in Chennai, Salem and Nammakkal. Researchers say syphilis is on a gradual incline across the country along with other STDs like genital infection caused by human papillomavirus (HPV) and, in some pockets, Herpes genetalis.

“And in some groups like men who have sex with men, the prevalence of syphilis is significantly high,” said Dr R R Gangakhedkar, director-incharge of National AIDS Research Institute. He said the prevalence of HIV has decreased across the country because of better intervention by Anti-Retroviral Therapy centres.

“While these centres cut the HIV transmission by 93%, a lot of other STDs go missed,” he added. While the transmission efficiency of HIV is low, varying between one in 100 to one in 1000, syphilis occurs in one in 30 people who has come in contact with a carrier. On the brighter side, he said most of those with STDs come at an early stage because of better awareness and hence treated before complications set in.

India records 30 million episodes of STDs annually, of which the government treats about 10 million.

While government facilities target high-risk groups like the transgender community, female sex workers and homosexual groups, private labs say they have been seeing a steady increase in those reporting with STDs among the general population, especially in the 18-35 years age group.

“We have seen a 20% rise of cases of HPV and Herpes. Some of the STDs are detected when the person presents with infertility-related problems,” said Dr Anita Suryanarayan, vice-president, operations (south India), Metropolis Healthcare Ltd. While the government has several targeted interventions for promoting safe sex, awareness is relatively low among youngsters from the middle and upper class, she felt.

[“source-timesofindia”]
Written by Loknath Das