India has become a central hub for clinical trials aiming to advance HIV treatment, with numerous studies currently underway to explore novel drug candidates and therapeutic strategies. These trials endeavour to improve the effectiveness of HIV management and pave the way for a potential cure.
Among the promising research, certain trials concentrate on latency-reversing agents like N-803 (nogapendekin alfa), which target and diminish the persistent nature of HIV that often hinders virus elimination. There is a strong focus on enhancing adherence to antiretroviral therapies (ART), with new formulations and long-lasting injectables under review to increase efficacy and convenience for patients. These initiatives are instrumental in refining treatment approaches and enhancing the quality of life for HIV-positive individuals both in India and worldwide, according to Dr. Swati Rajagopal, consultant – infectious disease & travel medicine at Aster CMI Hospital, Bengaluru.
Our nation has pioneered early infant diagnosis (EID) programs and implemented point-of-care diagnostics to identify HIV in newborns, though challenges remain in reaching rural populations. Progress toward the UNAIDS 95-95-95 goals by 2030 is evident, with 79% of those with HIV aware of their status and 71% undergoing antiretroviral therapy. Long-acting injectable ARTs, while promising improved adherence, are still in their nascent stages. Prevention efforts focusing on women and rural communities have succeeded in reducing overall HIV prevalence, although rising case numbers in some states underscore the need for region-specific strategies and broader public education efforts, Dr. Rajagopal noted.
While significant strides have been made to combat HIV/AIDS in India, challenges persist. Approximately 2.35 million people live with the virus, with an adult prevalence rate of 0.22%. Women, representing 44% of HIV-positive adults, alongside rural dwellers and young people, are particularly susceptible due to limited preventative resources and information access. States such as Maharashtra, Bihar, and Uttar Pradesh have reported increasing infection rates, while others show a decline. Since 1997, new HIV cases have decreased by 86%, yet obstacles like insufficient rural healthcare infrastructure and early infant diagnosis gaps remain.
World AIDS Day on December 1st highlights the theme ‘Take the Rights Path,’ yet AIDS continues to present challenges to communities. Through heightened awareness, preventive measures, and equitable care, change can occur, she stated.
With 71% of diagnosed people receiving antiretroviral treatment and roughly 79% of HIV-positive individuals aware of their condition, critical steps toward achieving viral suppression are being taken. However, hurdles in expanding testing and care accessibility, particularly in rural locales, persist, such as delayed diagnosis that impacts treatment efficiency and stigma discouraging individuals from seeking help. Limited healthcare infrastructure and fragmented supply chains hinder ART access. Continual ART adherence faces hurdles due to side effects, educational gaps, and socioeconomic issues. Marginalized groups, including LGBTQ+ communities and sex workers, confront additional barriers. Co-existing conditions like tuberculosis complicate management. Comprehensive planning is essential for forward movement, as stated by Dr. Rajagopal.
Although awareness and treatment have advanced, HIV/AIDS retains substantial stigma in India. This social stigma often deters individuals from pursuing testing and treatment, especially in rural areas where awareness and comprehension are limited. Individuals living with HIV frequently encounter discrimination not only in healthcare facilities but also within their own communities and families. Reducing stigma remains a key element of India’s expansive HIV/AIDS agenda, requiring ongoing educational efforts, advocacy, and supportive initiatives to dismantle these barriers, emphasized Dr. Swati Rajagopal.