On November 13, 2011, consultant venereologists and health professionals in Sri Lanka predicted that in future (by 2015 and beyond), MSM (men having sex with men) will be the main cause for the spread of HIV in Sri Lanka. The highest number of HIV infections in the Sri Lankan history was reported last year (2017) and the number is 285.
According to consultant venereologists, every week around six new HIV infections are detected in Sri Lanka and the estimated number of HIV infected persons in the country is around 4,200. One-third of those infected do not know that they are HIV positive. The new HIV infected persons detected in the country are between the ages of 15 and 49. The new HIV infections among youths have shown an upward trend over the last five years. Earlier, it was young adults around 30 and 35 who were susceptible to HIV infection, but now the age has gone down to 20–25.
It takes one year to 10 years from the date of becoming HIV positive to develop AIDS. Between one to three months, there may be little viral manifestation with symptoms such as mild fever, lymph-node enlargement, mild skin rash, etc. But it will disappear on its own.
If a patient is infected with the HIV virus, he or she may live without any symptoms for one year to 10 years. During this period, the HIV virus lives in their blood and sexual secretions. From HIV positive blood or sexual secretion contaminated with HIV virus, the HIV virus enters into the body of a normal person through blood or through the mucous membrane of the genital organ, anus or mouth.
Even with the HIV virus present in the blood, the blood tests results for HIV may be negative, if tested within three months from the date of infection. This is because the antibody development takes about three months from the date of infection.
This period is being called ‘the window period’. If we use a more sensitive test (antigen detecting test), the window period will be reduced to less than two weeks.
MSM acts as a bridge between safe persons and HIV infected or risky persons. HIV spreads mainly through sex workers and spousal relationships, either in the past or the present. MSM stands at number two among the high-risk groups. Sex workers are on the top of the list.
Sri Lanka needs to be vigilant about the increasing occurrence of HIV infections and needs to take all available precautionary measures to ensure the HIV prevalence rate doesn’t rise.
It is estimated that there are around 35,000 homosexuals (gay persons) in Sri Lanka. Commercial sex workers and MSM are two main causes for the increase in the HIV positive population. MSM will be the main cause of the spread of HIV.
According to health professionals, there are certain factors we have to take care of to maintain our low HIV and AIDS prevalence rates. There are certain internal and external forces that envy our extremely low HIV and AIDS prevalence rates. Therefore we have to be vigilant and active when it comes to maintaining these low prevalence rates. It is Sri Lanka’s rich cultural heritage and religions that protect its society from HIV and AIDS. Experts say Sri Lankan culture doesn’t encourage people to engage in risky sexual practices and always encourages them to protect themselves and their loved ones. It discourages pre-marital sex. All the religions in Sri Lanka espouse the same views. All communities and religions in the country encourage Sri Lankans to be faithful to themselves and to their spouses.
What should we be concerned about to maintain our low HIV and AIDS prevalence rates? The following are the main factors Sri Lanka should be focused on at the moment. There are certain groups of persons such as migrant workers, drug addicts (who use needles to inject drugs), commercial sex workers, MSM (men having sex with men), LGBT (lesbians, gays, bisexuals and transgender persons) in our society. The percentage of such persons is very low. The majority of them live invisibly while some politically and financially powerful LGBT persons live openly. But all of them face the same risk when it comes to health and HIV or AIDS.
When they visit health institutions, the authorities should ensure that they receive the best health care service plus education without any discrimination. This is the only way of minimising the spread of HIV in Sri Lanka.
The NGOs engaged in HIV or AIDS prevention should be careful as they are working with high-risk groups.
Homosexuals and lesbians and their organisations also have a big responsibility to look after their own health and the health of their partners, families, and friends. These specific groups of persons face an additional risk because of their risky sexual behaviour. It is a well-known fact that commercial sex workers are at a greater risk and they need to wear condoms. But sometimes their clients do not allow them to wear condoms. Another well-known fact is that the majority of MSM do not wear condoms for various personal reasons. LGBT persons often face the same problem.
Special attention should be paid to encourage the above groups of persons to use condoms and get themselves tested for HIV regularly. Still, the majority of HIV and AIDS awareness programmes do not focus on them.
It is of little benefit to educate the same educated target groups such as journalists all the time.
It takes extra work for the NGOs to find out strategies and implement them, but it should be done no matter how expensive and hard it is.
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