by IRIN News
Reducing social stigma and improving awareness is needed to better monitor and prevent the spread of HIV in Sri Lanka, experts say.
HIV prevalence in Sri Lanka is relatively low: The latest government figures (December 2009) indicated 1,196 cases - less than 0.1 percent of people aged 15-49, and less than 1 percent of those in high-risk groups.
Migrant workers like this one in Sri Lanka are reported to form half of those infected with HIV in the country ~ pic by: Lakruwan Wanniarachchi/IRIN
However, accurate assessment of HIV prevalence is difficult as social stigma and lack of knowledge make HIV prevention and information campaigns difficult. UNAIDS estimates the total number of infections is at least three times higher than indicated by official figures.
“The numbers are probably under-reported,” David Bridger, UNAIDS country coordinator, told IRIN. “What we really need to do is to concentrate on risk.”
“People know that AIDS is dangerous,” said Mohamed Naseer, coordinator of Positive Women’s Network (PWN), a national non-profit network of persons living with HIV. “Beyond that, they know very little else.”
Public efforts to spread knowledge about HIV have sometimes raised opposition, Naseer said.
On 10 December, a PWN director appeared on national TV to speak about HIV prevalence in Sri Lanka. The next day the PWN office was bombarded with threatening phone calls, and taxi drivers refused to give a lift to the official in question.
“We [people] are scared that we can get HIV by just sitting next to a victim,” Naseer said.
The stigma around HIV makes HIV-positive people reluctant to disclose their status or even get tested, warned a joint report by UNAIDS and the Family Planning Association of Sri Lanka entitled People Living with HIV Stigma Index Sri Lanka.
According to Bridger from UNAIDS, this makes it hard to launch programmes targeting high-risk groups, including migrant workers, since no one is sure which those groups are based on prevalence.
Job recruiters in the Middle East require HIV testing for Sri Lankan migrant workers, and preliminary results indicate HIV infection rates could be on the rise for this group.
More than half of reported HIV-positive cases in Sri Lanka are migrant workers, according to a November 2010 UN report, HIV and Mobility in South Asia.
With over a million Sri Lankans working overseas, and more people travelling since the end of a decades-long civil conflict in May 2009, Bridger warned that HIV monitoring is increasingly important.
“Sri Lanka is returning to normalcy… Tourism is taking off… The impact of this on the spread of HIV? This is a question we need an answer for.”