However, one issue that bothers Dr Gangakhedkar, and rightly so, is the economic impact of the pandemic that has pushed many more people below the poverty line. Some might have also resorted to risky behaviours, thus increasing their social vulnerabilities.
COVID-19 vaccination
COVID-19 vaccine gave hope to all of us, including the community of persons living with HIV. But there were a lot of misconceptions and myths around COVID-19 vaccines in the community - such as 'will it be harmful' or 'will it work for me'. Community sensitisation and counselling through webinars, mouth to mouth publicity and peer support helped a lot in dispelling the doubts and fear around the vaccine, said Daxa.
"One big problem was confidentiality. All vaccine recipients had to fill a form at the vaccination centres, in which they had to indicate if they had had any prior illness and/or if they were on any medication. I realised that this would pose a problem for those who did not want to reveal their positive status. So I told them that they were under no compulsion and it was entirely up to them to reveal their status while filling the database form, and that they could just put a cross against any prior illness, as there was no correlation between the vaccine and HIV infection. Also in my city (Surat), we started vaccination camps in our offices with the help of local authorities. And key populations like gay men and other men who have sex with men, transgender people, sex workers, etc came to these camps to get vaccinated," said Daxa.
Lessons learnt
Daxa lists three main lessons the pandemic has taught the community of people living with HIV: "It taught us the importance and use of technology to connect with the community members via social media and web-based platforms, as all face-to-face and onsite interactions had come to a stop. We learnt the importance of virtual meetings. Till then, I myself was not even aware of the word 'virtual.' But now I am able to facilitate webinars with ease. The second learning is about preparedness to deal with a calamity. Some alternative provisions, processes and policy decisions need to be in place as a part of the system. We are in dialogue with NACO about community-led drug refilling for disaster management. The third lesson is about using community as an asset to overcome challenges. We have seen stigma in our lives very closely. When we were diagnosed as HIV positive, when we started our medications we faced discrimination in society, in our families. But it made us stronger to face other challenges."
COVID-19 played a damper to a host of multiple strategies for HIV care and control that had been under consideration, including introduction of pre-exposure prophylaxis (PrEP), informed Dr Gangakhedkar. He is hopeful that with the pandemic easing out, we can now expect the implementation of PrEP in certain risk groups, as well as stigma-related interventions. Antiretroviral therapy dispensation guidelines are also likely to change for the better.
Daxa too wants that multi-month dispensing (for 2-3 months) done during the lockdown period should continue for those whose viral load is suppressed, who have no co-infection of TB or any other disease, and who are treatment literate and 95% adherent.
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