By Haobam Nanao
Imphal, March 25:
The first case of HIV in Manipur was reported in February 1990, originating from blood samples collected in October 1989 among injecting drug users (IDUs). In response, the State Government adopted the Manipur State AIDS Policy on October 3, 1996, becoming the first state in India to implement such a policy. Nationally, India initiated its response to the HIV/AIDS epidemic in 1985 through sero-surveillance, later institutionalizing efforts under the National AIDS and STD Control Programme (NACP) in 1992. Now in its fifth phase (NACP V), the program continues its mission to combat HIV/AIDS, aiming to reduce stigma and discrimination among people living with HIV (PLHIV) and key populations. Additionally, global commitments under the UN Sustainable Development Goals target the eradication of HIV/AIDS as a public health threat by 2030.
Despite robust policies, legal protections, and preventive initiatives such as the HIV/AIDS (Prevention & Control) Act of 2017, stigma and discrimination persist, mirroring the insidious nature of the virus itself. While free antiretroviral therapy (ART) was introduced in India in 2004, earlier interventions included the Prevention of Parent-to-Child Transmission (PPTCT) program in 2002, with mandatory HIV testing for pregnant women implemented in 2009.
Now, 35 years since the first reported case in Manipur, the landscape of HIV/AIDS in the state has evolved. A growing crisis is emerging among adolescents born with HIV, who, upon learning their status, react with anger, self-stigma, and defiance. Many of these youths, previously unaware of the nature of their medication, have reached an age where they question the necessity of their daily ART regimen. While some accept the explanations provided by parents, health workers, and counselors, others struggle to cope with the reality of their condition. The weight of societal stigma, combined with internalized shame, leads some adolescents to reject their treatment entirely.
This alarming trend has become a public health concern. Reports from healthcare workers highlight the increasing number of young PLHIV who abruptly discontinue ART out of defiance, depression, or misplaced blame toward their parents. The consequences of stopping ART are severe—leading to compromised immune systems, heightened vulnerability to opportunistic infections, and increased transmission risks. Families are left distressed, unable to convince their children to adhere to life-saving treatment. Meanwhile, field workers face mounting challenges as these youths actively evade counseling and intervention. Some have even turned to substance abuse as a coping mechanism, further endangering their health and well-being.
Adding to this crisis is a significant shortage of medical professionals specializing in HIV treatment within the state. Many senior doctors who have long dedicated themselves to this field are now approaching retirement, while others have expressed concerns about their diminishing expertise. This growing gap in healthcare expertise poses a critical risk, emphasizing the urgent need for the state to cultivate and train a new generation of dynamic doctors to address this pressing issue.
As the HIV/AIDS crisis in Manipur matures, so do its complexities. While national and global strategies continue to focus on treatment and prevention, emerging issues such as adolescent defiance, mental health struggles, and societal stigma require urgent attention. Addressing this silent crisis demands a multi-faceted approach—enhanced counseling services, community support initiatives, targeted mental health interventions, and continuous advocacy against HIV-related stigma. The battle against HIV/AIDS is not just about medical treatment; it is about ensuring that those affected receive the support and encouragement they need to lead healthy, fulfilling lives.
