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The recent revelation made by a high-ranking official of the National AIDS Control Society (NSACS) about the HIV prevalence among pregnant women in Nagaland should open the eyes of the public and trigger immediate action to prevent perinatal transmission of HIV or mother-to-child transmission. An official working with the National AIDS Control Society (NSACS) had recently informed that a total of 960 people were tested positive for HIV between April 2023 and March 2024 in Dimapur, Chümoukedima and Niuland districts alone, out of which 41 were pregnant women, indicating a high prevalence among mothers. As per the NACO HSS Plus report 2021, Nagaland has the highest HIV prevalence rate among pregnant women in India and the second highest among adults, only next to Mizoram. Globally, an estimated 1.3 million women living with HIV become pregnant each year, according to the World Health Organisation. The high HIV infection rate in antenatal care (ANC), which is less talked-about compared to adults, is a matter of concern for the state. It indicates that either more pregnant women are coming forward to take tests for HIV and other STDs amid awareness campaigns, or the infection continues to proliferate. If the former is the reason for the high prevalence, it’s a positive sign and should be encouraged to arrest the spread of the virus. If the trend is due to other reasons, including sheer negligence, ignorance or lack of awareness, concerted efforts should be made to arrest it by reaching out to the hidden population, especially in rural areas and the urban poor.
As per the data, the state managed to bring down the HIV prevalence rate among injecting drug users (IDU) from 39% to 2.4% over three decades ending 2021, thanks to aggressive awareness campaigns initiated by government agencies, civil society organisations, NGOs and church organisations. A similar approach should be taken to stop HIV transmission from mother to child by targeting those with a higher risk of getting infected. Immediate intervention is vital to prevent the spread of the virus to a child. According to studies, the chances of transmitting HIV from a mother living with the virus to her child during pregnancy, delivery or breastfeeding range from 15% to 45%. However, the good news is that mother-to-child transmission can be prevented by taking antiretroviral therapy (ART), which experts say can reduce the risk of infection to less than 1%. We should prioritise thwarting vertical infection by strengthening health systems, enhancing reproductive health services, promoting antenatal care among mothers and providing a comprehensive service package to the infected. It is equally important to do away with stigmatisation and discrimination against HIV patients, as many hesitate to undergo tests for fear of being disowned by society and even by their near and dear ones if tested positive.