Shillong: The Meghalaya government is seriously considering making HIV/AIDS testing mandatory before marriage, a drastic step proposed as the state grapples with a dramatic surge in infections, now placing it among India’s worst-affected regions. The proposal was announced by Health Minister Ampareen Lyngdoh yesterday, following a high-level meeting that confronted alarming statistics, revealing HIV/AIDS cases have doubled in the East Khasi Hills district alone. Meghalaya currently ranks sixth nationally in HIV/AIDS prevalence, with the northeastern region bearing a disproportionately high burden.
“If Goa has made testing compulsory, why shouldn’t Meghalaya have its own set of laws? These laws would benefit the larger community,” Lyngdoh stated, indicating the state’s resolve. “The state is mentally prepared to take strong actions.” The crucial meeting, chaired by Deputy Chief Minister Prestone Tynsong, included Health Minister Lyngdoh, Social Welfare Minister Paul Lyngdoh, and eight legislators from East Khasi Hills district. It culminated in a resolution directing the health department to prepare a cabinet note for a comprehensive HIV/AIDS policy, to be implemented in mission mode.
The scale of the crisis became starkly apparent with officials revealing that East Khasi Hills district now records 3,432 HIV/AIDS cases. Worryingly, only 1,581 patients are currently receiving treatment, with a concerning 681 patients lost to follow-up care. Furthermore, 159 deaths have been attributed to interruptions in Antiretroviral Therapy (ART) treatment. “We have spoken only about East Khasi Hills, and the number is very high. The highest in the state is unfortunately in the Jaintia Hills region, both West and East,” Lyngdoh added, underscoring the widespread nature of the problem.
The minister emphasised that while public awareness campaigns have seen some success, the primary challenge now lies in bolstering testing and screening capabilities. Existing legal frameworks might be limiting aggressive testing protocols, thus prompting the government to explore new legislation akin to Goa’s mandatory pre-marriage testing law. Notably, sexual transmission remains the predominant mode of HIV/AIDS spread in Meghalaya, a distinction from other states where injecting drug use often plays a more significant role. However, officials acknowledged difficulties in accurately identifying and testing all at-risk populations, suggesting that actual infection rates could be higher than current statistics indicate.
“We must ensure that everyone who has been tested is brought into the treatment system. HIV/AIDS is not fatal if treated properly, just like cancer or TB,” Lyngdoh affirmed, stressing the criticality of continuous care protocols. The government plans to extend consultation meetings to the Garo Hills and Jaintia Hills regions, collaborating with bureaucrats and medical professionals to devise area-specific strategies. Officials have also committed to avoiding stigmatisation by refraining from releasing specific data about infection hotspots within individual constituencies.
The minister observed that injecting drug use is not yet a dominant factor in Meghalaya’s HIV transmission patterns, attributing this to challenges in identifying users, unlike certain other states where needle-sharing forms a major component of the epidemic. Lyngdoh also voiced concern about undetected cases within communities, suggesting that despite the alarming official numbers, there could be more individuals who are not coming forward for testing, indicating that the state’s current testing capabilities might not be capturing the full extent of infections. The proposed comprehensive policy framework will address multiple facets of the crisis, ranging from prevention through mandatory testing to ensuring continuous treatment for all diagnosed patients, with the health department taking primary responsibility for implementation and legal experts examining the feasibility of compulsory pre-marriage testing legislation.
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