People living with HIV/AIDS don’t get life-saving tuberculosis treatment on time and the delay puts their life at risk, according to a recent multi-centre study conducted by the Indian Network for People Living with HIV/AIDS with support from Advocacy to Control TB Internationally.
The study indicates significant delays in both detecting and treating TB especially among people living with HIV/AIDS in the country. “Nearly half the 2.4 million people living with HIV/AIDS in India contract TB, making it the leading cause of death. Yet less than 5 per cent are automatically tested for TB,’’ notes the study.
The study also points out that lack of awareness and knowledge about TB ranks high among patients and causes delay in seeking appropriate diagnosis and treatment. Distance from the nearest TB service delivery point is also a key barrier from the provider end, with average travel times exceeding 90 minutes for over 50 per cent of the population surveyed.
Nearly a third of the surveyed population also reported paying for their medications, indicating an incomplete reach and awareness of the free national TB control programme.
“People living with HIV/AIDS are among the most vulnerable in getting TB infections. Any delay in this vulnerable population getting life-saving TB treatments is also indicative of broad systemic issues of accessibility that need to be addressed quickly,’’ said the lead researcher on this study from the Indian Network of People Living with HIV/AIDS, Dr. Venkatesan Chakrapani.
“The delay in getting appropriate diagnosis for HIV-infected individuals also reflects on the failure to get newer diagnostic tests on to the market and in our health care delivery points,’’ he added.
The currently used standard microscopy-based sputum tests fail to detect TB in samples from people living with HIV and having infectious TB, leading to false negative tests and delays in getting a correct diagnosis.
Dr. Bobby John of Global Health Advocates and an adviser on the study said: “There needs to be a further deepening of the service delivery to avoid long travel times for sick people. Distance and poor understanding cause people to drop out of their medications more often than not.’’
Ten per cent of the survey participants reported stopping their treatments for a week or more. Incomplete treatment adherence raises the risk of multi-drug resistant TB for the individual and in the community.
Supporting the study findings and emphasising the urgency to see greater coordination between HIV services delivered through the national AIDS control programme, Vivek Dharmaraj of the Advocacy to Control TB Internationally Project in India said: “People living with HIV should get TB diagnosis and treatment services from one window. It is no point putting people on life-saving anti-retroviral treatments for HIV to see them die of TB.”