Human Immune Deficiency Virus/Acquired Immune-Deficiency Syndrome (HIV/AIDS) is the term given to a combination of symptoms which results from a breakdown of the immune system. It is the final stage of HIV infection, which causes severe damage to the immune system and causes fatal infections. AIDS is the second widely spread communicable disease worldwide and the sixth common cause of death globally (WHO, 2004). HIV continues to be a major global public health issue, having claimed more than 39 million lives so far, with 29 million new infections estimated by the near 2020. The number of new HIV infections in people aged ≥15 years worldwide was 2.3 million in 2000. After a two decades-long fight, the number of new infections was still 1.6 million in 2019. These data indicate that HIV prevention has failed to a significant degree, and there are potential significant problems with our understanding of HIV transmission, and, therefore, our strategies for HIV prevention. The latest statistics shows that there were an estimated 37.7 million [30.2–45.1 million] people living with HIV at the end of 2020, over two thirds of whom (25.4 million) are in the WHO African Region. In 2020, 680 000 [480 000–1.0 million] people died from HIV-related causes and 1.5 million [1.0–2.0 million] people acquired HIV. Swaziland (Eswatini) has the highest HIV prevalence and incidence of any country in the world of 27% whereas Lesotho has the second-highest HIV rate in the world of 25% and The country with the third-highest HIV prevalence is Botswana, with an estimated 21.90% of the population diagnosed. About 370,000 people in Botswana are living with HIV. 85% of total adults with HIV and 38% of total children with HIV are on ART. It is observed that deaths related to HIV/AIDS declined, however the number of new infections is rising. AIDS is caused by a virus called as Human Immune Deficiency Virus (HIV) that attacks the immune system and leaves the body vulnerable to a variety of life-threatening infections and cancers. HIV is transmitted through illegal male female relationships, transfusion of infected blood, use of no sterile, HIV infected or contaminated syringes and needles and from an infected mother to her unborn child. HIV/AIDS is a life-threatening disease, and therefore people react to it in strong ways. HIV infection is associated with behaviors (such as homosexuality, drug addiction, prostitution or promiscuity) that are already stigmatized in many societies. Most people become infected with HIV through sex, which often carries moral baggage. There is a lot of inaccurate information about how HIV is transmitted, creating irrational behaviour and misperceptions of personal risk. Religious or moral beliefs lead some people to believe that being infected with HIV is the result of moral fault (such as promiscuity or ‘deviant sex’) that deserves to be punished. There are certain chances of getting ostracized at different places and settings like marriage, place of worship, train, bus, workplace, hostel, hospital and others. HIV/AIDS is one of the biggest challenges faced by India and there are about three million people suffering from HIV/AIDS. It is reported that more than 5000 people were living with HIV virus in the Jammu and Kashmir state. HIV remains a major public health issue that affects millions of people worldwide. Although the world has made significant progress in recent decades, important global targets for 2020 were not met. AIDS is caused by a human immunodeficiency virus (HIV), which is believed to have originated in non-human primates in Central and West Africa. While various sub-groups of the virus acquired human infectivity at different times, the global pandemic had its origins in the emergence of one specific strain – HIV-1 subgroup M – in Léopoldville in the Belgian Congo (now Kinshasa in the Democratic Republic of the Congo) in the 1920s. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is more virulent, easily transmitted and is the cause of the vast majority of HIV infections globally. The pandemic strain of HIV-1 is closely related to a virus found in chimpanzees of the subspecies Pan troglodytes troglodytes, which live in the forests of the Central African nations of Cameroon, Equatorial Guinea, Gabon, the Republic of the Congo, and the Central African Republic. HIV-2 is less transmittable and is largely confined to West Africa, along with its closest relative, a virus of the sooty mangabey (Cercocebus atys atys), an Old World monkey inhabiting southern Senegal, Guinea-Bissau, Guinea, Sierra Leone, Liberia, and western Ivory Coast.
The majority of HIV researchers agree that HIV evolved at some point from the closely related simian immunodeficiency virus (SIV), and that SIV or HIV (post mutation) was transferred from non-human primates to humans in the recent past (as a type of zoonosis). Research in this area is conducted using molecular phylogenetics, comparing viral genomic sequences to determine relatedness. Scientists generally accept that the known strains (or groups) of HIV-1 are most closely related to the simian immunodeficiency viruses (SIVs) endemic in wild ape populations of West Central African forests. In particular, each of the known HIV-1 strains is either closely related to the SIV that infects the chimpanzee subspecies Pan troglodytes troglodytes (SIVcpz) or closely related to the SIV that infects western lowland gorillas (Gorilla gorilla gorilla), called SIVgor. Using HIV-1 sequences preserved in human biological samples along with estimates of viral mutation rates, scientists calculate that the jump from chimpanzee to human probably happened during the late 19th or early 20th century, a time of rapid urbanisation and colonisation in equatorial Africa. According to the natural transfer theory (also called “hunter theory” or “bushmeat theory”), in the “simplest and most plausible explanation for the cross-species transmission” of SIV or HIV (post mutation), the virus was transmitted from an ape or monkey to a human when a hunter or bushmeat vendor/handler was bitten or cut while hunting or butchering the animal. The resulting exposure to blood or other bodily fluids of the animal can result in SIV infection. Prior to WWII, some Sub-Saharan Africans were forced out of the rural areas because of the European demand for resources. Since rural Africans were not keen to pursue agricultural practices in the jungle, they turned to non-domesticated animals as their primary source of meat. This over-exposure to bushmeat and malpractice of butchery increased blood-to-blood contact, which then increased the probability of transmission. A recent serological survey showed that human infections by SIV are not rare in Central Africa: the percentage of people showing serore activity to antigens—evidence of current or past SIV infection—was 2.3% among the general population of Cameroon, 7.8% in villages where bush meat is hunted or used, and 17.1% in the most exposed people of these villages. How the SIV virus would have transformed into HIV after infection of the hunter or bush meat handler from the ape/monkey is still a matter of debate, although natural selection would favour any viruses capable of adjusting so that they could infect and reproduce in the T cells of a human host. Several of the theories of HIV origin accept the established knowledge of the HIV/SIV phylogenetic relationships, and also accept that bush meat practice was the most likely cause of the initial transfer to humans. All of them propose that the simultaneous epidemic emergences of four HIV groups in the late 19th-early 20th century, and the lack of previous known emergences, are explained by new factor(s) that appeared in the relevant African regions in that timeframe. These new factor(s) would have acted either to increase human exposures to SIV, to help it to adapt to the human organism by mutation (thus enhancing its between-humans transmissibility), or to cause an initial burst of transmissions crossing an epidemiological threshold, and therefore increasing the probability of continued spread. According to Pépin’s 2011 book, The Origins of AIDS, the virus can be traced to a central African bush hunter in 1921, with colonial medical campaigns using improperly sterilized syringe and needles playing a key role in enabling a future epidemic. Pépin concludes that AIDS spread silently in Africa for decades, fueled by urbanization and prostitution since the initial cross-species infection. Pépin also claims that the virus was brought to the Americas by a Haitian teacher returning home from Zaire in the 1960s. Sex tourism and contaminated blood transfusion centers ultimately propelled AIDS to public consciousness in the 1980s and a worldwide pandemic. João Dinis de Sousa, Viktor Müller, Philippe Lemey, and Anne-Mieke Vandamme proposed that HIV became epidemic through sexual serial transmission, in nascent colonial cities, helped by a high frequency of genital ulcers, caused by genital ulcer diseases (GUD). GUD are simply sexually transmitted diseases that cause genital ulcers; examples are syphilis, cancroids, lympho granuloma venereum, and genital herpes. These diseases increase the probability of HIV transmission dramatically, from around 0.01–0.1% to 4–43% per heterosexual act, because the genital ulcers provide a portal of viral entry, and contain many activated T cells expressing the CCR5 co-receptor, the main cell targets of HIV. India as a country that is populous, large, and culturally complex and economically diverse will agree that HIV adds to its woes. It has been more than two decades of time Kashmir is living with HIV/AIDS. No matter the first case was reported in 1986, the same year India reports its first case. HIV has not been hovering over Kashmir the way it does to whole of India but at the same time the fact cannot be overruled that Kashmir is living with this virus since 1986. HIV/AIDS is a social disease as well as a medical condition. The progression of AIDS as a medical disease runs parallel to the drastic and irreparable stigma and discrimination. AIDS has a culminating effect on the social life and society as a whole. In the literature we notice that relationship between religion and HIV/AIDS has been an ongoing one, since the advent of the pandemic. Many faith communities have participated in raising awareness about HIV/AIDS, offering free treatment, as well as promoting HIV/AIDS testing and preventative measures. Christian denominations, such as Lutheranism and Methodism, have advocated for the observance of World AIDS Day to educate their congregations about the disease. Some Churches run voluntary blood testing camps and counseling centers to diagnose and help those affected by HIV/AIDS. The other major religions of the world are also concerned about this disease. Worldwide many Muslims view the AIDS epidemic through what is called the “prism of sin”, and as the consequence of sinful behavior, such as prostitution, sex with multiple partners or promiscuity. Awareness of the HIV/AIDS epidemic is growing among the Muslim community and efforts are being initiated to prevent its spread. The Muslim Awareness Program (MAP), based in South Africa is a faith-based organization that promotes HIV/AIDS prevention strategies based on the moral teachings of Islam. These activities include the promotion of abstinence from all sexual activity outside marriage; refraining from drug use, and instilling faithfulness within marriage. Muslims believe, the key to combating to the HIV/AIDS epidemic is prevention. In Muslims view, the Islamic position on morality, chastity and the sanctity of marriage needs to be shared with the world. Islam cites sex with multiple partners, sex outside marriage, other promiscuous sexual behaviors and homosexuality as immoral and as a result of this Muslims consider this behavior the main cause of HIV/AIDS, believing that promoting abstinence, chastity, and intramarital sex is the key to ending or at least containing the epidemic. World AIDS Day was first conceived in August 1987 by James W. Bunn and Thomas Netter, two public information officers for the Global Program on AIDS at the World Health Organization in Geneva, Switzerland. It was first observed on December 1, 1988 to bring greater awareness to HIV, as well as to commemorate those affected by the disease. Today, it is regarded as the longest-running disease awareness initiative of its kind in the history of public health. Since those early years, the epidemic has changed enormously and so, too, has the global agenda. Worldwide about 38 million people with HIV, universal testing is the main key to halting the number of new infections. Testing will identify all those who need access to treatment, which will help those with HIV live longer and healthier lives. The first World AIDS Day focused on the theme of children and youth in order to bring greater awareness of the impact of AIDS on families, not just the groups commonly stigmatized by the media (including gay and bisexual men and injecting drug users). From 1996, World AIDS Day operations were taken over by the Joint United Nations Program on HIV/AIDS (UNAIDS), which expanded the scope of the project to a year-round prevention and education campaign. The World AIDS Day themes over the years have mirrored the policy goals of public health authorities, moving from awareness and education to the larger objectives of community and global cooperation. The theme of World AIDS Day 2021 is “End inequalities. End AIDS”. With a special focus on reaching people left behind, WHO and its partners are highlighting the growing inequalities in access to essential HIV services. On 1 December 2021, WHO is calling on global leaders and citizens to rally to confront the inequalities that drive AIDS and to reach people who are currently not receiving essential HIV services? The current evidence suggests that people living with HIV have a higher risk of becoming seriously ill from COVID-19. People living with HIV infection who have a compromised immune system should be extra cautious to prevent coronavirus infection, as they may be at an even higher risk of getting seriously ill. COVID-19 vaccines are considered safe for people living with HIV. However, HIV appears to be less of a risk factor than other health conditions, such as obesity, diabetes, severe asthma, respiratory disease, heart disease, liver disease, stroke, dementia, or older age. Antiretroviral therapy is claimed to be the main reason for the decrease in new HIV infections among children since 2000. The best way to stay healthy is by taking antiretroviral treatment, as well as any medication prescribed for other health conditions. In conflict zones, all peacekeeping and peace enforcement soldiers should be trained in international human rights laws, gender consciousness and preventing gender hostility, and HIV/AIDS safeguards.
(While Bilkees Nazir is a Research scholar at the Department of Zoology University of Kashmir Hazratbal Srinagar, Dr Bilal A Bhat is an Associate Professor at S K University of Agricultural Sciences & Technology-SKUAST Kashmir Srinagar. Views are their own)