Re-link: Tell us a bit about the work you do?
Dr. Shirgopikar: I started working in the HIV/AIDS field with HIV Mother to Child Transmission clinical Research in Mumbai in 1993. After successful completion of clinical research I started working in HIV field with intervention projects for sex workers, LGBT, workplace intervention, Anonymous , confidential blood testing centres. I have also been actively working in creating HIV awareness for various target group like judiciary, media, youths and others. I have helped create workplace policy, gender sensitization, medical treatment of HIV infected, advocacy for free drugs for treating HIV from Government and many others since last 26 years.
Re-link: What is the difference between HIV and AIDS?
Dr. Shirgopikar: HIV (human immunodeficiency virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom), or through sharing injection drug equipment.
If left untreated, HIV can lead to the disease AIDS (acquired immunodeficiency syndrome). AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus.
Re-link: Who are at risk of HIV?
Dr. Shirgopikar: Some groups of people are more likely to get HIV than others because of many factors, including the status of their sex partners and their risk behaviors. Sexually active people from the age group of 15 to 50 are at high risk. Other risk groups include gay and bisexual men, also, transgender women who have sex with men are among the groups at highest risk for HIV infection, and injection drug users remain at significant risk for getting HIV. Transmission through unmonitored blood transfusion and mother to child transmission is also common.
Re-link: Can a person with HIV lead a healthy and normal professional-personal life?
Dr. Shirgopikar: Person infected with HIV Virus can lead a normal, healthy and professional life. Currently we have many patients who are living with the virus for more than 25 years leading normal and healthy lives. This has become possible because of Anti-retroviral therapy; hence this disease has become a chronically manageable disease like diabetes and Hypertension.
Re-link: Do people diagnosed with HIV experience mental health issues as well?
Dr. Shirgopikar: After two decades of HIV infection came on the scene to this date there is lot of stigma attached to HIV. Newly diagnosed infected people undergo tremendous mental trauma with severe depression, anxiety and sometimes have suicidal tendencies because of stigma attached to the disease. Infected people do not disclose their HIV status to closed family members, friends, and colleagues as it causes lot of negative emotions and they are socially ostracised. They face discrimination at various levels and indifferent forms. They also face isolation, loss of work, dignity and honour pushing them to periphery and loss of support from family and friends.
Re-link: What are the some of the physical issues related to HIV?
Dr. Shirgopikar: Yes. It’s common for people living with HIV to have other health issues. Some of these issues may be directly related to HIV or its treatment. Others may be completely unrelated. Thanks to improvements in HIV treatment, people living with HIV are living longer than ever. But even when HIV is well controlled with medication. Over time, that takes a toll on the body, putting people living with HIV at greater risk for health conditions such as cardiovascular disease, kidney disease, diabetes, bone disease, liver disease etc. Some people also experience side effects from HIV medicines that can continue for a long time.
Re-link: HIV, AIDS & Poz carry taboo even today. Why do you think that is the case?
Dr. Shirgopikar: Unfortunately yes, even after two decades of HIV epidemic stigma, taboo, and discrimination is prevalent everywhere. Despite sustained and continuing awareness campaigns still stigma and discrimination is severely faced by infected people in all walks of life even in medical institution access to medical treatment becomes difficult and denied.
It’s a sorry state of affairs we are still struggling to mitigate the impact caused by disease in the society at large.
Re-link: In your experience, how open and ready is the corporate workplace to tackle the issue of HIV at workplace?
Dr. Shirgopikar: It’s no different, corporate workplaces also reflects the same attitude and behaviour like what we see in society at large. There are lot of myths and misconceptions about the disease in the society and there is no doubt that on the ground we see lot of people with judgemental attitude even so with well informed and literate people.
Many of our patients faced job loss and discrimination at workplace because of their HIV status. In pre-employment medical testing people with positive HIV status were denied job and excluded from the shortlisted candidates for jobs. Some companies found discreet ways to test their prospective or existing employees by testing their HIV Status through medical check-ups with blood tests but not informing them.
Recently some companies have been supportive and have made accommodative policies in their companies and align them with code of ethics given by International labour organisation and state workplace intervention policy.
Re-link: What are some of the different needs of people with HIV and how can organisations support?
Dr. Shirgopikar: People living with HIV/AIDS (PLHAs) need comprehensive holistic support socially mentally and also financial support. PLHAs need to take Anti-retroviral drugs for lifetime and along with that they have to do monitoring investigations for whole of their life. There are many things people need because of their HIV status besides medical help like legal help for property related matters, nutrition, skill development, and workplace support with enabling environment so that they can work productively with dignity.
Companies can conduct awareness programmes to keep their work force healthy and productive. Companies can support with preventive, promotive and curative services. Companies should help PLHAs with flexi-work hours and/or work from home specially for people starting medication. Nowadays many corporates are paying more attention to mental health interventions, they can train the staff to help PLHAs. Sensitization activities need to be conducted for supervisors with PLHAs reportees. Corporates can also tie up with pharmaceutical companies to provide PrEP (anti-HIV medication that keeps HIV negative people from becoming infected) to people who are at high risk.
Re-link: How can support services be communicated to employees in a manner that will resonate with them?
Dr. Shirgopikar: Support Services are important for PLWHAs as there are various agencies with different kind of services which can be networked and can be accessed to create support. Corporates can create awareness programs on HIV & AIDS. They can also start by communicating any anti-discrimination and support policies which have been created for PLHAs, also ensuring the confidentiality of their status is maintained. It’s important to understand that a variety of people are at risk of HIV; so the more we talk about it the lesser the stigma becomes and more people are open to seeking help and support for their needs.
Re-link: What policies and health interventions will you a recommend an organisation to put in place to support persons with HIV?
Dr. Shirgopikar: National AIDS Control Organisation (NACO) is a central agency has already spelt out policy framework and guidelines for workplace in India and all the corporate companies should device their policies accordingly and create enabling environment and support for PLHAs. The ultimate purpose of workplace policy framework is to prevent stigma and discrimination at workplace.