Chandigarh, January 2
An assessment of the extent of HIV and AIDS prevalence among central police and paramilitary forces has revealed a disturbing picture. Besides lack of proper record-keeping and reliable data, the attitude of personnel towards HIV/AIDS affected is also discriminatory. The system of treating affected persons also leaves a lot to be desired.

There was no organised system of surveillance based upon blood testing. The procedures for rapid and confirmatory tests were not institutionalised and they varied from unit to unit and from hospital to hospital, a research by three experts under the aegis of the National AIDS Control Organisation (NACO) has revealed.

Though it was generally recognised that HIV/AIDS was a serious problem and may become worse, the organisations however, were not equipped to handle the issues and interventions were ad hoc and uncoordinated.

Though troops well cued-up about HIV/AIDS, the research found that discriminatory attitude towards HIV/AIDS infected persons was widely prevalent in the forces, including senior officers. The study was of the opinion that it was unlikely that perceptions and attitudes would change.

As far as infrastructure and facilities are concerned, the research team found that the standard of facilities and supplies for HIV/AIDS varied greatly from force to force and from place to place and no minimal standards have been laid down. Most hospitals lacked proper facilities for HIV testing and there were no separate clinics or specialities for such cases though a few proposals were underway.

Further, ARV drugs were not available or where available were not adequate and there was no proper system of reimbursement of medical expenses. It was revealed that a number of affected persons went to quacks or private practitioners in the absence of drugs or reimbursement of medical expenses.

It was found during research that there was almost a complete isolation of the HIV infected and their families. They generally stayed outside the paramilitary community where they could lead an anonymous life. There was little possibility of even elementary care or support being made available to them within the paramilitary community, the report said.

Medical officers in hospitals, according to the research, were neither given systematic training about HIV/AIDS or in the adoption of universal safety precautions. Even barbers employed in units were not imparted training to adopt safety precautions to prevent possible transmission through the use of infected blades or scissors.

The research has also found organisational and institutional structures inadequate as far as handling HIV/AIDS cases are concerned. The matrix system of organisation, where the administrative control of medical staff is with the sector commanders and professional control with the medical director at headquarters, is not able to cope with the unusual demands imposed by HIV/AIDS. Horizontal linkages need to be strengthened at the sector level between the medical staff and local commanders.

There was also no clear direction and coordination between force headquarters and lower establishments, commanders and chief medical officers and sectors/ group centres and state AIDS control societies. Networking between various establishments was ad hoc and dependent on initiative of individuals. The research also revealed inadequate budget for HIV/AIDS programmes.