Indian Government to establish small antiretroviral clinics to provide treatment to more people from rural areas

The Indian government plans to establish "link centers," or small antiretroviral clinics, in rural areas to address the challenges associated with accessing the drugs in isolated areas, Reuters reports. According to Reuters, long distances between clinics are hindering the country's efforts to reduce the spread of HIV/AIDS, particularly in rural areas.

Although there are 147 clinics that provide antiretroviral drugs in India and the government provides access to no-cost antiretrovirals, many HIV-positive people in rural areas are unable to travel to the clinics to receive treatment. According to a physician at a hospital in New Delhi, HIV-positive people from rural areas who do not have support from their families cannot afford to travel, and women who are reluctant to travel alone often "give up" on HIV treatment. Patients who do not follow treatment recommendations could develop resistance to first-line antiretrovirals and require second-line treatments, which are not widely available in India, according to Reuters.

The link centers will be small facilities located closer to rural areas to make it easier and more affordable for people to obtain treatment. "They just come to pick up the [antiretrovirals] if they have no side effects, and they go home," Sujatha Rao, director-general of the National AIDS Control Organization, said, adding that the approach "saves transport and other costs." Rao added that the government eventually plans to establish 500 link centers throughout the country.

India has 2.47 million HIV cases, and the virus is spreading to the general population, according to health workers. Rao added that in some areas, HIV prevalence among pregnant women is 1%. Of India's 611 districts, 156 have an HIV prevalence greater than 1% of the population, Reuters reports. "The epidemic is getting deeper into (certain) rural, general areas of the country ... it is migrant-related," Rao said. According to Reuters, many health workers have said that India's HIV epidemic is related to poverty and that the government should address poverty in its efforts to reduce the spread of the virus (Lyn, Reuters, 6/3).