When the first HIV case was detected in the country in 1993, the public responded with alarm and panic.  It was a cause of deep concern.

The consolation was Bhutan had the advantage of being able to prepare for the worst, drawing from the experience of other countries, and benefitting from years of intensive medical research by then.  The priority then was to raise awareness among all sections of society to prevent the spread.

Since then a lot has happened.  And the number of detections increased too. The average yearly detection for the last three years is 42 people.  This should be a cause of equal concern. We could say that detection has increased because of improved surveillance, but still, after years of attention and awareness, the number is on the rise.

There is an advantage in early detection, as people living with the virus can be put to early treatment.  But looking at the stats, the trend is discouraging.  There are civil servants, corporate employees, and businessmen, quite a huge number, who are, or appear to be, a group that can avoid it.

Another disturbing trend is the mode of detection.  About 90 percent of the cases were transmitted through the sexual route.  This is again after years of awareness campaigns, including the free distribution of condoms.  A common scene at every World Aids Day observed in the country is a woman holding up a wooden phallus and demonstrating how to wear a condom.  While it does titillate the audience, the message gets conveyed.

Apart from the improved surveillance that is helping in detection, it would be difficult to pin down why more people are getting affected. But there the word is that people are convinced that there are more dangerous diseases than HIV/AIDS.  It is true.  Alcohol-related diseases and cancer are killing more people than HIV.

This does not mean that we should be careless.  The virus affects innocent lives right after their birth.

Bhutanese are known to be an open people to the extent that we boast of being a promiscuous society.  This is not helpful.  If there is discomfort in buying a condom from a medical store because there are other customers around, there are other contraceptives that will not protect people from sexually transmitted diseases or HIV.

The talk is that everybody is walking around with an Ipill, an emergency contraceptive pill, in their pockets.  Such pills may prevent pregnancy, but not HIV/AIDS or other diseases.

HIV/AIDs is no longer a killer disease. And with anti-retroviral treatment available, free of cost, HIV/AIDS has lost the compelling impact it used to have when first detected. The only fear is ostracism or the slur of infidelity.

It is comforting to hear that the health ministry is re-strategising its approach for detection by identifying the population at most risk.  That is only one approach.  The key word should still be awareness and responsibility.  And that responsibility lies with every individual.