The number of people living with HIV (PLHIV) on ART (antiretroviral treatment) has increased over the years. Today, almost 80 percent of PLHIV – 495 out of 627 – are on ART.

Kabita Kharka, programme officer with Lhaksam, network of HIV positive people in Bhutan, said that in the past only those PLHIV with CD4 count of less than 200 were on ART. Now anyone detected with the virus is immediately put on ART.

Treatment is offered free of cost by the government.

ART consists of the combination of antiretroviral drugs to maximally suppress the HIV virus and to stop the progression of HIV disease. ART also prevents onward transmission of HIV.

Lhaksam’s executive director, Wangda Dorji, said that while there was no cure for HIV, the treatment was highly effective.

He said that treatment not only improved the lives of PLHIVs, but also prevented further transmission of HIV. “This is why the treatment is started for all PLHIVs as soon as they are detected, irrespective of their CD4 cell count.”

According to Lhaksam, of the total reported cases, 118 PLHIVs and 45 PLHIVs who were on ART died due to HIV related complications.

In terms of mode of diagnosis, about 38 percent, the highest, was diagnosed through contact tracing, followed by medical screening  (29) and antenatal check-up (12). Five percent was detected from construction site screening and seven from blood screening.

Kabita Kharka said that the epidemic in the country was recorded highest among the sexually active or reproductive group.

HIV was reported highest in the age group between 30 and 39 years (209 cases). Of the total reported cases, 144 people, including 76 females were aged between 25 and 29 years, 89 were aged between 40 and 49 years of age while 84 were aged between 20 to 24 years.

While 10 were aged between six and 14 years, about 27 were aged below five-years-old.

In terms of occupational background at the time of detection, housewives were the highest with 146 cases. Farmers and people working in private organisations or doing businesses followed with 130 and 105 cases respectively. About 59 were drivers, 36 from armed forces, and 32 civil servants. About 31 were corporate employees and 36 were minors. Unemployed constituted 16 of the total reported cases while 12 were sex workers, 11 were from the religious body. Nine were students or trainees and three were prisoners.

Kabita Kharka said that Lhaksam’s advocacy and awareness programmes in districts brought in notable changes in people’s understanding of HIV/AIDs and their perception of those living with it. “It has improved their HIV service seeking behaviour and promoted concerns for prevention as everyone’s responsibility.”

Except for Gasa, Lhaksam has taken advocacy and awareness programmes in all the dzongkhags with focus on marginalised population like the migrant workers, high-risk women, farmers and students, among others.

“We give advocacy and awareness on two broad topics, PLHIV for the spread of HIV and AIDS epidemic in the country and for the LGBT+ (Lesbian,Gay,Bisexual,Transgender) community in the country which is headed by RAINBOW Bhutan,” Kabita Kharka said.

Providing treatment literacy sessions on HIV and AIDS, outreach and networking, training of the media people, LGBT+ community forum, and social and educational support to key affected population and their affected family members are some of Lhaksam’s primary mandates.

About 138 participants, including PLHIV, LGBT members, and PLHIV and affected children have attended treatment literacy session from 2018 to date.

Dechen Tshomo