Shillong: Stigma surrounding HIV/AIDS and the subsequent reluctance of people living with HIV (PLHIV) to come forward for treatment continue to pose challenges to Meghalaya’s efforts to achieve 100% antiretroviral therapy (ART) coverage, officials said.
Dr Joram Beda, Commissioner and Secretary of the Health and Family Welfare Department, said stigma remains one of the key reasons why some people discontinue treatment or become difficult to reach after testing. “There is a certain stigma associated with this, and as a result, people are not coming forward. So there is a discontinuation of the treatment,” Beda said.
e explained that while contact details and addresses are collected during testing, health authorities sometimes find it difficult to follow up with patients later as they are unable to establish contact. Beda stressed the need to address the social stigma surrounding HIV and create a more open environment where people feel comfortable seeking treatment and discussing their condition.
Health Minister Wailadmiki Shylla said the state government is preparing a five-year plan to strengthen HIV testing and treatment services, particularly in rural areas. Shylla acknowledged concerns over the limited availability of ART centres in rural parts of the state and said the plan would focus on increasing the number of ART and testing centres, as well as strengthening the required manpower. He said the Cabinet has already approved the plan and that the government now has funds available to expand testing and treatment facilities. However, the minister stressed that increasing the number of centres alone would not be enough if people remain hesitant to access them because of stigma. “If we increase the number of treatment centres or ART centres, if the people are not coming forward, if they don’t come for treatment, then there is no point,” Shylla said.
Shylla while speaking to the media after the launch of the Intensified Information, Education and Communication (IEC) campaign at Lady Keane College on Wednesday said that apart from expanding healthcare infrastructure, the state plans to intensify its IEC campaign to encourage people to come forward for testing and treatment. Shylla said the government is also engaging with networks representing people living with HIV to better understand the barriers preventing them from accessing services. “Stigma was one of the issues and ultimately it is privacy, confidentiality,” he said, adding that HIV-related information is protected under government policy and cannot be disclosed.
Despite these safeguards, Shylla acknowledged that fear of stigma continues to discourage people from seeking services. Asked whether a shortage of doctors was hindering HIV testing and treatment, Shylla said the issue was not a major constraint specifically in the HIV programme. He pointed out that HIV testing and procedures such as CD4 testing do not necessarily require doctors at every stage, and said the state has adequate equipment. The five-year plan, he added, would also allow the government to increase manpower where required. Shylla, however, acknowledged that Meghalaya continues to face a broader shortage of doctors across the health sector.
The government is also looking at ways to make testing and treatment more accessible and comfortable for people in rural areas, particularly those who may fear being identified. Shylla said discussions with community groups and people living with HIV would help the government understand what is preventing people from accessing services and explore more effective approaches to testing and treatment. The focus, he said, would be on ensuring that people are aware of their rights to privacy and confidentiality while strengthening outreach services.
Shylla said legislators could play an important role in addressing HIV-related stigma within their constituencies, but emphasised that the responsibility cannot rest with elected representatives alone. “Definitely, not only a legislator, everyone,” he said, calling for collective action to create a more accepting environment for people living with HIV. He said greater public understanding was needed to recognise that many people acquire HIV unintentionally and that discrimination only creates further barriers to testing and treatment. According to the minister, achieving broader ART coverage will therefore require not only expanding healthcare infrastructure but also tackling the stigma that prevents people from accessing and continuing treatment.