“Well, oral intercourse is the safest mode of sexual intercourse. Saliva kills germs and viruses that cause Sexually Transmitted Infections (STIs) and Diseases. So we are safe,” a 42-year-old from Nugegoda area says.
A 26-year-old from Ratnapura said, that a person could contract STIs and Human Immunodeficiency Virus (HIV) by using a public lavatory.
“I know I am safe because I trust my sexual partner. We don’t have to worry about STIs,” says a 34-year-old from Moneragala.
These ideas were expressed when the Sunday Observer inquired regarding HIV, an illness that damages cells in the immune system and is incurable. Sadly, none of these statements are true.
Yesterday (December 1) people across the globe commemorated World AIDS Day under the theme “Know your status”. UNAIDS, that aims to end AIDS as a public health threat by 2030 as part of the Sustainable Development Goals, states, today three in four people living with HIV across the globe know their status. Data from World Health Organization (WHO) shows 1.8 million people were newly infected, while 0.9 million died from HIV in 2017.
According to the latest statistics of the National STD/AIDS Control Program (NSACP), Ministry of Health, Sri Lanka, cumulative HIV cases reported by the end of the first three quarters of this year is 3,117, while AIDS (potentially fatal infections occurring as a result of HIV virus damaged immune system) cases is 757. Twenty-four AIDS related deaths were reported the same year.
Cumulative HIV cases by gender by the end of the same period were reported at 2,086 males and 1,031 females.
Comparatively, by the end of 2017 the reported AIDS related deaths were 33. The estimated number of people living with HIV at the end of that year was 3,500. Thus, there is an increased growth in 2018 compared to 2017, where 2,766 cases of HIV and 690 cases of AIDS were reported by the end of the third quarter. The highest number of cases was reported in the Western Province.
The majority of HIV positive persons are in the 25-49 age group, while, according to cases reported in the period 2003-2017,15-20 per cent are young adults in the age group of 15-24, the NSACP states. The National Program also revealed that HIV prevalence among men who have sex with men (MSM) was high, and increasing.
Acting Director and Consultant Venereologist, NSACP, Dr. Lilani Rajapaksa said, the increase of cases could be due to the increased number of HIV/AIDS screening conducted across the island. The number of HIV tests carried out during the last year was 1,171,596.
Meanwhile, in Ratnapura where the first Sri Lankan HIV patient was detected in 1987, there had been no HIV cases reported this year. The District Medical Officer in Charge of the HIV/STD Clinic, Dr. Kanchana Upasena said, this could be due to patients seeking health aid elsewhere.
He said the biggest barrier in preventing new HIV cases was misinformation or insufficient information regarding sexual intercourse the key mode of transmission of the virus. The other modes include drug use via injections or through blood and blood products, vertical transmission or mother to child infection.
“Not just HIV cases, but the overall number of STIs too is on the rise. The main reason for infection is unsafe sex,” Dr. Upasena declared.
He flagged negative outcomes of the lack of sexual education in schools or other educational institutions, as reasons.
“We tell our adolescents and youth that safe sex is the best way to avoid STIs. We ask them to wear condoms when performing sexual activities, but do we teach them to use the condoms in the correct manner?” he questioned.
The NSACP states, having one sexual partner and wearing a condom during any form of sex is the pivotal method of preventing the infection of STIs. Studies among sero-discordant couples have shown that consistent condom use reduces the risk of HIV transmission by 80 to 94 per cent.
A condom acts as a barrier that prevents blood, semen or vaginal fluids passing from one sexual partner to another. However, if a partner contacts any of these fluids while removing, during or before using a condom he or she will be at risk of contracting STIs from an infected partner.
Trusting a sexual partner is another hurdle people have to overcome in preventing the contraction of STIs. Speaking to the Sunday Observer, Rohan Krishantha* in his mid 30s said he did not use a condom, though he knew how to use it, because he trusted his partners. “I did not see why I had to use protection. I thought my partners were safe,” Rohan said, and he was proved wrong. Rohan was diagnosed with HIV in his late 20s.
“Not knowing how and when to use a condom is a big issue in the country,” National Professional Officer of Communicable Diseases and Immunization, WHO, Dr. Janakan Navaratnasingam said. He added that people, at times, are even reluctant to talk about safe modes of sexual intercourse making the elimination of STIs an arduous task.
Nonetheless, he said, the national program to tackle the issue is an innovative approach as the country has increased HIV testing across the island.
Recognising that mandatory testing would drive those at high risk of HIV infection beyond reach and prevent their access to public health preventive activities and other health services, the Government promotes voluntary confidential counselling and testing. Testing is carried out according to accepted international guidelines. The NSACP also conducts awareness programs to prevent people from getting infected. The key approach for the reduction of HIV cases in Sri Lanka is identified as ABC or abstinence, being faithful and condom usage.
Consultant Venereologist, NSACP, Dr. Chandrika Jayakody said, changing the behaviour of people is of utmost importance for the prevention of HIV/AIDS.
“HIV is not a fatal disease anymore, it is a chronic disease. With proper care and treatment an HIV patient can lead a near normal life,” she added. And Sri Lanka offers the best HIV treatment in the South Asian region.
Adding to the concern, Acting Director, NSACP, Dr. Rajapaksa revealed that social media is becoming a tool aiding the transmission of STIs in the island. She said, more and more people are meeting sexual partners online, which is extremely risky.
“People are not focussing much attention on this issue. There is not enough dialogue surrounding the infection of HIV, and therefore, people take the subject lightly,” Dr. Rajapaksa said, adding that all citizens have a responsibility to reduce the number of HIV cases in the country.
*Name changed to protect the identity of the source.
Quality sexual health
In its vision to promote ‘Quality sexual health services for a healthier nation’ the National STD/AIDS Control Program, at No.29, De Saram Place, Colombo 10, is coordinating, planning and implementing the HIV National Strategic Plan and AIDS Policy in Sri Lanka.
As at the end of 2017 there are 33 full-time STD clinics and 23 branch STD clinics across the island that includes 21 clinics that provide antiretroviral treatment services.
People are encouraged to get their STI tests done at these clinics, conducted free and with utmost confidentiality.
For more information visit
contact +94 11 26 67163 / +94 11 26 67029