HIV and AIDS: let’s start talking about it

HIV is a treatable long-term condition, not a verdict. Who should get tested, what treatment really does, and what supportive care can honestly add.

Say the plain thing first, because most harm in this disease comes from people believing the wrong thing for two years. Antiretroviral treatment — ART — is the treatment. Taken daily it pushes the virus down so far that immunity recovers, the person stays well, and sexual transmission stops. No herb, powder, diet, chanting or Ayurvedic plan reduces HIV, and nothing replaces ART. A person who stops treatment to try an alternative usually returns months later with a higher viral load, a lower CD4 count and an opportunistic infection that could have been avoided.

What we do and do not claim

• We do not treat HIV at our two centres and we do not pretend otherwise. Anyone who tells you they can is either mistaken or selling something.
• What we can do, when an HIV-positive person comes to us for something else — a skin problem, back pain, acidity, weight, sleep, fatigue — is treat that complaint carefully, keep nutrition, gut, sleep and stress in the picture, and stay honest with their treating physician.
• Everything we add is disclosed. Some herbs interfere with ART levels or with liver tests, and a person on treatment deserves to know what is running in their body alongside it.
• If you arrive here because someone promised you a cure, we will say no and point you to an ART centre. That refusal is the most useful thing we can offer.

The part that actually injures people: silence

• Diagnosis arrives in a queue, a hallway, a phone call — and then the person carries it alone because no one in the family knows. Secrecy is where adherence collapses, not the medicine.
• Disclosure is a decision, not a duty. It is safest done with a counsellor present, and in India a treating facility can help with partner notification in a structured, confidential way instead of it becoming a family courtroom.
• Testing is voluntary, confidential and, at government ICTC and ART centres, free. A test is not a confession.
• Marriage, work, insurance and education are not barred by a diagnosis, and disclosing it to an employer or a landlord is not something anyone can compel. Where stigma turns into extortion, the local legal-services authority and district AIDS control society are real routes.

Who should get tested

• Anyone who has had unprotected sex with a partner of unknown status, or with more than one partner, at any point — not only recently.
• Anyone whose partner has been diagnosed, and every pregnant woman at booking, because treatment in pregnancy almost always gives an HIV-negative baby.
• Anyone with TB, a recurrent fever, prolonged diarrhoea, unexplained weight loss, repeated oral thrush or a rash that will not settle.
• Anyone who has shared needles, had a tattoo or piercing with unsterilised equipment, or had a needle-stick injury at work — post-exposure prophylaxis works only within seventy-two hours, so this is an urgent visit, not a plan.
• A single reactive screening test is not a diagnosis. It goes into a confirmation algorithm, and a negative test inside the window period is not a negative result — it is repeated at the right interval.
• Symptoms do not diagnose this. Early HIV illness looks like a flu, and flu happens all year in Delhi. Most people with a flu do not have HIV, and most people with HIV had no idea at the time.

What good care looks like, so you can tell whether you are getting it

• ART started as soon as possible after diagnosis, usually a single daily combination, not a slow build of many drugs.
• A viral load measured on schedule — that is the number that tells you whether treatment is working — alongside CD4 where it is used.
• Screening for TB, hepatitis B and C, syphilis, anaemia and kidney or liver function before and during treatment.
• Vaccines, smoking cessation, dental care, mental health follow-up and a diet with real protein. None of this is a side note; these are what keeps a fifty-year-old body working on a thirty-year-old diagnosis.
• Appointments kept even when everything feels fine, because the medicine is what makes it feel fine.

What supportive care can honestly add

• Nutrition: enough protein every day, iron and B12 where the diet is vegetarian, food safety when immunity is low — no raw or undercooked egg, meat or unpasteurised milk, no cut fruit left standing.
• Mouth and skin comfort: thrush, angular cracks and dry itchy skin are manageable, and they are also signals that the treating doctor should hear about rather than hide behind a cream.
• Gut and appetite: persistent diarrhoea is a medical problem in this disease and gets investigated, not treated with a home remedy for a month.
• Sleep, anxiety and alcohol: ART tolerance improves with a fixed dose time, and alcohol is the habit that most reliably destroys both adherence and a liver already processing medication.
• Gentle movement and strength work twice a week; long-term treatment and long sedentary recovery both cost muscle.
• Herbs, honestly: turmeric, tulsi and ashwagandha are what people ask about first. They are not harmless in the way 'natural' implies — they can alter liver enzymes and drug levels. Nothing goes in without the ART doctor knowing, and nothing that promises to 'boost immunity against HIV' is worth the money in it.
• Avoid: unlabelled capsules, megadoses of anything, injected or 'detox' cleanses, fasting regimens during treatment, and steroids bought without a prescription, which can unmask infection.

Report to the treating doctor quickly

• Fever lasting more than a week, or any fever with breathlessness or a dry cough.
• Weight dropping steadily, or diarrhoea running past a month.
• A spreading white coating in the mouth with painful swallowing, or new lumps under the skin.
• Severe headache with a stiff neck, a fit, confusion, or a sudden change in vision.
• A stretch of missed doses longer than a week — this needs a plan, not shame, and it is far easier to fix early.
• Any new medicine, herbal preparation or planned pregnancy, before starting it, not after.

For the family sitting in the next room

• HIV does not spread through sharing food, plates, a toilet, towels, handshakes, hugs, sweat or mosquitoes. It spreads through specific body fluids, mostly through unprotected sex and shared needles, and not at all once a person's viral load is suppressed on treatment.
• The child of a mother on effective treatment is very usually negative. Caring for a family member with HIV is ordinary caregiving.
• What families actually need is a routine for doses, a way to keep appointments, and the decision not to make the diagnosis the loudest thing in the house. In our experience the second one is the hardest, and the one that changes outcomes most.

If you want to talk to someone

• Your nearest government ART centre, an NACO helpline, or a counsellor at a district HIV care centre are the right first calls for testing and treatment questions.
• Our two centres, Model Town and Burari, will always give a free first consultation, will never promise to treat HIV, and will help you find the correct door if that is what you need.