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Shortage of Second Line Anti Retrovirals


ANTI RETROVIRALS (ARTs) are crucial in sustaining an HIV-positive individual’s life by supressing the viral load in the body.

This enables the immune system to recover sufficiently enough to be able to withstand the threat of infections.

ARTs can produce debilitating side effects, such as nausea, diarrhoea, headaches and skin rashes. They can also cause peripheral neuropathy (nerve damage) and lipodystrophy (fat redistribution – which can lead to strokes).

Women In Need plays a vital role in encouraging HIV-positive women to continue taking ARTs until eventually, in most cases, the side effects subside. However, due to ignorance, many are persuaded to take alternative treatments that falsely promise a cure.

WIN keeps a constant vigil over those who have just begun ART, ensuring that treatment is continued; failure to do so can result in drug resistance.

Drug resistant HIV can be passed directly onto a partner through sexual contact, and some of the women the charity supports, have been infected by their husbands with resistant HIV, which is unresponsive to first line ART. In addition to this, a number of HIV-positive women the charity has been supporting for over 10 years have developed resistance to first line ARTs through long term use. The demand for second line ARTs is now greater than ever. Nagpur is one of only a few centres across India that provides second line ARTs. However, there has been a shortage of the drugs throughout Maharashtra for the last nine months. In order to receive the drugs, a viral load blood test is required, and this can only be done in Mumbai, which is 842 kilometres away. The equipment used for the test is currently out of order, which means that those who are unresponsive to first line ARTs are currently unable to access second line ARTs. This is a great concern for Women In Need, and we have pledged to increase our efforts to support this vulnerable group of women. WIN is keeping a close watch on developments in this matter, and we are consulting specialists to ensure that we receive the best guidance. Pictured:

35-year-old Savita Mahar has been waiitng four months for second line ART while first line drugs are unable to prevent the HIV virus from destroying her immune system. Her children and husband are also HIV-positive.

Working as a domestic servant, Savita earns a small income. Her husband is bedridden and suffers constantly from diarrhoea.

He is an abusive alcoholic and refuses to take ARTs. As his carer, Savita finds little time to address her own health needs. If she takes too many days sick leave, she could loose her job.

WIN is providing financial assistance, food rations, medication and emotional support to this extremely needy woman and her family. Usha talks to a concerned group of HIV-positive women and children. WIN has increased its symptomatic treatment and nutritional support.


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