Rising HIV Cases in Sri Lanka is a public health concern in Sri Lanka, particularly among young men. Over the years, I’ve come across more stories on TV, in newspapers, and on social media reporting about this alarming rise. When you examine the data more closely, it becomes clear that male-to-male sexual relationships significantly contribute to new HIV infections. This article will explain why this is the case, while also discussing how we can prevent and treat HIV, with a special focus on educating the public.

The Data Speaks: Why HIV Is Increasing Among Young Men

According to the 2022 data, young people aged 15 to 24 made up 12% of all reported HIV cases in Sri Lanka. Within this group, 92% were young men, and 80% of them reported male-to-male sexual encounters. Clearly, same-sex relationships are playing a major role in the increase of HIV cases, especially among young men.

Breaking it down further, district-specific data show that Colombo, Gampaha, Kalutara, and Kurunegala in the Western and Northwestern Provinces, along with Galle in the Southern Province, reported higher HIV rates. Additionally, many individuals receive their diagnosis at a late stage, with low CD4 counts—a sign that early detection is lacking, increasing the risk of severe disease and further transmission.

Why Male-to-Male Sexual Relationships Are Linked to HIV Spread

There are several reasons why men who have sex with men (MSM) face a higher risk of contracting HIV:

• Biological vulnerability: The rectal lining is more prone to small tears, which allows HIV to enter the bloodstream more easily.
• Low condom use: Studies like the 2018 IBBS survey found that only 18% of MSM used condoms during their last sexual encounter, greatly increasing their risk.
• Stigma and discrimination: Due to societal stigma, many MSM avoid seeking preventive care like HIV testing, which further increases their risk.

Prevention Strategies: How to Reduce HIV Transmission

Thankfully, there are ways to prevent HIV. First and foremost, public health campaigns must promote consistent and correct condom use during all sexual encounters. As we often see in global prevention efforts, this simple step can significantly reduce the risk of transmission.

In addition, PrEP (Pre-Exposure Prophylaxis) offers an effective way to prevent HIV. PrEP is a daily medication that, when taken regularly, can lower the risk of contracting HIV by up to 99%.

Thirdly, regular HIV testing is essential. Many individuals are unaware of their status, increasing the chances of unknowingly transmitting the virus. Testing is available for free at government hospitals and private clinics. Fortunately, 86% of people living with HIV in Sri Lanka know their status. However, there is still room for improvement to reach the UNAIDS goal of 95%.

Finally, reducing stigma is critical. The stigma surrounding MSM and HIV discourages people from seeking the healthcare they need. Community outreach programs, along with broader education efforts, can help dismantle this stigma.

Treatment: Living with HIV

Modern treatment makes it possible for people living with HIV to lead long and healthy lives. Antiretroviral therapy (ART) is the main treatment. These medications suppress the virus and prevent it from replicating in the body.

Encouragingly, 80% of diagnosed individuals in Sri Lanka are on treatment, and of these, 87% have achieved viral suppression. This means their viral load is so low that they are unlikely to transmit the virus to others, and they can maintain good health. However, it is crucial that people continue their medication as prescribed and attend regular medical check-ups.

Educating the Public: The Key to Reducing HIV

In my opinion, education plays a pivotal role in preventing HIV transmission. People need to fully understand how HIV spreads and what they can do to protect themselves. This requires comprehensive sexual health education in schools and public health campaigns aimed at high-risk groups, including MSM, transgender individuals, and sex workers.

Additionally, it is vital to address the stigma that surrounds HIV and male-to-male sexual relationships. As I’ve observed in the media, many young men are afraid to seek help due to the fear of discrimination. Creating a supportive and non-judgmental environment is essential for encouraging people to get tested, seek treatment, and access preventive care.

Conclusion: Turning the Tide on HIV in Sri Lanka

The rise in HIV infections, especially among young men in same-sex relationships, presents a significant challenge for Sri Lanka. We must focus on expanding access to HIV testing and treatment, promoting safe sexual practices, and fostering a more inclusive society. By taking these steps, we can help reduce the spread of HIV and ensure a healthier future for all Sri Lankans.