The situation would indeed have been much worse in the absence of relentless efforts of scientists and researchers to understand the virus, find its source, causes of spread, routes of transmission and modes of prevention. Yet, it is indeed strange that in spite of the colossal losses suffered in terms of social, economic and manpower costs, the common man is growing strangely apathetic towards the disease as time goes by. The ostrich-like mantra of "it cannot happen to me" still defines the average attitude even in the face of catastrophic proliferation of infected individuals. One reason for this can be the very nature of the disease-a very long period where the patient stays asymptomatic, i.e., after the initial infection stage, there is, for a very long period of time (sometimes stretching for a period of 20 years) no sign or symptom of any disease/infection. The tendency to associate illness with a related symptom(s)-having a fever means that the body temperature will rise-is ingrained in our brains. In such a situation absence of any symptom makes it extremely difficult for an infected individual to accept the fact that anything is amiss. The infected person goes about his/her life as if nothing untoward has taken place in the absence of any discomfiture/illness, while the virus continues to play havoc inside the body, only to surface with severe symptoms of opportunistic infections after this lull and, prove fatal. The asymptomatic period of HIV infection is also dubiously credited for accounting for the most transmissions from the infected person to others, as dual factors come to play : fear of severe stigma may force an informed infected person to forgo disclosure of his/her diseased status and fall into a state of denial, continuing with the daily business of living (have unprotected sex, donate blood, bear children) without taking precautions against the virus' transmission. The second factor may be ignorance of the nature of the infection itself : once the initial symptoms have disappeared, the infected person becomes asymptomatic, it may seem that whatever the ailment was, has now disappeared. The virus continues to exist in the body, not only destroying the immune system of the one infected but also turning him/her into a repository, from where the disease can spread to all who come into contact in a way that involves exchange of body fluid (s). Absence of symptoms creates a feeling of well-being and failure to take precautions against transmission.

The past twenty years of HIV/AIDS has seen a plethora of forums, discussions, conventions; planning and establishment of innumerable governmental and non-governmental bodies at local, national and global levels to deal with the pandemic in the burgeoning AIDS bazaar. Millions have been spent and still more pledged to find a cure, and prevent the spread by raising awareness and information levels. No doubt that a lot was (and continues to be) done with the right purpose, but the efforts have not really percolated to the grassroots where the danger of infection is still nurtured in the soil of ignorance. The proof is the ever increasing number of infections per day-almost 16,000 people. Commercial sex workers still fight shy of insisting on the use of condoms, for fear of losing a source of paltry income, to the demanding customer who comes in to satisfy his urge and not to enjoy a candy while keeping it wrapped in its cover. Thousands of single men migrating to cities in order to alleviate their economic status continue to feel the pinch of sexual poverty as they leave their spouses behind in the native places, but carry the baggage of sexual urges-only to find release in commercial gratification of their pent-up desires without care or concern for long term issues like health and well-being. Monogamous wives are made vulnerable to infection consequent to the sexual escapades of their philandering husbands in patriarchal societies which turn blind-eye to such misdeeds but endorses the right of the husband to demand unprotected intercourse from his wife. Intravenous drug users continue to sell contaminated blood to pay for their next dose of narcotic substance. And, infected children continue to be born to unsuspecting mothers who are ignorant of their HIV+ status. Thousands of breadwinners continue to die, leaving impoverished families populated by dependents like children and aged who have to forego education or take up the cudgel of earning a living to keep them going from day-to-day. Agriculture continues to lose farm workers, lowering production of food grains; factories lose workers adding to their cost of production as new recruits have to be hired and trained to keep assembly lines going, till a new victim is claimed. Schools lose teachers who fall prey to the virus; students are lost as they abandon classrooms to pick up some form of economic pursuit to keep themselves going in the face of loss of parents. Society faces an increased number of delinquents as families disintegrate. Medical resources are stretched to their thinnest limits as more and more people develop symptoms as the disease progresses. All around it is as if society is being tested to its limits. Yet, ask an average person on the streets, and you will find that prevention against HIV infection (if he/she is aware of the phenomenon) is way down in his/her list of priorities for the day. education/information can do just that much-provide the tools for safeguarding. Whether that tool is used in a sustainable manner to fight refractory behavior cannot be guaranteed at all. The irony of HIV infection is that although it leaves an all-permeating effect on our lives, both inside and outside our homes, it starts with the most intimate of all behavior that takes place behind closed doors-where no policing is possible, save to believe in the fact that good sense will prevail and instead of being carried over by the throes of passion some thought will be spared to "prevention" of self and the partner. Why have we become so complacent even in the face of devastating fallout's staring from all sides? Is it that HIV has also become a "20 year wonder"? New issues crop up everyday-the old are abandoned, or stored, at best, at the back of our minds, never to be spared a thought in the scheme of daily things. That is the general nature of things. Every year, on December 1, the world commemorates AIDS Day. The people are shaken of their slumber, only to fall into a state of ignorance weighed ennui once again. All over the world, diseases that had once lost their clout, thanks to the advances in medicine and awareness, are raising their ugly heads once again to strike the immune-compromised human body-diseases like pneumonia, tuberculosis, rare cancers, sexually transmitted diseases like gonorrhea and syphilis. The availability of treatments in the form of expensive drug cocktails for HIV/AIDS holds promise for a very few, that too in affluent countries. The rest of the world-where AIDS is most potent, like Africa and South East Asian countries-still have to count on the efforts of information, education and prevention to make them go through the day. Conservative societies where sex education is still a taboo, activists continue to struggle to include AIDS-related education in the curriculum of daily living. That does not stop an adolescent from indulging in sexual activities; nor provide any impediment in the path of the man seeking the services of a prostitute. Blood safety considerations serve as minimal deterrence in places where supply is scarce and a thriving black market dictates the terms of availability. Ignorant reuse and unscrupulous re-marketing of disposable equipment-all continue without bated breath. Porous environment like this provides a golden opportunity for an infectious agent like HIV to circulate in a much wider area. Are we really victims of ignorance? Or, have we entered a stage of information-fatigue consequent to over exposure, courtesy the media? Even people who are well aware of HIV/AIDS refuse to acknowledge it as a serious threat to them or their families. Pushing aside or ignoring an issue has never solved any problem. Each and every individual must play a responsible role, both at personal and social levels, to act so as to adopt prevention against the transmission of the virus in a sustainable way : change behavior, value systems, educate others, always be aware of the risks on a personal level and, adopt a compassionate attitude towards those who have already succumbed. Only then will the fear of stigma and ostracization dissolve-the single most effective deterrent in the path of owning up to one's infected status and put an end to playing a vector. "It cannot happen to me" is not a solution-remember, the virus loves an ostrich.

More articles by Debashree

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