This Bangalore doctor has been treating people with HIV since 1998

It was in 1987 when a very sick, unmarried, American man was admitted to Bangalore Baptist Hospital. His deteriorating condition led him to the ICU where he asked his treating doctor, Dr Glory Alexander, an infectious disease specialist, if he had AIDS, adding that his HIV test was negative in the US. His blood sample was sent to CMC, Vellore as there was no HIV testing facility at that time in Karnataka. The man breathed his last in a few days, after which the doctors received his HIV Positive test report. Since nobody claimed his body, it was handed over to the American embassy. Despite knowing he was HIV positive, the man hid it. He had chosen to spend his last days at an Ashram in South India and to stay away from the stigma in the US. “His death perturbed me,” recalls Dr Glory, now in her 60s. 

She has been working for the cause of HIV for the last 26 years. It was his case which motivated her to dedicate herself to the cause. In 1998, Dr Glory with like-minded supporters, established the Action, Service and Hope for AIDS (ASHA foundation), a charitable Trust helping HIV/AIDS-infected people, their families and society in Bangalore. “The fact that he chose to die away from his family, society and country to avoid discrimination, shook me. When he asked me if he had HIV, he perhaps gave me a hint,” says Dr Glory. 

Launched Karnataka’s first AIDS helpline

One of the first initiatives of ASHA was the AIDS helpline, an Interactive Voice Recording System (IVRS) was launched in June 1998. They have marked 4 lakh calls so far on the helpline. “Most of the callers initially were of the age group 19-35 years. It included those who were concerned about contracting the infection after sexual contact,” says Dr Glory.

In the initial phase of her work, Dr Glory observed a pattern of HIV-positive men transmitting the infection to their wives and to kids in some cases. There were young widows left with no hope. “The in-laws would blame the woman for the man’s death and refuse to take care of her and her children. The response would be no different in her parent’s house. The young HIV-positive widows faced rejection and were left with no support and financial aid. This was the pattern until early 2000. Our services catered to their medical needs and assisted them in building self-help groups and to live a dignified life,” says Dr Glory.

ASHA’s five service projects include:

1. HIV counselling and testing services
2. Adolescent Health Education Project (workshops conducted in schools)
3. Children-at-Risk Project (catering HIV infected and affected children)
4. The Prevention of Mother-to-Child Transmission (PMTCT) of HIV Project
5. Camp Rainbow Project (for children living with HIV)

For her unwavering dedication, Dr Glory has been honoured with multiple accolades including the Dr B C Roy Award in 2016, the highest Indian award in the medical category. 

ART, the magic bullet

Dr Glory emphasises that the most significant support for people living with HIV (PLHIV) has been Antiretroviral Therapy (ART) available in India since 2004. Initially, the ART was restricted to those whose Cd4 count was below 250 cells. Cd4 count is the measure of Cd4 cells in the body that fight an infection. It reflects the fight against the immunity system and it should ideally be between 500 -1400 cells per cubic millimeter of blood.

“Earlier, due to the side effects of the medicines, the ART was not given to every PLHIV, unless one meets the threshold criteria of Cd4 counts. Now the policy is to ‘test and treat’ every positive case as the side effects of the medicine are minimal,” says Dr Glory, who firmly believes that ART is the magic bullet.

“ART is the lifeline of hope, which has made a huge difference. Adherence to daily medicine is a must. ART has resulted tremendously in bringing down the viral load to undetectable levels. If the viral load is undetectable, the infected person does not spread the infection to anyone. In HIV, undetectable=untransmittable, as described by the joint United Nations Programme on HIV/AIDS, (UNAIDS)” she adds.

The highest viral load, 77 lakh, was seen in a man aged 42 years, in 2017 at ASHA, recalls Dr Glory. With strict adherence to the ART regime, his viral load came down to undetectable levels. “Counselling requires adherence to medicine and to take it every day at the same time,” she adds.

HIV: No more a life-threatening disease

Dr Glory is content that, in her lifetime, a once life-threatening disease associated with stigma and discrimination has now become a manageable infection with medicine and the person integrating to society, without spreading the infection to others.

PLHIVs need to be on ART every day to ensure viral suppression and be at zero risk of transmitting HIV. “Apart from taking ART, it is important to check the viral load regularly,” she adds.

Dr Glory and her team played a vital role in preventing mother-to-child transmission of HIV. “HIV-positive pregnant women are treated so that their babies are born HIV-negative. So far, over 2.3 lakh pregnant mothers have been tested for HIV under our project, of which 1102 were HIV positive. The risk of transmitting HIV from mother to child has been reduced from 45% to 1.6% in our cohort,” says Dr Glory, adding that the last HIV-positive baby born was in 2013 in ASHA’s network.

ASHA also conducts a five-day residential camp for children with HIV, to teach them life skills, counselling HIV awareness and medication adherence. “In the same camp, we train volunteers,” says Dr Glory, whose motto remains saving lives, improving quality of life and eliminating the stigma associated with HIV.