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Antiretroviral Therapy (ART) is one of the most important pillars in the global fight against HIV/AIDS, transforming the disease from a life-threatening condition into a manageable chronic illness. ART involves the use of a combination of antiretroviral drugs that suppress the replication of the human immunodeficiency virus (HIV) within the body, reducing the viral load to undetectable levels. This not only improves the quality of life and life expectancy of individuals living with HIV but also significantly reduces the risk of HIV transmission to others. Early initiation of ART is critical and is recommended for all individuals diagnosed with HIV, regardless of their CD4 count or clinical stage, as it helps prevent disease progression and opportunistic infections. The therapy typically combines drugs from different classes to prevent drug resistance, which can occur if the virus adapts to a single medication. Despite its proven effectiveness, access to ART remains uneven, with barriers such as stigma, limited healthcare infrastructure, and socio-economic factors hindering widespread availability in many low- and middle-income countries. Recent advancements, including long-acting injectables and simplified treatment regimens, aim to enhance adherence and accessibility. Global health initiatives continue to prioritize ART scale-up, as achieving universal coverage is essential to ending the HIV/AIDS epidemic and meeting the United Nations Sustainable Development Goals.
The national antiretroviral therapy (ART) coverage demonstrated consistent improvement, rising from 62% in 2015-16 to 84% in 2021-22, representing a substantial advancement in treatment accessibility. Southern states, particularly Kerala and Telangana, achieved near-universal coverage of 95% by 2021-22, setting a benchmark for other regions. Notably, Manipur in the northeastern region showed remarkable progress, with coverage increasing dramatically from 55% in 2015-16 to 90% in 2021-22. Traditional lower-performing states also made significant strides, with Bihar, Jharkhand, and Rajasthan all-surpassing 85% coverage by the end of the study period. However, the analysis also unveiled persistent regional disparities. Some regions consistently lagged behind the national average, with Uttarakhand and Delhi reporting relatively lower coverage rates of 67% and 73%, respectively, in 2021-22. The findings underscore both the overall success of India’s ART program and the continuing challenges in achieving uniform coverage across all states and union territories. The achievement of near-universal coverage in some states demonstrates the feasibility of high ART coverage rates within the Indian healthcare context, while the persistent regional variations suggest the need for focused attention on underperforming regions to ensure equitable access to HIV treatment nationwide.
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