A RECENT blitz in the world media about the widespread increase in the incidence of HIV through used needles in Asia, specifically naming India, has refocused attention on AIDS. Also, a World Health Organisation (WHO) study claims that atleast half of all medical injections in a group of 17 developing countries (including India) "were unsafe," and that the epidemic has been fuelled by the reuse of disposable needles. Dr Bernhard Schwartlander, director of the AIDS programme for WHO, says the problem is greatest in Asia, as needle reuse and frequency of medical injections are most common here.

Indian doctors have a different viewpoint. "Unsterilised needles cannot transmit HIV," says Dr Madan Gaekwad, director, Sagar Apollo Hospital, "This only happens when drug addicts pass around a syringe. The HIV virus is highly unstable and gets killed within minutes." The main causes for HIV transmission. The greatest cause of HIV transmission in India is still unprotected sexual contact. This is followed by transmission of infected blood from mother to unborn child, he says.

Microbiologist Dr SK Amarnath says the quantity of blood required for transfer of HIV is 0.02 ml. There is a much greater risk from hepatitis B which requires only 0.00004 ml of infected blood to effect a transfer and is a far more stable virus, remaining alive for far longer.

"Reused needles transmitting HIV occurs more in north-east India, because of widespread drug abuse," says Dr Amarnath, "It might also be more prevalent in smaller. towns where stringent sterilisation practices don't exist, and quacks might abound, but not in larger hospitals in big cities."

In fact, many hospitals follow strict norms of waste disposal. Says Rajesh Pandey of Manipal Hospital, "There are international waste disposal norms, where colour-coded waste is separated into 10 categories. We have our own inhouse systems, and all waste is disposed in the prescribed way. " Dr Gaekwad adds, "We have a waste management cell at Sagar Apollo and an agency which takes care of waste disposal." So the problem of HIV through reused needles is less acute than projected. Says Dr S Ramesh, consultant physician, "Unsterilised or reused needles are a greater cause of diseases like tetanus and hepatitis." He advises, "Buy syringes and needles from reputed medical shops, which won't trade in reused items. Check the expiry date. They shouldn't look tampered with or dark." Though the number of drug users getting the virus is less in Karnataka, it cannot be ruled out, he adds.

"Drug users hit a vein, draw blood and then inject the drug," says Dr Amarnath, "The needle is passed on the next user within minutes. This is when the virus gets transferred." There have been few major de-addiction programmes or systematic studies undertaken in Karnataka, he says, and drug abuse is on the rise.

The biggest problems regarding HIV and AIDS are widespread myths and fears, he says. Large scale general awareness programmes and counselling are needed on a war footing.