At least a dozen HIV-positive people have committed suicide in Assam in the last few months while hundreds of others are struggling for survival as there is virtually no access to treatment.
"We have details of about 10 HIV-positive people who committed suicide in recent months. The situation is indeed alarming as there could be more such people who might have ended their lives unable to cope with the stress," Jahnabi Goswami, president of the Assam Network of Positive People (ANPP), told IANS.
Goswami, 30, is one of the few women in India fighting to raise awareness about the disease and also belongs to an even smaller category of people who have publicly declared they are HIV-positive.
Although Assam is one of the few Indian states to have set up Voluntary Counselling and Testing Centres (VCTC) in almost all districts, the fact remains that the recent cases of suicide were a result of people not being able to come to terms with reality.
"There are some very dedicated counsellors. But in some cases one finds certain lacunae in the way post-test counselling was done," Goswami said.
Counselling apart, hundreds of people living with HIV/AIDS are passing agonising days with no access to treatment. The state has just two Anti Retroviral Therapy (ART) roll out centres - one each at the Guwahati Medical College and the Assam Medical College in Dibrugarh.
ART is a combination of medicines that helps a person living with HIV to fight off infections and live a longer life, although it is not a cure. Besides, ART also significantly impact transmission by reducing the viral load concentration and minimising the risk of transmission to their sexual partners.
"Access to comprehensive care and treatment has been a distant dream for people living with HIV/AIDS in Assam," Goswami said.
There are many tales of woes.
"One of our members died recently at a hospital in Silchar without any medication, while many more are not even getting the mandatory opportunistic infection medicines with the authorities saying there is no supply. Many like us are suffering without any access to treatment," said Maniruddin Laskar, general secretary of the Barak Valley Network of Positive People in southern Assam.
"There is just one CD-4 Count machine in Assam, a vital component for managing HIV."
There are no official estimates or studies to ascertain the number of HIV-positive people living without any medication in Assam.
"It is difficult to say how many HIV-positive people are living without medication. We have about 500 such people enrolled with the ART roll-out centres although not all positive people requires ART," Shyamala Rao, head of the government-run Assam State AIDS Control Society, told IANS.
India accounts for about 5.7 million HIV-positive people, reportedly surpassing South Africa.
India's northeast has been declared as one of the country's high-risk zones with close to 100,000 people infected with HIV. There are some 1,750 HIV-positive people in Assam although unofficial estimates put the number at close to 30,000.
Despite the National AIDS Control Organisation (NACO), India's apex healthcare body to fight HIV/AIDS, promising appropriate care and support to persons infected with the disease and rational treatment for follow up of HIV related illnesses, in reality it is a far cry.
"The number of Voluntary Counselling and Testing Centres should be equally matched by professionally trained physicians for ART management. Otherwise the entire efforts at controlling the epidemic would be futile," S.I. Ahmed, head of the AIDS Prevention Society, a leading community healthcare group in Assam, said.
"Not being able to access treatment is a matter of serious concern."