The growing number of HIV-positive cases in Leh district has emerged as a serious public health concern, with health experts urging urgent action, awareness, and de-stigmatization. Since 2009, Leh has reported 84 confirmed cases of HIV—21 among local women, 16 among local men, and 48 among non-local residents. Thirteen individuals, all between the ages of 40 and 45, have died from AIDS-related complications. 

This year alone, by the end of June 2025, six new cases have already been confirmed. Health workers are now sounding the alarm over a concerning trend: many of the new cases involve co-infections, including Hepatitis B and tuberculosis, which can severely complicate treatment and recovery.

“We are seeing a rising number of patients with dual or even triple infections,” said Stanzin Dolma, Counsellor at the Integrated Counselling and Testing Centre (ICTC) at SNM Hospital, Leh. “This makes timely diagnosis and treatment all the more critical.”

HIV (Human Immunodeficiency Virus) primarily weakens the body’s immune system by targeting CD4 cells, which are crucial for fighting infections. If untreated, HIV progresses to AIDS (Acquired Immunodeficiency Syndrome), leaving the body vulnerable to potentially fatal opportunistic infections.

Stanzin Dolma explained, “One of the most important indicators of HIV progression is the CD4 count. A healthy person has a count between 500 and 1500. When it drops below 350, the immune system is significantly compromised. This is when symptoms like rapid weight loss, oral fungal infections, and appetite loss starts to appear.”

Adding to the health concerns in the region is the increasing number of syphilis cases. Syphilis, a sexually transmitted infection (STI) caused by the Treponema pallidum bacterium, is being reported more frequently, often alongside Hepatitis B and HIV—pointing to a trend of rising co-infections in Ladakh.

Another alarming trend is the increasing use of injectable drugs in Leh. Drug users are highly vulnerable to contracting HIV and Hepatitis B or C due to the practice of needle sharing. “This calls for urgent preventive education and strong community engagement,” Dolma stressed.

Although there is no permanent cure for HIV, the U=U (Undetectable = Untransmittable) model offers hope—if the virus is suppressed to undetectable levels through medication, it cannot be transmitted to others.

However, persistent stigma and lack of awareness remain the biggest barriers. “There is a dangerous myth that HIV doesn’t exist in Ladakh. People think it's only a concern for big cities,” Dolma said. “This kind of denial, especially in closely-knit societies, can be deadly.”

Despite the challenges, Leh’s ICTC center is equipped with reliable diagnostic facilities and provides free antiretroviral treatment (ART). Early detection has been key to managing infections and reducing transmission. Encouragingly, most recent HIV cases have been detected in the early stages.

Under the Prevention of Parent-to-Child Transmission (PPTCT) programme, all pregnant women are screened for HIV, Hepatitis B, Hepatitis C, and syphilis, allowing doctors to intervene early. So far, five HIV-positive cases in children have been detected—four are stable, while one involves an unborn child whose mother is currently pregnant. Thanks to early diagnosis and medical support, there is a strong possibility that these children will be saved from infection, reinforcing the importance of continuous awareness, routine testing, and community outreach.

She also highlighted that many avoid getting tested due to fears over privacy. “But I want to reassure the community—all information at our center is kept completely confidential. People must not hesitate to come forward”, she added.

Dolma emphasized that sex education is one of the strongest tools in combating such ignorance. “Sex education isn’t about promoting sex. It’s about understanding puberty, menstrual hygiene, safe practices, and respect. It’s about equipping young people with facts, not fear.”

Stigma continues to prevent many from speaking out or seeking treatment. HIV is not spread through casual contact—not through touch, sharing food, or hugging. It is transmitted through four well-defined routes: unprotected sex, infected blood transfusions, mother-to-child transmission, and shared needles.

“Education is the strongest tool we have,” Dolma said. “The more we talk about HIV, the more we normalize testing and treatment, the better we can protect our community.” 

All HIV testing and treatment at SNM Hospital are free and confidential. Patients are also given nutritional support and mental health counselling during treatment. With early detection, adherence to medication, and community backing, people living with HIV can manage the virus successfully and prevent transmission to others.

The rising HIV numbers in Leh are a wake-up call for the region. As Ladakh undergoes rapid social and cultural changes, the health system and community awareness must keep pace. Combating HIV is not just a medical challenge—it is a societal one. The tools for prevention, diagnosis, and treatment are already in place. What’s needed now is open conversation, education without fear, and collective responsibility. Only then can Ladakh ensure that silence and stigma do not become deadlier than the virus itself.