AIDS/HIV

AIDS/HIV Ever since India's first AIDS case was reported from Mumbai in 1986, the HIV/AIDS (human immunodeficiency virus; acquired immunodeficiency syndrome) epidemic has posed a huge threat to the country. Many of India's 1.3 billion people do not as yet understand how potentially dangerous a health issue AIDS has already become, despite the fact that five million Indians have been infected by HIV/AIDS, according to official estimates. Prevalence rates of HIV/AIDS among the working age population (between the ages of 15 and 59) is 0.9 percent. Close to 90 percent of the cases reported fall within India's working age population; 25 percent are women. As reported by the United Nations (UNAIDS), India also houses around 170,000 HIV-infected children, most of whom are either already orphans or will soon become orphans.

India's National AIDS Control Organisation has arrived at these figures by using sentinel surveillance data collected from several sources: women attending antenatal clinics; STD (sexually transmitted disease) clinic attendees; injecting drug users; and men who report having sexual relations with men. However, the data do not include rural areas, private hospitals, or other groups of people, including those with cases of full-blown AIDS, sex workers, and people who do not fall into the age group of 15 to 49. This deficiency has caused widespread criticism of the reliability of the figures supplied by the government of India. Other sources put the figures much higher. Various health workers in the country have estimated the current number of HIV/AIDS-infected Indians as close to 10 million.

Indian states have been divided into three groups according to their HIV/AIDS prevalence rates. Group I states, called high prevalent or generalized epidemic states, include Maharashtra, Tamil Nadu, Karnataka, Andhra Pradesh, Manipur, and Nagaland; in these states, infection rates have risen over 1 percent in antenatal women. Group II states, called moderate prevalent or concentrated epidemic states, include Gujarat, Goa, and Pondicherry; infection there is 5 percent or more among high-risk groups but is below 1 percent among antenatal women. Group III states, called low prevalent states, include all the other states of India; the HIV infection rate in this group is less than 5 percent in high-risk groups and less than 1 percent in antenatal women.

HIV/AIDS in India is transmitted through unsafe sex, from mother to child, and among injecting drug users. The prevalence of HIV/AIDS in India is especially troubling because of its rapid spread to the general population. It is no longer an urban sickness contracted only by high-risk groups. It is, on the one hand, spreading to the general population through bridge groups such as truckers (about 4 million men). Its spread is geographic as well, reaching far-flung villages of the vast country. It is thought that the disease will continue to spread at an even faster pace.

The future scenario of India's HIV/AIDS epidemic is especially grim. According to official accounts, approximately 25 percent of Indians live below the poverty line. Poverty increases the incidence of HIV/AIDS in several ways. Poor people are not able to afford medical treatment, either for HIV or for other infections. Poverty also forces some people to sell sex in order to earn a living; others sell their blood, which is often contaminated. Ignorance and lack of awareness about the AIDS epidemic has also increased India's vulnerability. The National Behavioural Surveillance Survey in 2001 found overall awareness of HIV/AIDS in India to be only 76 percent. The survey also noted that nearly 7 percent of the adults of the country reported having sex with non-regular partners in the previous twelve months. Only 33 percent of these people reported consistent condom use. The stigma attached to AIDS, and to the people infected by it, further contributes to the suffering of those infected, and discourages people from seeking testing and treatment. Many people will not even discuss the disease. Attacks against HIV/AIDS patients are widespread, and in some villages, HIV-infected people are treated as outcasts.

The AIDS control program in India receives help from the United Nations, the World Bank, major international nongovernmental organizations, and other private organizations, including the Bill and Melinda Gates Foundation. However, it remains to be seen whether such initiatives, bereft of a vigorous, pro-active, and open public campaign, will be able to eradicate the disease from India; even those countries that have carried out nationwide campaigns have achieved only limited success after a very long period.

The government of India, after some initial hesitation, has realized the need to urgently address the HIV/AIDS situation in the country. The government-led initiative to bring the situation under control has focused on the following areas among others:

• Ensuring blood safety
• Implementing programs to reduce the spread of sexually transmitted diseases
• Promoting condom use
• Emphasizing the importance of information, education, communication, and social mobilization
• Giving care and support for people living with HIV/AIDS
• Training the public on HIV/AIDS/STD prevention and control (through workshops, etc.)
• Targeted interventions (among the most vulnerable and marginalized populations)
• Providing facilities for voluntary counseling and testing

Happymon Jacob

See alsoHealth Care

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