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HIV in India
  Burying differences to tackle HIV/AIDS in India
HIV prevalence rising among newly-weds

Rahul Kumar
OneWorld South Asia
26 October 2005
New Delhi: India has been under a global scanner for over a year because of the HIV/AIDS epidemic which international agencies and Indian non governmental organisations (NGOs) say is growing phenomenally though the Indian government has denied it. The controversy has ballooned to include accusations that the HIV/AIDS problem is being unduly magnified to attract international funds. The irony lies in the fact that Indian organisations are sparring even as the infection soars in the country.
The country erupted into a major debate over AIDS figures after the chief of the Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria, Richard Feachem said that the number of people suffering from HIV/AIDS in India had exceeded those in South Africa, which has 5.3 million cases. He said that India might have nearly 8.5 million sufferers.
The Indian government reacted sharply to these statements and released figures jointly with UNAIDS which say that India has 5.134 million people infected with AIDS and that these figures have been vetted by the World Health Organisation (WHO). The Indian government has also tried to blunt comparisons with South Africa by saying that while 21-23 per cent of the South African population is stricken with the infection, less than one per cent of the Indian population suffers from the disease.
HIV prevalence continues to increase in India and that there are major inter-state disparities. The country is vulnerable to HIV because of its huge population, widespread illiteracy and ignorance, poverty, poor health access and stigma that prevails not only in the population but also amongst doctors. The primary cause of the spread of the infection is heterosexual sex, blood transfusions and intravenous drug use.
The causes for the infection vary because of differences in the regions. In certain south Indian states sex workers are believed to be the main reason for the infections, while in north east India and the metropolises intravenous drug use amongst the youth is a major cause.
India gets funds from the World Bank, USAID, Department for International Development (DFID) of the UK government, the Bill and Melinda Gates Foundation for its HIV/AIDS efforts. The World Bank and DFID would fund the National AIDS Control Organisation (NACO) which falls under the Union Ministry of Health and Family Welfare. But with the recent advent of international agencies Indian NGOs are also looking forward to massive funding for their work on AIDS, primarily from the Gates Foundation.
The first HIV case was reported in 1986 from the south Indian metro city of Chennai - the capital of Tamil Nadu. Though India had launched its HIV-prevention programme in the very early stages of the epidemic and has tried to keep up with the dynamic ever-changing scenario, its huge and ever-growing population makes it highly vulnerable to the infection.
In 1994 the country also introduced free antiretroviral treatment in government hospitals in six states. Earlier this year trials of drugs to combat the epidemic were conducted in a number of states in India.
Though awareness about the infection has been increasing steadily, impediments like stigma persist. Last year two children in the south Indian state of Kerala, a state that boasts of literacy levels akin to the West, were denied admission to schools as they were the victims of the disease. Cases of infected women having been thrown out of homes have surfaced in the media. Even in New Delhi, the capital of India, the media has reported cases of doctors not attending to AIDS patients out of fear.
Many experts say that unless the disease is treated like any other sexually treated disease (STD) HIV/AIDS would continue to spread. People have to understand that the disease, over a period of time, has spread in the society and is no longer confined to the high target groups like sex workers or truck drivers. Also the epidemic has moved from urban to rural areas.
The seriousness of the infection is such that the United Nations has added it prominently in its Millennium Development Goals (MDGs). MDG six - Combat HIV/AIDS, Malaria and Tuberculosis - says that HIV/AIDS, tuberculosis, and malaria are among the world's biggest killers and impact poor countries and poor people more than anyone else.
Target 7 of the MDGs says that the international community should make efforts to stop HIV/AIDS by 2015 and thereafter should be able to reverse the spread of the disease.
For Indian organisations - the government as well as the NGOs - the need of the hour is to bury differences and get together to tackle the infection at the earliest. Otherwise, the economic burden brought about by HIV/AIDS will start eating into the progress that the country is currently making.
HIV prevalence rising among newly-weds
[Tuesday, October 25, 2005 12:22:35 am TIMES NEWS NETWORK]
HYDERABAD: Even as the government is contemplating the proposal of pre-marital HIV testing, the number of newly-weds turning out to be HIV positive is increasing in the state. At several HIV counselling centres in the city and around the state, 90 per cent of the support seekers are recently married young couples.
"I have noticed this trend in the past one year, where women aged between 18 years and 25 years, who were recently married and contracted the disease from their husbands are approaching us in large numbers," said P V Ramesh, president of the NGO, Telugu Network for HIV Positive People (TNHPP) where all the members giving help are also HIV-positive.
These young women are tested either at the time of their first pregnancy which in most cases is within one year of marriage or when their husbands fall sick or die. Statistics available with the AP State Aids Control Society (APSACS) show that 80 per cent of the women are monogamous or have relations with just one man, who is their husband in case of married women.
For men, the means of contracting the virus are many. Experience of many NGOs providing counselling for the infected shows that a lot of young men are contracting the virus from having sexual relations with an older lady in the neighbourhood. "They have physical relationships with these 'aunties' whose husbands are away.
The 'uncle' would have contracted the disease during one of his tours and gives to his wife who in turn passes it on to the younger man. This young man gets married and infects his wife. The cycle is the same in the cases of almost every newly-wed couple who comes to us for counselling," said K Badri, a counsellor with the city-based NGO, Cheyutha.
This means of contracting the virus is not restricted to a particular economic class. In many districts, there are cases of young boys who have indulged in MSM or male-sex-with-male. The TNHPP has been getting at least four to five cases of MSM in each district in the past year, where 16 to 18-year-old boys are involved.
MSMs, truck drivers, sex workers all these come under the high-risk group. However, recent studies by APSACS show that even the general population is showing high-risk behaviour. The figures this year show that out of the total infected population in the state, 45 per cent are in the 15 to 24 year bracket and another 45 per cent in the 25-49-year bracket.
According to the counsellors at the city-based Network for HIV Positive People where 'positives' counsel fellow 'positives', the high-risk group should now include college-going boys and girls as well. "Many young college boys and girls are finding it easy to indulge in pre-marital sex as there are many brokers around the city who can provide them with a room at a nominal rate.
They form more than 90 per cent of the people approaching us for guidance on what to do after being diagnosed HIV positive," said M Swapna, president of the network.
However, these 'positive' people working to aid other 'positive' people, feel while pre-marital testing could be useful to some extent, there is no guarantee that either the husband or the wife would not indulge in unsafe sex after marriage. "People should themselves start realising their moral responsibility to their partner and be safe," Swapna said.
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