Last night was the "AIDS in India" show. It did not turn out how I wanted but we were able to raise around 200 dollars for ASAAP. Noelle, Mandippal, and Alysha performed; all were amazing as expected. I was too sick to sing but I [barely] managed to get through my short talks on HIV prevention in India. (Buckley's Decongestant Liquid was in full force.) Dr. Krell and Dr. Deshpande gave short talks as well. Iman refused to dance – I guess I should think again before asking performers with bigger egos than talent…
After the show, I realized how difficult fighting preventing HIV/AIDS in India will be. I just hope I'm strong enough to persist.
The following is an excerpt from a piece I wrote on AIDS in India:
To answer the question, the virus must become extinct for AIDS to discontinue. As such, biologists in the medical field must find a cure to destroy the virus within the body. Sadly, however, biological medicine has become highly commoditized and, as was mentioned, HIV/AIDS most greatly affects those with little money living in the undeveloped world. The director of the HIV/AIDS programme at Human Rights Watch, Joanne Csete, was quoted saying, "It is a sad irony that India is one of the biggest producers of the drugs that have transformed the lives of people with AIDS in wealthy countries. But for millions of Indians, access to these medicines is a distant dream."
To protect future generations from acquiring the virus, the social aspects of AIDS transmission must be looked at. Through prevention and safe sex education and practice, new cases of HIV/AIDS will decrease and eventually, if there are no new cases, then the virus will die out. Bringing safe sex practices into a culture is something that can be done by the people and does not require a doctrine or lab funding.
Still, it is very unlikely every infected individual in the world will practice safe sex. Research from both disciplines is currently required to end the issue at hand, focusing on the five major groups and their interconnected relationship.
Although injecting drug use has declined from 13% to 10% in 2005, it is still an issue for HIV transmission in India. It is difficult to pass on knowledge about HIV transmission to this group. There are very strict laws against drug usage in India which in turn make it hard to actually reach out to this group of people. More importantly though, it must be known that needle-sharing has implications that go beyond the circle of drug users. The government must allow HIV messages regarding needle-sharing to be presented to this group if changes are to be made. Many injecting drug users are male truck drivers. India has one of the largest road networks in the world, involving millions of drivers and helpers. "There is no entertainment. It is day-in-day-out driving... When they stop, they drink, dine and have sex with women. Then they transfer HIV from urban to rural settings."[i] Truck drivers not only infect the women the sleep with on the road but their wives when they return home. Improvements must be made regarding economic and personal benefits for truck drivers. Their travels must be kept shorter giving them time to go home to their families and not resort to drug use and one-night-stands.
Research has shown there is a direct correlation between stigma/discrimination and a young gay male's risk of HIV. "Feeling accepted and supported as a young gay man is very important in terms of self-acceptance and self-esteem. Having high self-esteem among young gay men has been shown to have positive impact on confidence about negotiating sexual relationships and practicing safe sex.."[ii] Permissive laws which equalize the rights of gay men with others in the population can help normalize sexual differences and cause decline in stigma surrounding homosexuality. The social stigma makes it difficult and at times dangerous for young men to disclose their sexuality and 'come out'.[iii] In India, homosexual sexual intercourse is illegal and can hold a 10-year jail sentence.[iv] These anti-homosexuality laws were drafted by the British in 1861. Also, Section 377 of the Indian penal code prohibits "carnal intercourse against the order of nature with any man, woman or animal".[v] Denis Broun, UNAIDS India coordinator, said: "Criminalization of people most at risk of HIV infection may increase stigma and discrimination, ultimately fuelling the Aids epidemic."[vi] "It [the law] can adversely contribute to pushing the infection underground and make risky sexual practices go unnoticed and unaddressed," a Naco (National AIDS Control Organization) statement said.[vii] The Indian government must abolish laws against homosexual activity to decrease stigma and discrimination. Since homosexual sex is illegal and homosexual relations are frowned upon, many gay young men marry women. These men secretly continue to have sex with other men, thereby increasing the likelihood of being infected and infecting their wives with HIV.
Unfaithful heterosexual men place themselves and their wives at high risk of being infected with HIV, particularly when they engage in sexual intercourse with sex [street] workers. Sex work is very common in India compared to many other countries. Although brothels and other forms of organized sex work are illegal, sex work is not strictly illegal in India. Women usually turn to this work because of poverty, marital break-up, or because they are forced into it. The government has plans to introduce stricter legislation regarding sex work. This change has been opposed by organized sex worker groups who claim that such legislation would just push the trade underground and make it harder to regulate. It would also make it more difficult to reach sex workers with information about HIV. One national study suggested that 42% of sex workers believe that they can tell whether a client has HIV based on physical appearance. Misinformation and lack of information about AIDS within this group is widespread. To tackle this problem facing the sex workers in Mysore, a 'smart card' scheme has been implemented. Sex workers are given cards that they must present at a health check-up at least once every three months to remain valid. These cards read their medical details/status. These same cards can be used to get discounts for food and clothes in certain shops if the sex worker continues to go to her medical appointments. This encourages sex workers to look after their own health. This plan raises sex workers' self-esteem by integrating them into mainstream culture and thereby, helps them negotiate on condom use with clients. Also, in 1992 the Sonagachi project was implemented. The basis of this project is the three R's: Respect, Reliance and Recognition – respecting sex workers, relying on them to run the program, and recognizing their professional and human rights. Sex workers act as peer-educators and are sent to brothels to teach others about HIV/AIDS and condom use.[viii]
In India, the monogamous housewife is at greater risk of being infected with HIV/AIDS than a sex worker. The rising number of women (over 1.9 million at the last count) afflicted with AIDS is causing alarm in the Indian medical fraternity—especially since more than 90% of these are married women and are in a monogamous relationship.[ix] As the campaign says, these faithful housewives must ask the question "I care for you. Why don't you care for me?" Microbicides will give Indian women the chance to protect themselves from HIV but still be able to get pregnant, which is very important with the social pressures to produce a son. In addition, men in India must be taught the ABC (Abstinence, Be faithful, Condomize) method, with emphasis on being faithful to their wives.
The biological and anthropological issues facing the five groups must be addressed and the interconnected relationship between these groups must been kept in mind to solve the problem at hand.
"The challenges India faces to overcome this epidemic are enormous. Yet India possesses in ample quantities all the resources needed to achieve universal access to HIV prevention and treatment… defeating AIDS will require a significant intensification of our efforts, in India, just as in the rest of the world."[x]
[i] (2006). "HIV and AIDS in India: Who is Affected?". Avert. Retrieved 13 November 2006 from the World Wide Web: <http://www.avert.org/hiv-india.htm>
[ii] (2006). "HIV, AIDS, and young gay men."Avert. Retrieved 13 November 2006 from the World Wide Web: <http://www.avert.org/aidsyounggaymen.htm>
[iii] IBID.
[iv] (2006). "Anger at 'Shameful' India gay laws." BBC News. Retrieved 13 November 2006 from the World Wide Web: <http://news.bbc.co.uk/2/hi/south_asia/4602068.stm>
[v] (2006). "India HIV group backs gay rethink." BBC News. Retrieved 13 November 2006 from the World Wide Web:
[vi] (2006). "Anger at 'Shameful' India gay laws." BBC News. Retrieved 13 November 2006 from the World Wide Web: <http://news.bbc.co.uk/2/hi/south_asia/4602068.stm>
[vii] (2006). "India HIV group backs gay rethink." BBC News. Retrieved 13 November 2006 from the World Wide Web:
[viii] (2006). "HIV and AIDS in India: Who is Affected?". Avert. Retrieved 13 November 2006 from the World Wide Web: <http://www.avert.org/hiv-india.htm>
[ix] Khosla, Surabhi. "AIDS and the married Indian Woman." The South Asian. Retrieved 13 November 2006 from the World Wide Web: <http://www.the-south-asian.com/June2005/AIDS-Women-in-India.htm>
[x] (2006). "HIV and AIDS in India: Who is Affected?". Avert. Retrieved 13 November 2006 from the World Wide Web: <http://www.avert.org/hiv-india.htm>
