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World on Fire: Update on HIV and AIDS in India

Since 1988, December First has brought millions of people around the globe together to appeal and inform their governments in how important funding and research is needed in a disease that has now inflicted 40 million people around the world. The theme this year for World AIDS Day is “Stop AIDS; Keep the Promise – Accountability” but what does that mean?

The country with the most HIV/AIDS inflicted people is India at the global prevalence rate of 15%.

To many Americans, especially those of South Asian descent, the virus still seems “exotic” and found only in indigenous countries. As Bushra Bhatti, a rising medical student at the University of North Carolina at Chapel Hill observes, “Unfortunately, a lot of people of South Asian descent do fall into the mind set that it’s not their problem. That since they don’t know people who have AIDS, it doesn’t affect them, but the truth it’s a global epidemic. And even worse, it’s becoming, more and more, an epidemic for the poor. As citizens of the world who have more, we have a responsibility to do what we can to help those that are affected by this disease.”

So being fully “accountable” really wouldn’t make sense if it’s about a virus that isn’t exactly an everyday threat, right? Well as it turns out, HIV/AIDS has just made the world a lot smaller with new reports of how the virus is exploding in the sub-continent of India. From a culture of knowing how important it is to “keep” promises, South Asian Americans are beginning to realize that the HIV/AIDS epidemic has just entered the community.

Epidemic
Main Entry: ep·i·dem·ic
Pronunciation: “e-pi-‘de-mik
Function: adjective
: affecting or tending to affect a disproportionately large number of individuals within a population, community, or region at the same time

The Human Immunodeficiency Virus (HIV), the precursor to Acquired Immune Deficiency Syndrome (AIDS), first touched the subcontinent of India twenty years ago in the city of Chennai, Tamil Nadu. Diagnosed among commercial sex workers, the country soon set up screening centers, but focused primarily on foreigners, then moved along to blood banks. Major urban areas didn’t see HIV screening centers until the beginning of 1987, the same year that the government put the National AIDS Control Program into play. The program consisted of blood screening and products with disease surveillance with education. However, it wasn’t until 1992 that India’s National AIDS Control Organization (NACO) was born. NACO became the umbrella over the National AIDS Control Program, which also added a strategic plan for prevention that year as well. The project contributed to may breakthrough improvements in early HIV prevention in India.

“Unfortunately, a lot of people of South Asian descent do fall into the mind set that it’s not their problem. That since they don’t know people who have AIDS, it doesn’t affect them, but the truth it’s a global epidemic.”

It’s no secret in India that sex is a secret. With saxophone laced songs paired with scantly clad sirens, films hint at sexual desires but always with the result in pregnancy, not with something considered “unglamorous” as contradicting an STD. Consequently, a country with the world’s 2nd biggest population at 1,120,000,000, it’s understood that India’s been around the block a few times. More then 85% of the AIDS cases reported has been due through heterosexual transmissions. The rate of HIV prevalence in the state of Tamil Nadu, the birthplace of the virus in India, is 50% among sex workers. India may be home of the Kama Sutra but even more so, India is a country whose traditions are rooted in deep spiritualism and ancient religions. This epidemic alone has shown how venerable traditions are literally battling modern values with life and death. HIV/AIDS prevalence is the highest among the five states of Maharashtra, Andhra Pradesh, Nagland, Karantaka, and Tamil Nadu with less then 1% reported in antenatal clinics. The Joint United Nations Progamme on HIV/AIDS (UNAIDS) states “The latter two states were among the earliest in India to respond to the epidemic, and current trends reflect their sustained HIV prevention efforts over the past several years.”

The three elements that have been the fuel to fire this subcontinent’s epidemic and forcing the country to recognize its dirty secrets are prostitution, drug use, and homosexuality. Each subject forces a culture where familial honor and dignity are held up above self importance to acknowledge the skeletons that each owns in the closet. Every class level isn’t spared either, from rich playboys sharing needles to middle class families sending their sons to well trained “aunties” to save the family name on wedding nights to the impoverished men selling themselves secretly for pederast tastes.

With hit Bollywood films like Umrao Jaan and Chameli, prostitution is one vice that however glamorous portrayed is still an ugly and somewhat accepted truth in Indian society. While the business isn’t illegal, the trade is mainly located in big cities such as Calcutta and Mumbai with designated red light districts possessing with more then 100,000 employees. It’s estimated that close to 75% of Mumbai’s prostitutes alone live with the virus.

Another detrimentally growing factor is the use of infected needles for drugs. The North East region of the country is the primary site for this habit. A resounding belief is that the use of needles is combined with the services of the sex industry. NACO reported in April of 2006 that “Nationally, HIV prevalence among injecting drug users appears to have declined slightly in recent years, from 13% in 2003 to 10% in 2005”. Although the government does crack down on drug trafficking, rehab and treatment isn’t encouraged much, if provided.

“‘I thought it would be a minority thing, I could hardly even conceive of a male sex worker.” Partly that’s because in India, “even homosexuals don’t accept homosexuals…

While prostitution and drug use that may be socially regarded slightly, one element in the advancement of HIV/AIDS prevalence that has yet to be fully acknowledged and defined is homosexuality. The lack of acceptance has led most sexual activities dealing with homosexual circumstances to be paid for and in secret. Time Magazine‘s Alex Perry interviewed Dr. R. Lakshmibai of the Tamil Nadu AIDS Initiative last May who said how ‘shocked’ she was to find the number of male sex workers, “‘I thought it would be a minority thing, I could hardly even conceive of a male sex worker.” Partly that’s because in India, “even homosexuals don’t accept homosexuals, [Male] clients who pay for sex with a man don’t consider it sex at all.” In believing so, condom usage or even understanding the AIDS campaign isn’t recognized, Lakshmibai went on to say “a persistent myth is that AIDS is a ‘straight plague.’

The silence in accepting homosexuality in Indian culture also brings into the equation the status of the hijras. Known as the “third sex”, hijras are usually known in English terminology as eunuchs of ancient times, “the male takes on the appearance of a female and the female takes on the appearance of the male” as George Artola writes in his book, The Transvestite in Sanskrit Story and Drama. There hasn’t been an official consensus on the number of hijras living in India but the government estimates that it is close to 50,000 to 5 million.

In the same Time Magazine article, Perry writes about Neelu, a 26 year old hijra “an example of a culture many Indians would prefer to forget” from when they were integrated into society, even holding position in royal courts. The denial of full acceptance in society has denied hijras and homosexual any legal status in obtaining HIV/AIDS preventative programs such as testing, protection, or even condom distribution.

“Like witches in medieval Europe, hijras make money blessing clients and cursing their enemies. But they are also the dirty little secret of some rail commuters. Neelu speaks of servicing 20 men a day for as little as 50¢ each while wandering the platforms of Madras’ rail stations. On the lowest rung of India’s social order, hijras have existed almost entirely outside mainstream society. “No ration cards, no identity cards, no vote,” says Neelu. “Not even clients talked to us.” Now, paradoxically, “AIDS has given us respect and recognition. Health workers and government people come to us, accept us, treat us as human beings.”

When Bill Gates announced in 2003 his plans to donate $100 million dollars to India’s HIV and AIDS research, the Indian government went into an uproar

The Kaiser Family Foundation has reported with NACO to stating that the number of adults from ages of 15-49 living with HIV/AIDS in India has increased since 2000 by 35% despite being stable during 2003 and 2005. UNAIDS estimated that by the end of 2006, 5.7 million people of all ages will be living with HIV/AIDS in India with the prevalence rate of 0.9%.

“Once a country’s prevalence rate is greater then 1%, it is considered to have a ‘generalized epidemic’ and HIV may spread more rapidly.”
-The Henry J. Kaiser Family Foundation
HIV/AIDS in India
September 2006

Pandemic
Main Entry: pan·dem·ic
Pronunciation: pan-‘de-mik
Function: adjective
: occurring over a wide geographic area and affecting an exceptionally high proportion of the population

In 1920, a German meteorologist by the name of Alfred Wegener proposed a theory that a “super” continent existed at the time of the Paleozoic and Mesozoic eras. A continental drift occurred, breaking off each continent and sending it to the locations known today. The supercontinent was named Pangaea which was derived from the Greek word, Payyia, meaning “all of Earth [land]”.

Seventy years after Mr. Wegner defined to the world what Pangaea meant on a geological level, a new Pangaea has emerged. Sweeping “all of Earth” HIV and the AIDS virus have shown no proclivity in choosing its victims. From the orphans of Africa to investment bankers of New York, not one race, religion, gender, class, or age group has been protected from its domain. UNAIDS, in conjunction with the World Health Organization (WHO) published the latest statistics, as of November 2006, stating that an estimated population of 40 million are living with HIV/AIDS worldwide. The virus has already claimed the lives of 25 million since 1981.

The growing amount of HIV/AIDS infecting the people of India has send shockwaves through out the globe. Almost overshadowed by the attention that Africa has been given, India’s contribution to the disease has almost blindsided leaders and activists from within its country and abroad.

It’s a fact known that Africa possesses the highest HIV/AIDS prevalence in the world at 64% with 25.8 million living the disease but keep in mind, this is a continent made up of many countries. The country with the most HIV/AIDS inflicted people is India at the global prevalence rate of 15%. India is where Africa was ten years but is rapidly catching up.

Technically, a country can’t be considered part of the HIV/AIDS pandemic until its prevalence rate is greater then 1% which would mean the virus is infecting more people faster, India’s own prevalence rate was 0.9%. Holding the title of “The Country with the Most Rapid Population Growth”, India is the only nation on the planet that can fit all of Africa, Australia, and Latin America’s populations combined with still room to spare. The United Nations has predicted that by 2019, if enough aid is not given, India’s prevalence rate will be at 1.9% and 12.3 million will already be dead.

It’s simple for anyone from the outside to make generalized judgment and commentary on such a heavy issue while feeling that the “battle” is already lost; but there are things that anyone can do to help without being trust fund babies or on Forbes’ list of top ten millionaires.

The growing amount of HIV/AIDS infecting the people of India has send shockwaves through out the globe. Almost overshadowed by the attention that Africa has been given, India’s contribution to the disease has almost blindsided leaders and activists from within its country and abroad. But the first step in solving any problem is accepting and more importantly, acknowledging it. India’s government has yet to face this issue with the brutal honesty that its people and the world needs. When Bill Gates announced in 2003 his plans to donate $100 million dollars to India’s HIV and AIDS research, the Indian government went into an uproar, accusing the richest man in America was “spreading panic” with “complete inaccurate data” in its country.

The HIV/AIDS campaign in India does receive a small amount of public money despite having to deal with attacks by angry mobs but overall funding is provided from countries, businesses and philanthropists from abroad. Internally, India is a country conflicted with two sides; one who wants to educate the masses of the dangers and protection from the virus to those who believe such education will be the corruption of India’s morals and values. Now more then ever though, resources and contributions are needed as the disease has already taken the country in a stronghold as S.Y. Quraishi, the director general of NACO told Perry for Time, “The world’s battle against HIV and AIDS is going to be won or lost in India.”

It’s simple for anyone from the outside to make generalized judgment and commentary on such a heavy issue while feeling that the “battle” is already lost; but there are things that anyone can do to help without being trust fund babies or on Forbes’ list of top ten millionaires. As the world begins to understand how complex this issue has become and administer the means to face it head on, it’s important to remember how much power each of us as Americans, as children of South Asian descent, as women, have to be able to take the opportunity to address and fight this virus that has taken the world into global possession. Volunteering at local HIV/AIDS centers, supporting local polices that help further research nationally and internationally, even buying MAC’s Viva Glam lipstick line, which also sends a 100% of all proceeds to HIV/AIDS programs around the globe, are just small steps that can help fight the disease. It’s imperative to realize that the conflict with HIV and AIDS is no longer a “problem” that happens to countries over seas or to different communities you may never be a part of, but an issue that has not only reached the newspapers but our backdoors. The fight isn’t over till a cure or vaccine to HIV/AIDS is found and the threat has subsided because after all, there isn’t a World Flu Day. — Salma Khan

For more information in how you help fight HIV and AIDS:
World AIDS Campaign
Alliance for South Asian AIDS Programs
Program (red)
Until There’s A Cure
M.A.C. AIDS Fund
Avert: AVERTing HIV and AIDS

7 thoughts on “World on Fire: Update on HIV and AIDS in India

  1. HIV/AIDS is still rampant today and there is no cure for it. we need to practive safe sex all the time because an ounce of prevention is still better than a pound of cure.

  2. Hi – really good web site you have created. I enjoyed reading this posting. I did want to write a remark to tell you that the design of this site is very aesthetically sweet. I used to be a graphic designer, now I am a copy editor for a merchandising firm. I have always enjoyed working with information processing systems and am trying to learn computer code in my spare time (which there is never enough of lol).

  3. HIV is a disease that is still incurable today. We should always practice safe sex and also educate our people how to avoid the spread of this disease.

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