AIDS in India: Denial and Disaster. (Global Notebook)

Article excerpt

With 3.97 million reported cases, India has the second largest HIV-positive population in the world, with an expected 20 to 25 million cases by 2010.

These numbers are thought to be underestimates, as the stigma attached to harboring the HIV virus precludes some individuals from being tested and treated. This stigma is perhaps particularly pronounced in India, where religious and social forces repress expression and discussion of sexuality.

The first documented case of AIDS in India was reported in Chennai in 1986. The ensuing debate about the appropriate legal recourse was varied and intense. Some officials called for the deportation of African students and outlawing sex with foreigners. Some members of the government offered to pay sex workers to retire, while others drafted legislation to tattoo HIV-positive sex workers and made public appeals for a return to traditional national values. The first legislation passed, however, was an HIV quarantine law. Because the disease was thought to have been imported by a tourist, the government felt that containment could prevent an outbreak. The ensuing legislation had the opposite effect. By mandating severe repercussions for those harboring the virus, the policies reinforced the stigma attached to the disease, and thereby discouraged individuals from seeking testing and clinical care. The law's focus on foreigners as the souce of infections associated popular conceptions of HIV with the more sexuall y permissive West.

To combat the spread of AIDS, the Indian government created the National AIDS Committee in 1986 and launched the National AIDS Control Programme in 1987. In its first years, the program promoted public awareness through educational programs, conducted surveillance activities, and mandated blood screening during transfusions in AIDS hotspots. Since privatization had previously led to transfusions without screening, blood banks underwent a mandated licensing process designed to slow the transmission of AIDS, syphilis, malaria, and Hepatitis B. The government also sought to phase out professional blood donors and reduce the use of whole blood for transfusions, but the mandate was impossible to enforce due to the large number of successful private blood banks in the country.

In 1992, the Indian government formulated a multi-sectoral strategy for the prevention and control of AIDS. The program was implemented both at the national level through the National AIDS Control Organization and at the state level through local legislation. The strategy concentrated on surveillance, research, information, education, and communication in cooperation with non-governmental organizations. It also aimed to control the spread of sexually-transmitted diseases through condom distribution and blood safety education.

Educational campaigns were initiated but were few and far between, largely due to cultural aversion to discussion of AIDS-related topics. Within five years, government studies showed that awareness levels had risen from nothing to 80 percent in urban areas. Disappointingly, they remained around 30 percent in rural areas. …