HIV and the Golden Quadrilateral Highway: In Six Indian States, Prevalence Rates Are More Than One Percent in the General Population and Even Higher among High-Risk Groups. Dr Smarajit Jana Explains How CARE International Is Working to Control the Epidemic among Long-Distance Truck Drivers and Sex Workers

Article excerpt

"In recent years, the Indian government has been developing a huge national ring road in an effort to improve the country's transport links. The Golden Quadrilateral Highway will eventually cover almost 6,000 kilometres and connect Delhi, Kolkata, Chennai and Mumbai. As sections of the road have been completed, the number of trucks ferrying goods between towns and cities has increased. Unfortunately, so has the prevalence of HIV/AIDS.

The truck drivers are often away from home for weeks at a time. They stop at roadside rest houses for food and drink and, sometimes, a room for the night. This large number of men encourages people to congregate at these dhabas to sell various products and services. The sex workers who engage with the truckers tend to be male and transgender, as well as female.

A number of factors has led to the spread of HIV/AIDS in this context. Among truck drivers, poor levels of education and literacy mean that the majority are unaware of how HIV is spread. The same is true of the sex workers, but they have to contend with various other problems. A lack of financial security means sex workers are often forced into high-risk behaviour--if they don't know where their next meal will come from, it will be difficult to negotiate over condom use, for example. The police tend to see sex workers only in the context of law and order: if they find women with condoms they see it as proof they are sex workers and put them in jail or demand money or sexual favours. …