Aids In India: The Quiet Killer

“The truth is generally seen, rarely heard”. The words of Baltasar Gracián ring true today in the context of the HIV/AIDS epidemic in South Asia. While rivers of ink have flowed (and deservingly so) over the crisis in Africa, relatively few words have addressed the same issue present in the Indian subcontinent. But simply because the truth has been rarely spoken does not mean it cannot be seen.

After sub-Saharan Africa, the South and South-East Asian region has the highest total number of HIV infections in the world with approximately 7.4 million people living with the virus. The greatest problem is in India as of those infected in South and South-East Asia, 5.1 million live in this country. To put this into perspective, India’s HIV infected population is roughly equivalent to the populations of Toronto, Montreal, Vancouver and Quebec City combined. What’s more is that these numbers are likely conservative as many more cases go unreported.

After sub-Saharan Africa, the South and South-East Asian region has the highest total number of HIV infections in the world with approximately 7.4 million people living with the virus.

The environment for this epidemic is not unlike the environment found in other regions with large numbers of people living with the virus. Those most likely to carry the disease are sex workers, injecting drug users and the poor (who often lack the knowledge and/or preventative tools). However, although not exclusive to the region, one of the greatest obstacles to addressing and battling this growing problem are the people themselves. The social stigma in India and the surrounding South Asian region is strong and poses a grave danger in the fight against the spread of the AIDS virus.

A recent study by UNAIDS, the Joint United Nations Programme on HIV and AIDS, reported that 36% of respondents in one study believed that those infected with the virus deserved their fate while 20% of respondents believed that the virus was a punishment from God. A prevalent feeling in India is that AIDS is a sickness of the “sinful” – those with the disease are marginalized and discriminated against. What this treatment of those living with the disease leads to is a fear among the population to even seek treatment, let alone have it known they carry the “sinful disease”.

The general treatment of those infected would irk even the strongest. Children, whose parents are HIV-positive, are often not allowed to enter public schools. Women are often blamed if their husband contracts the disease, even if it was actually through extramarital relations. Women, in fact, face some of the worst HIV/AIDS discrimination in India. Studies have shown many HIV-positive women face harsh mistreatment from family as they are often denied shelter, household property, and access to proper treatment and care. These mistreatments can be traced back to the community at large as families with HIV infected members are often ostracized as a group.

India’s HIV infected population is roughly equivalent to the populations of Toronto, Montreal, Vancouver and Quebec City combined.

Worse still, mistreatment is also found in the health care sector. This can include denial of admission, neglect and breaches in confidentiality. These further contribute to the secrecy of those living with the virus.

What’s more is that the general mistreatment of those groups such as sex workers, hijras and homosexuals often keeps those infected from seeking the help they need as they may be accused of being a part of one of these socially marginalized groups.
Even those wanting to help HIV/AIDS infected people are often harassed. In 2002, it was reported that AIDS outreach workers and peer-educators were being harassed at the hands of local law enforcement.

This severe level of discrimination is clearly a problem insofar as it vilifies the victim. What’s more threatening, though, is it works to hide the disease from the public and, in turn, further spread the virus. Keeping the disease from one’s peers and community, and living as though the disease does not exist only further enables the virus to strengthen its hold on the population. Ignorance, in this instance, is definitely not bliss.

Educating the population about the virus – it’s causes, related problems and, most importantly, its prevention is key to containing the disease but so is creating an environment where the disease, and those living with it, are not discriminated against. What is needed is a tolerant and caring society. It is important for those infected to feel safe enough to tell whom they wish to tell and seek the appropriate treatment.

Among the World Bank’s seven behavioral objectives to address the AIDS epidemic in South Asia was the “display of tolerant and caring behaviors towards people living with HIV/AIDS and members of vulnerable populations”. So, it is a social, cultural and a behavioral change that the wider population of South Asia needs to make among themselves to help combat the disease that currently affects more than 5 million people in India alone – many more if we include their friends and their families.

Without a doubt there are a myriad of factors that have led to the current level of HIV/AIDS in South Asia and it is not simply a product of the environment. However, the current environment is simply intensifying the already growing problem. The environment, the culture, the society, have forced many living with the disease to live in silence – to keep the truth from being heard. But, if we look carefully we can see that truth. And oh how the truth hurts.