1. HIV/AIDS in India World AIDS Day 2006 December 1
Tej Ram Jat
IFP Alumni
Cohort 3

2. Status of Epidemic 1 Case 1986 to 5.206 million 2005
HIV prevalence among adult population at 0.91 %
1,70,000 children below 15 are living with HIV (as per UNAIDS projections)
6 states as high prevalence, 3 states moderate prevalence and 14 states highly vulnerable States & 12 states are vulnerable states
111 districts are high prevalence districts with HIV prevalence more than 1% in ante-natal women and/or more than 5% in high risk groups
India is second only to South Africa in absolute numbers

3. Changing face of Epidemic
Movement from
High risk groups to general people
From urban to rural areas
From High Prevalence states to all states

4. What we were told… AIDS is an incurable disease and leads to death
AIDS is common among particular high risk groups like sex workers, drug users, truck drivers ( others…. not us)
HIV infection spreads through unprotected sex with many partners (and having one sexual partner is safe)
We were initially told that AIDS is a disease of foreigners and the Indian value system would not let the disease spread in the country
Now we know that India has the second highest highest number of positive persons in the world

5. What was the response…
IEC and BCC– School and University programmes, Newspaper Advertisements, Hoardings and bill boards : stationary and mobile, TV programmes….
Family Health Awareness Camps – STD control
Condom promotion
VCT
Targeted Interventions (among CSWs, Truck Drivers, anti-Trafficking programmes)
Blood safety
Surveillance

6. Why did this not work? Denial, false morality and lack of openness…..
That many Indians have sex with multiple partners and that same sex behaviour is common
That commercial sex work is common
That HIV infection could happen to any of us
That young people should have sexuality education
Delay in understanding the socio-economic basis of the infection
Sluggish health system response

7. Where are we now ?
Many of us may have the infection, others have friends who have the infection
Many know of people who died after wasting away without any proper disease being established
We know AIDS is commoner among urban, rural people, the poor, among women and young people
We know HIV infection can take place among persons who have had only one sexual partner
We know that AIDS is now a treatable condition
We know a vaccine is still far away
and so
we have to co-exist with the virus.

8. New issues for consideration
Poverty, economic vulnerability and HIV : Migration preparedness
Gender discrimination, Violence and HIV : Couple Counselling
HIV – Stigma and discrimination: Role of the media
Living with HIV – Support, Care, Treatment
Women and HIV: Multiple Vulnerabilities, Care-giving, Stigma, Blood-banking
Holistic integrated approach vs narrow vertical programme ( with high external inputs)

9. The way forward ……
Thinking beyond a ‘technological fix’- condoms, testing, ART, microbicide, vaccines
Improving government's response in ‘high vulnerable’ as well as other states
Addressing economic and social vulnerabilities – incorporating these into the response
Focusing on women’s empowerment and gender equality – involving men as partners
Providing leadership opportunities to the vulnerable and affected
Protecting the rights of the vulnerable and affected
Providing long term care, support and treatment: integrating social with medical support

10. Lets join HANDS..

11. Thank you