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HIV/AIDS in India: The Wider Picture
Economic & Political Weekly EPW February 7, 2009 79
A slightly different version of this article was earlier posted on
the web site of Women's International Perspective. Rupa Chinai
(rupachinai68@...) is an independent writer on health and
development issues and is based in Mumbai.
Being HIV-positive does not mean death. It is the body's "red alert"
warning that the immune system should be immediately repaired with
nutrition through "real food", and a changed lifestyle. Despite the
enormous amount of money spent by India's AIDS programme, it has
failed to communicate this message.
Many AIDS patients have been driven to commit suicide. An informed
public debate is necessary to deal with the ignorance and prejudices.
On 5 August 2008, a young HIV-positive couple in Mumbai, Babu Ishwar
Thevar and his wife Amothi committed suicide after killing their
three children aged between 6 and 10 years. They had just discovered
that their youngest child too was infected by the deadly virus. The
stigma of AIDS has taken many lives long before the disease itself
claimed them but the extent of such suicides and the reasons behind
them have rarely become public knowledge.
It is not known that AIDS has a critical link to the immune system
and the factors that influence it. Society's limited Understanding of
this disease leads to innocent people paying a terrible price. At a
time when we do not have a cure for AIDS, we cannot assume to know
its cause. Increasingly, voices across the world are questioning the
narrow approach to a single disease, especially the huge financing
for AIDS over all else in basic healthcare. Though welcome and long
overdue, this debate must now move further.
Our approach to this disease needs to change for the sake of families
like that of Babu and Amothi Thevar.#]
In 1993, I completed a journalist fellowship at the Harvard School of
Public Health in Boston, and came back deeply influenced by teachers
such as the late Jonathan Mann, a public health expert with renowned
international experience. He believed that the discovery of a new
disease like AIDS was an opportunity to scrutinize fundamental issues
such as the link between disease and poverty, the need to examine the
workings of the entire health system, access to preventive health
information and the means to support health in all its physical,
mental and social dimensions.
Based in Mumbai, I witnessed the unfolding of the "HIV/AIDS epidemic"
in what was dubbed the "AIDS capital of India" and extensively
reported on it over the course of a decade. At that time, the medical
community shield away from treating this disease. As a result,
patients were in the stranglehold of a small group of doctors that
took every opportunity to fleece, frighten and even conduct illegal
vaccine trials on the patients.
Denied any support, the patients believed that HIV meant death.
Mercifully, that stranglehold was subsequently broken when heightened
international focus widened the circle of medical practitioners and
nongovernmental organisations (NGOs) willing to treat the patients.
One of the few but important gains of the focus on AIDS in India has
been the emergence of a few genuine community based groups for the
first time in public health. Many of them provide an interface
between marginalised groups, the wider community and public health
services. This process empowers those who were previously voiceless
and ignored, and who must continue to receive priority support. This
success however, is marginal in comparison to the enormous havoc this
narrow and ill-conceived focus on HIV/AIDS has created in India's
public health system.
There is an urgent need to expand the treatment to a comprehensive,
primary health-based approach – one that takes into account the total
health needs of communities in developing countries that cope with an
already enormous burden from other killer diseases.
Improving the primary health system will have an impact on a range of
these killer diseases, including AIDS. Inflated Numbers Contributing
to this climate of fear and myopic focus were many myths that gained
currency. In particular, AIDS fatality figures were severely inflated.
The past two decades have seen warnings about the huge numbers of
HIV/AIDS infected persons who would "die like flies". The
projections, provided in particular by the Central Intelligence
Agency (CIA), Joint United Nations Programme on HIV and AIDS (UNAIDS)
and the World Health Organisation (WHO), ranged from five million to
20 million estimated cases in India alone. Local and international
groups that questioned the high numbers faced severe criticism and
Ultimately, the sceptics were proved right. The AIDS lobby has since
backtracked on its pronouncements without acknowledging the extent to
which they have misled the public. UNAIDS has now reduced world HIV
estimates from 39.5 million to 33.3 million but still calls for
dramatically increased spending on AIDS from $9 million to $42
billion by 2010 and $54 billion by 2015.
The National Family Health Survey (NFHS-3) was the first to provide
data on what is happening at the general community level and it
forced international agencies to scale down their figures. Estimates
of India's HIV/AIDS prevalence are now 2.5 million, a significant
decrease from the earlier Indian official estimate of over five
million infected. While HIV causes only 3.7% of global mortality, it
receives 25% of all health aid.
Additionally, it receives a large portion of domestic expenditure,
which often exceeds domestic health budgets, says Robert England,
chairperson of the Health Systems Workshop, an independent think tank
promoting comprehensive primary health systems reform in developing
countries. It is important to analyse how these high projections came
about in the first place, and to ask how those in authority accepted
these figures without asking the basic questions voiced within the
community. It is vital to know what is happening on the ground and
discover for ourselves India's true experience with this disease.
During a 2008 media workshop with Asian and African journalists in
Geneva, the WHO placed the blame for flawed Fatality projections on
the home countries.
"The WHO has no mechanism for monitoring numbers and its estimates
depended on the data supplied by the Indian government", it said.
Policymakers in Delhi and Washington had applied universal yardsticks
without examining local geographical and cultural traditions of
health seeking behaviour in developing countries.
India's HIV/AIDS surveillance system drew samples from the following
sources within public sector institutions: Clinics for antenatal
mothers; sexually transmitted diseases (STD) treatment centres; blood
banks; and NGO groups catering to the needs of "men who have sex with
men" (MSM), commercial sex workers and their clients. The problem
with samples taken from these sources is that these segments do not
represent the general population; they represent "high risk groups".
While pregnant women attending antenatal clinics in public hospitals
would come from the general population, they still represent the
lower socio-economic strata. The picture these samples show does not
portray the total image with its manifold nuances.
Typical patients who seek the services of the urban public sector in
India are migrants who come to the cities and live in stressful
conditions. They suffer from malnutrition and carry a heavy burden of
disease that has compromised their immune systems. If they were to
undergo an HIV test, it is likely that it would show a false positive
result because of a cross-reaction due to the presence of other
infections commonly found in developing countries.
Data drawn from the public sector connects with another Indian
peculiarity. Studies have revealed that 70% of Indians turn first to
the private sector when they suffer from a health problem.
They do so because the primary health service offered by the
government sector is neglected and in a shambles. It is only when
they run out of money or suffer the consequences of wrong diagnoses
that patients turn to the public sector hospitals, resulting in the
over-burdening of referral services by patients suffering from minor
problems. Thus, comparative data drawn from the private sector
services, which covers the majority of India's population is the key
information missing in the HIV/ AIDS surveillance systems. The class
of people who come here are better nourished and healthy. HIV testing
done on them may demonstrate different results.
Such comparative data is readily available with all leading private
hospitals in Mumbai, who subject their patients to an HIV test on
admission. The administrator of one leading private hospital in the
city said that the number of such HIV patients found in their
hospital is, in fact, not large. Their numbers are restricted to a
small group of patients who shop around for services in the city's
private hospitals because of the stigma. Strangely, the national
surveillance system has completely left out this vital sector from
Why are researchers and scientists not interested in comparing the
private and public sector data on HIV/AIDS? What makes the better
nourished, wealthier class of people less vulnerable to AIDS and
other infectious diseases compared to the poorer segment of society?
False Test Results
Apart from misleading estimates of those affected by HIV/AIDS, there
is also a realization that an HIV positive test result is fraught
with uncertainties and causes havoc when it shows up in an
In the course of my journalistic work HIV/AIDS patients from across
the country often shared their stories with me. Those were the years
when the hysteria around this disease was reaching its most fevered
pitch and mass HIV testing within the general population was being
encouraged or enforced. The patients however reported that their
experiences did not conform to the tutoring of the AIDS lobby.
Mushtaq's (name changed) experience is consistent with that of the
many "patients" I met. While seeking a work permit for the Gulf, he
tested HIV-positive during a mandatory test. Although subsequent
tests conducted by a reputed private hospital laboratory showed a
negative result, the Gulf Board rejected the "HIV-positive" candidate.
Sadly, stigma from the flip-flop testing still sticks to him wherever
he goes. In another case, a private hospital denied admission to two
pregnant women after a positive HIV test. Their babies were later
administered a course of the toxic and controversial AIDS drug, AZT.
However, a routine second HIV test showed negative results on both
Those interacting with HIV/AIDS patients are well aware of the
innumerable cases of men and women who seek repeated testing at
leading laboratories and still come up with conflicting results.
Cases where a pregnant woman tests positive during her pregnancy and
negative after giving birth have no explanation. There is no
explanation for "discordant couples" wherein one partner is HIV-
positive while the other remains negative despite practicing
The government-run J J Hospital in Mumbai which has documented such
cases, also points to patients who show other symptoms of immune
suppression, such as lymphatic cancer or skin lesions.
Such cases of false HIV-positive results or unusual symptoms are only
the tip of the iceberg. The extent of such incidents remains unknown
because the AIDS lobby and the health authorities have no system for
monitoring such cases across the country or the desire to know why
they occur. These cases however reveal how an HIV test conducted on
those with no clinical symptoms of AIDS can cause havoc in their
lives. In fact, many patients accept their first "HIV- positive"
result as a death sentence.
The poor cannot afford to do a second confirmatory HIV test as per
subsequent WHO guidelines. These stipulate a requirement of at least
three confirmatory tests, to eliminate the possibility of picking up
other infection markers.
They clarify that a single HIV test is not enough to label a
person "HIV-positive". For the poor however, a single HIV test
continues to remain the norm across India and in most developing
The health authorities in Mumbai acknowledge that there is a problem.
A senior official at the Mumbai AIDS Society attributes it to the
many private laboratories in the city that lack accreditation and
technical expertise to assure standardised testing. Beyond the urban
metros, the situation is worse, particularly in the rural districts.
Most developing countries have not built up a cadre of trained
microbiologists or laboratory infrastructure to ensure accurate
The absence of professionals and technology also has an adverse
impact on the monitoring of patients on anti-retroviral (ARV) drugs
Unable to bear the high costs of HIV testing, public hospitals in
Mumbai no longer insist on an HIV test on admission. They rely
instead on clinical symptoms such as repeated bouts of diarrhoea,
fever, rapid weight loss or tuberculosis (TB) – the common symptoms
of AIDS-associated illness – that warrant suspicion and the need for
a confirmatory test.
Private hospitals in Mumbai, however, insist on a routine HIV test
for all admissions.
At various times fly-by-night NGOs in Mumbai have called for mass HIV
testing. Such insistence of HIV testing serves the interest of test
kit manufacturers but is fraught with consequences for those
subjected to it. Manufacturers of testing kits also admit that the
HIV test is unreliable.
Abbott Laboratories' printed literature states that their product is
not specific to the detection of HIV antibodies. Thus in developing
countries, the poor and malnourished who regularly suffer from
infection and disease are likely to test HIV-positive because the
antigen cross-reacts with the host of infections already present in
Quality of Tests
Scientists have pointed out that false positive- HIV test results may
show up in 70 different conditions, which include malaria, TB or
influenza and even in pregnancy.
Thus the ground reality in most developing countries is that a death
sentence is passed on the basis of a single test conducted by ill-
equipped laboratories and poorly trained technicians who are more
likely than not to have erred.
The test conducted on a poor class of patients who are malnourished
and in poor health is therefore likely to produce misleading results.
Meanwhile, even if a test is clearly HIV positive, it only means that
a person suffers from a severely compromised immune system.
Many eminent western scientists are now questioning the assertion
that sexual transmission is the sole cause of AIDS, raising the
possibility that the presence of the virus merely represents the
marker of a suppressed immune system. The real cause of AIDS, these
scientists say, is the assault of toxins and deficiencies on the
body's immune system.
These factors include antibiotic abuse, recreational drug abuse and
nutritional stress, all of which are major public health problems in
India. Evidence both within India and outside, suggests that the
damage caused to the immune system is reversible even without drugs.
The experience of developing countries shows that the presence of
microbes in the body does not necessarily indicate progression into
disease, for much depends on the status of the immune system.
In Asia and Africa, where TB is rampant, even healthy people are
carriers of the TB germs and may have a positive report if they
undergo a diagnostic test. Their ability to live with the microbes
and prevent the downslide into disease depends on their nutrition and
The same analogy works for AIDS. Africa is a continent in the throes
of AIDS. Health historians say that AIDS in Africa is a consequence
of the depletion of the body's nutrition pool over the generations
and the destruction of the immune system. As sub-Saharan Africa
plunged deeper into the cycle of poverty, malnutrition and civil war,
it also suffered epidemics of Ebola and Marburg or Lhassa fever,
which stayed within the population for decades. AIDS could be the
result of this depletion of the nutrition pool.
Until now, India despite its poverty and malnutrition like many other
Asian countries, has not seen an impact of AIDS similar to that of
sub-Saharan Africa. Barring pockets of malnutrition in tribal areas
of India, the last major Indian famine took place in Bengal during
the British rule. In both cases malnutrition and famine was, and
remains, a consequence of poor public food distribution services,
corruption, maladministration and lack of purchasing power.
The African experience of the structural adjustment programme (SAP)
led to the loss of local food security when international donor
agencies compelled these countries to convert their agriculture to
cash crop cultivation of coffee. The subsequent crash in
international coffee prices plunged these countries into economic,
political and social chaos which in turn led to the health
consequence of AIDS.
India took up the SAP in the early 1990s and similar consequences are
beginning to show here as the country plunges along the path of
unequal economic development, throwing vast segments of the
population into deep poverty. At stake are the issues of local food
self-sufficiency and national sovereignty in determining agriculture
and development policies. It is this wider picture that must now come
Over the past decade, women diagnosed as HIV/AIDS patients in Mumbai
and whose husbands died of AIDS have become "long-term survivors".
There are three factors that have helped these women to live well
without having to resort to ARV therapy. They found support from
women who were similarly afflicted and counseling groups that gave
them hope; through these groups they got access to doctors who
treated their opportunist infections in time and they learnt how to
look after their health through a combination of diet and
When first detected as HIV-positive, their vulnerability to cold,
cough, fever and diarrhoea increased and they also suffered from
These women believe that their physical vulnerability was more an
outcome of the tension, fatigue after caring for their sick husbands
and economic burden rather than AIDS-induced infections. They believe
that their men died because of addiction to alcohol, tobacco,
neglecting to take medicines and refusing to change their lifestyles.
As Lata, Sharda and the others point out, they do not eat and drink
outside (this has helped in reducing bouts of diarrhoea, cold, cough
and fever), are no longer careless about medication and keep
themselves busy by volunteering to help other patients when they
cannot find paid work.
Their diet primarily consists of dal (lentils) and rice. Seasonal
fruits and green vegetables that they desperately need are a rare
Luxury but they are learning that food that is cheap, seasonal and
locally available is a powerhouse of energy that can boost the body's
immune system in fighting AIDS-related opportunistic infections.
A daily diet consisting of a banana, some lemons and a couple of
dates, along with seasonal fruits and vegetables like gourd, has been
very helpful. Some key issues that would make a difference in the
care and support of the AIDS afflicted, the women say, is ensuring
access to TB treatment along with nutrition support for those on
therapy; the presence of well-trained doctors in rural areas;
security for their children and organisational support in solving
legal and other disputes with family members.
This phenomenon, taking place within the general population in
Mumbai, is important to monitor. Following a cohort of 900 HIV
patients from within the general population in Mumbai, the Salvation
Army, for instance, found that only 15 had died in the course of a
decade. The main causes of death were TB or malnutrition, often
coupled with alcohol abuse amongst the men. Such evidence calls for
broad based interventions, through policies that focus on access to
real nutrition (as opposed to chemical-based supplements) and
comprehensive primary health services, which include addiction
This implies the need for a hard look at our trade and development
policies (which have caused the loss of local food self-sufficiency)
and our narrow approach to health issues through "vertical
programmes", all of which are leading to adverse health outcomes.
Fixated on the sexual transmission theory of HIV/AIDS, mainstream
western science has resisted such evidence and held fast to the view
that the answer to AIDS lies in condoms, sex education and ARVs
The public messages communicated at great financial expense, insist
that HIV/AIDS spreads through multi-partner sexual activity and
bodily fluids, and knows no barriers of class or social status. Now
the wheel has turned full circle and the AIDS lobby is steadily
backtracking on its earlier pronouncements.
Forced to come down on its earlier inflated estimates of the numbers
affected by HIV/AIDS, it now admits that AIDS assails only the
marginalised and specific segments of the population.
This reversal is evident in a new report by the Asia Commission on
AIDS, tabled in the UN in March 2008. It states that the epidemic is
restricted to specific and vulnerable groups engaged in "high-risk"
Such people, says the report, are those who engage in unprotected
paid sex (commercial sex work), injecting drug users who share
contaminated needles and syringes, and men who have unprotected sex
with other men.
This assertion appears to be correct and conforms to the trend noted
in cities like Mumbai during the course of two decades. Here, the
reality on the ground has clearly shown that those who suffer a rapid
downslide into AIDS and death are primarily those from the low socio-
economic group and commercial sex workers, injecting drug users,
homosexual men and alcoholics appear to be more vulnerable.
The intense pressure by drug companies to launch patients into ARV
treatment is meanwhile not without problems. Evidence from the JJ
Hospital reveals that this treatment is helping patients whose CD4
count falls below 200. Access to treatment however, is still not
available to the most marginalised segments such as commercial sex
workers. The hospital data also points to the severe, toxic effects
of ARV drugs. Patients who are poor and malnourished cannot maintain
long-term drug adherence.
It points to gross and widespread malpractice within the private
sector whereby patients are given wrong prescriptions through sub-
therapeutic drug combinations and dosages. Earlier data shows that
there is resistance to the first line of ARV drugs and a second line
of treatment is required. Undoubtedly, patients who seek ARV
treatment must have the right to access available treatment
especially when it is a matter of life and death. All the same, these
drugs do not offer a cure and they are expensive to sustain on a
lifelong basis, even when it is the cheaper, generic version.
Besides, there is no guarantee of indefinite free supply of ARV
therapy. More importantly, it is suicidal to promote it when the
infrastructure to administer and monitor it is non-existent in most
For these reasons, ARVs can never be the drug of first choice; the
quest for solutions through research in traditional medicines is a
crying need of patients in developing countries.
There has been far too little analysis of what these strands of
information from the ground mean within the wider picture of health.
They raise one key question: Assuming that the better off segment of
the population is as sexually active (maybe even as promiscuous) as
the poor, why are we seeing two different trends, where only the poor
are more vulnerable to AIDS?
Is it time to re-evaluate the theory of sexual transmission of this
virus as the only factor leading to immune suppression and a disease
called AIDS? When we do not have a cure for AIDS, why are we assuming
to zero in on only one factor of causation?
This rigidity of approach has done great disservice to the cause of
public health including the treatment of AIDS.
There is a crucial link emerging between nutrition and immunity.
A joint statement by two UN agencies, the WHO and the Food and
Agricultural Organisation confirms that, A good diet is one of the
simplest means of helping people live with HIV/AIDS and may even help
delay the progression of the deadly virus.
The nutritional aspect of HIV/AIDS has been ignored for a long time.
The attention was always focused on drugs… The message was always:
`Take two tablets after meals'. But they forgot about the meals.
Unfortunately, this insight has not translated into action. For AIDS
patients in Mumbai who desperately need access to a nutritious diet
of fresh seasonal fruits and green vegetables, such food is a rare
The millions spent in the name of AIDS have facilitated the survival
of the AIDS lobby but not the patients. Our policy planners have yet
to understand the vital role of local food self-sufficiency, national
food sovereignty and public education on what the body needs to stay
Preventing this comprehensive health approach is a western donor-
driven agenda, says a growing movement of health policy experts.
While southern realities cry out for access to real, nourishing and
affordable food, clean water, sanitation, means of economic survival
and access to comprehensive healthcare – interventions that would
have an across-the-board impact on health – there appears to be
little shift in the northern perspective.
The focus of major funding and policy diktat from the north remains
obsessed with the pumping of more technological interventions –
drugs, vaccines, diagnostic kits or food fortification therapies (a
pre-dominance of expensive lab produced chemicals to fortify food as
against natural, real food).
This approach is contrary to their own achievements which were gained
through a revolution in hygiene, sanitation and water services.
Southern experience shows that a technology driven approach cannot
have a tangible impact on malnourished populations who lack the means
for basic survival. Conditions of poor health infrastructure are
abysmal in developing countries of Asia, Africa and Latin America.
During field studies done in Uganda and Haiti, our group of health
journalists found conditions similar to that in India. Health centres
have no doctors, drugs or electricity. Access, particularly for those
living in the interior areas, is difficult because of poor roads and
Absence of public transportation.
There is high maternal and infant mortality; TB, malaria, high blood
pressure and a host of other diseases. Acute and chronic malnutrition
is rampant and it remains the main hurdle in bringing these countries
out of poverty. Health agencies such as the United Nations Children's
Fund (UNICEF) are clear that drugs and food therapies do not address
the key issue – national production of food and restoration of
agricultural self sufficiency.
The bulk of international aid money coming to developing countries
Focuses on HIV/AIDS and involves "very big players" for whom "money
is not a problem" says UNICEF. At the forefront is the US, which is a
major supplier of pharmaceutical drugs. Its major concern however is
not with the needs on the ground but how aid money can be ploughed
back to US industries which have invested heavily in HIV/AIDS drugs
The Bush government for instance, initiated the "President's
Emergency Plan for AIDS Relief" (Pepfar) which is a major programme
to provide ARV drugs and the diagnostic kits for detection of
Haiti in the Caribbean Islands has recently scaled down its inflated
HIV/AIDS estimates, but US funds for AIDS drugs to Haiti have
steadily risen from $28 million in 2004 to the present $100 million
Aid That Distorts ARV drugs presently provided free by the US
government cost $15,000 as compared to $300 through the cheaper,
generic versions made available by countries such as India. Here too,
the US provides no guarantees that free drugs will be available
While initially the World Food Programme supported patients on the
ARV programme with food, it has now stopped doing so. Like in India
skin diseases, stress, TB, diarrhoea, STD are amongst the many
problems also faced by AIDS patients in Haiti, but there is no access
to support and treatment. There is no doubt that such money in the
guise of "international aid" would be ploughed back to boost western
research and industry, even as developing countries fall deeper into
a debt trap and poverty. Meanwhile aid that comes with conditions has
served to distort national priorities.
"Haiti's family planning programme also started like this", says
Marie Mercy Zevllos, Director of the Hope Centre, which provides AIDS
counselling in the capital, Port-au-Prince. "Initially we received
all the support – technical and financial.
But then when the government changed in the US, the programme ended.
The current approach is good for the pharma industry in the US, it is
helping us to help themselves", she said. International health
experts in Geneva reveal that although 75% of health expenditure
comes out of the pockets of the poorest in developing countries, they
have no say in setting the priorities.
Meanwhile money from the donors – up to $16 billion until 2006,
according to the WHO – has come with conditions that distort national
Money poured into technology interventions is considered inadequate
while the gains in health remain intangible.
There is little understanding of the wider linkages that affect
access to health or concern for research in the neglected diseases
that add to the burden of ill health and death.
For health journalists looking at the wider picture a key insight
gained is that technology by itself can never be a magic wand. It can
be a boon and a gift of life when it is based on other broader
interventions that have to be in place first. In view of the emerging
food and energy crisis – key issues for the coming years – it is
crucial for the developing world to evolve its own sustainable
Solutions that promote health and prevent AIDS.
You are invited to join AIDS INDIA eFORUM
If you are already a member of this FORUM, Please forward this to a colleague
who may find this FORUM useful.
(This is an automated message send every month to all the subscribers)
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Thank you for your attention.
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AIDS INDIA eFORUM
[Editors note: State Training and Resource Centre (STRC) has been setup in
Delhi by NACO as part of its strategy to develop a sustainable system for the
capacity building of organizations implementing Targeted Intervention projects
for High Risk Groups(HRG) in the state. STRC is managed by Delhi School of
Social Work, University of Delhi, http://www.strcdelhi.org/]
The institution of STRC in Delhi has nearly brought about a spanking new
vitality in the otherwise deliberate rhythm of work in Delhi TIs working for the
prevention of core groups.
I ought to applaud the DG NACO on this fabrication of STRCs endeavored! The
incredible work done by STRC here has not only brought about technical
articulacy about various components of TIs in the existing staff of
various TIs but also helped us to see the gaps we were never being able to
understand before in spite of our hard tried efforts for the past so many years.
When this process of ‘Outreach Planning’ instigated in mid November 2008, there
seemed to be inundation of training programs and our staff seemed to be more
engaged in these training exercises rather than indulging in day to day
activities causing a concern about meeting our usual targets as annual
evaluations are approaching soon.
But rather as this exercise seemed to approach its finishing point it has not
only brought about accuracy to plan our targeted goals but the incursion of
mentorship in this program has also fetched a team spirit in all the TIs
encouraging us with a common platform to meet our universal goals.
I must state that this model exercise and its outcome is the unrelenting and
hard tried efforts of the DSACS and STRC teams here and there efforts should not
just be appreciated but should be taken as learning for many states sheathing
Monica Mendiratta PD,
E mail: drishtikon95@...
This quoted below is the Segment from the US state Dept Global Human Rights
Report, that pertains to the LGBT/HIV situation in India. It quotes the NACO
Policy, the 377 case, the Karnataka arrests, the UNDP Launda Dancers report, and
the Sanju Behara case. The report can be accessed at the following URL:
Full report can be accessed at the following URL:
And the relevant portion is pasted below:
Other Societal Abuses and Discrimination
The law punishes acts of sodomy and bestiality; however, the law was often used
to target, harass, and punish lesbian, gay, bisexual, and transgender persons.
Gays and lesbians faced discrimination in all areas of society, including
family, work, and education. Activists reported that in most cases, homosexuals
who did not hide their orientation were fired from their jobs. Homosexuals also
faced physical attacks, rape, and blackmail.
Police committed crimes against homosexuals and used the threat of arrest to
coerce victims into not reporting the incidents.
Voices Against 377, a high profile campaign to overturn Section 377, which
outlaws homosexuality, continued its efforts during the year. On August 27, the
Law Ministry rejected the demand of the Health Ministry to legalize
In 2006 the Supreme Court ruled that the Delhi High Court should not have
dismissed an earlier case challenging Section 377 brought by two NGOs and
returned the case to the Delhi High Court, which began hearings on September 18.
The government opposed the case based upon the Ministry of Home Affairs' view
that homosexuality is morally wrong. On November 7, the Delhi High Court allowed
litigants one week to present final statements. The case continued at year's
On May 21, 40 gay and transgender groups collaborated on a bid for funding from
the International Global Fund for AIDS, Tuberculosis, and Malaria (GFATM). The
occasion marked the first time the groups had formed a united front to secure
benefits for their cause.
On August 28, the Home Ministry informed the Delhi High Court that it was not
empowered to issue directions to treat transsexuals as a special class entitled
to jobs and other benefits. The Ministry was responding to the Public Interest
Litigation regarding the dismissal of Sanju Behra from the CRPF on the grounds
of gender ambiguity.
Notices were issued to the CISF, Home Ministry, Ministry of Women and Child
Development, and the Health Ministry during the year.
In December the central government submitted a report which asserted that
legalizing homosexuality would lead to more cases of HIV/AIDS.
In March 2007 the UN Development Program released a report on "launda
dancers," young men and boys hired to dance in women's clothing at various
events in Bihar and Uttar Pradesh. Dancers were vulnerable to exploitation by
being cheated of earnings or being forced into prostitution. Sexual assault and
gang rape were frequent, and dancers were at high risk of contracting HIV/AIDS.
Some laundas who had illegal castrations to join the hijra (traditional
transvestite) community suffered from post operation complications due to
inadequate medical care.
According to the National AIDS Control Organization (NACO), the government
agency responsible for monitoring HIV/AIDS, there were approximately 2.3 million
persons living with HIV/AIDS in the country, and according to the International
Labor Organization (ILO), 70 percent of persons suffering from HIV/AIDS faced
HRW reported that many doctors refused to treat HIV-positive children and that
some schools expelled or segregated them because they or their parents were
HIV-positive. Many orphanages and other residential institutions rejected
HIV-positive children or denied them
NACO, with support from UNAIDS and the WHO, produced revised AIDS estimates that
showed as of December 2007 approximately 2.31 million persons were living with
the virus and that HIV prevalence among adults was around 0.36 percent.
Estimates for previous years (since 2002) have also been revised.
On February 14, an AIDS victim's body was denied cremation in Kendrapara
district, Orissa, due to fears the smoke from the funeral pyre would spread the
On August 13, Kerala became the first state to reserve government jobs for
On August 14, an initiative to provide insurance to persons with HIV/AIDS was
launched in Karnataka. The state estimated that 250,000 residents were infected
with HIV/AIDS; however, only 22,000 were registered with the main HIV/AIDS NGO,
the Karnataka Network for Positive People.
In Karnataka, civil society organizations alleged that since the May
elections there was an increased intolerance on the part of police. On
October 20, police in Bangalore arrested five hijras on unclear charges. When
representatives from Sangama, a Bangalore-based NGO that defends the human
rights of sexual minorities, visited the jail, they alleged that both they and
the original arrestees were verbally and physically abused, and at least one
female representative was assaulted by police officials. The confrontation
escalated, and 31 were eventually arrested.
The group included women and men who were detained in the same cell, in
violation of police code. Cases were pending at year's end, but all those
arrested were released within 24 hours on bail. On November 9, Bangalore police
issued notices to a number of landlords in the Desarahalli neighborhood alleging
that hijras were "indulging in immoral activities on the premises" and demanding
that the landlords appear at the local police station. The landlords responded
evicting some 30-40 hijras, many of whom were long-term residents.
In 2006 authorities denied five HIV-positive children admission to the Mar
Dionysius Lower Primary School in Kottayam district, Kerala, after pressure from
the community. In August 2007 state government authorities readmitted them.
This moment we have 10 community Care Centres (CCC),out of it 8 are fully
functional and another 2 are about to start very shortly in West Bengal. The
main mo-to of it is to keep the clients on observation when they are starting
ARD because there is a question of Adherence and also to watch the side-effect.
Really we are very much lucky,because we have lots of CCC in this moment.
But the problem is that clients are getting confused where they will go and
where not to.I am not it is happening in all the CCC of West Bengal,but it is
happening in Kolkata. In Kolkata we have one main ARD centre called STM. All the
ORWs of those particular CCC which is nearer to STM are coming to the ARD centre
because they have to take the client for their CCC at any cost.
Some time they are saying come to our CCC we will give you two egg,some time
they are saying come to our CCC we will give you more facility then others are
My question is when the same funding agency is giving the fund how they can do
it or say it like that?
That way clients are getting confused.Almost every month coordination meeting is
going on with DLNs and with other stake holder but it happening like, meeting+
eating = Next Meeting.
Solutions are not coming out. Every CCC are going for the area demarcation,but
nobody is looking for the clients choice. At any cost they have to show that
their beds are full all the time.Because they have to fixed their place for the
next phase. They do not bother what clients are feeling,they do not bother about
their mental satisfaction.At any cost they have to snatch the clients from other
Because of it,
Clients are getting confused.
They are not understanding the importance of the Drug Adherence.
The result is when they are coming back to their home they are not having
medicine properly, some time they are also not having it,and in the serious
condition they are going to the hospital for admission due to their serious
Loss to follow-up cases are increasing day by day.
My suggestion is that area demarcation is fine but the priority should give to
the clients where they will go and where not to go. By name of the demarcation
they should not force the clients.Choice should be given to the clients.
--- On Sat, 28/2/09,
HIV is not a health problem it is one of the major social problems.
It is creating the more social commotion in the children and their
families. I am working for 5 years with HIV/AIDS affected and
Infected children. I observed so many case studies of the children in
Due to AIDS, children become Orphans. It is estimated that more than
20 million children, bellow 18 years have been orphaned as result of
AIDS. This number is increasing day by day in the communities, states
and national scenarios.
Children lost their both/single parents and are suffering from
emotional trauma, attached stigma & Discrimination, deprived of basic
needs (such as food, shelter and cloths) health, education and having
sibling separation. Children lost parental love, care, affection, and
support and depend on others such as grannies; relatives, hostels,
homes, friends, communities and foster families. Approximately 50-60%
AIDS Orphans is living with their aged (65 to 70 years) grannies.
A few of the foster families, relatives and neighbors are exploiting
the children and snatching their properties and are being thrown out
to the streets. As a result Children had to stop their education and
resulting in emergency of child headed families, child labour, child
workers, street children, mediators between the lovers, mentally
retard, commuting anti social elements ,committing suicide and a few
are addicted alcohol, Gutkas, drugs, going to pornographic movies.
If AIDS orphan is a girl, she has more risk than boys. They can
easily fall in Love or depend on a one; it leads to trafficking and
sex work. If the AIDS Orphan is a HIV positive nobody comes forward
to provide care and support and they are under malnutrition and
passing away. This is the current situation of the AIDS orphan.
This is not for all the AIDS Orphans, but majority of the AIDS
Orphans are having the same problems. We need to develop the
intervention on AIDS Orphans in the SACS and other NGO Programmes.
VACANCY ANNOUNCEMENT: Documentation Officer, SWAASTHYA
Last date for submission – 15th March 2009
Preferred Profile of the candidate
- Masters in Social sciences/Social work/sociology or any other related stream
- 1-2 years in development sector
- Strong writing and communication skills
- Proficient in Hindi and English writing and speaking
- Computer literate and web savvy
- Developing reports
- Support to business development plans and proposal development
- Library work
- Assist process documentation
Remuneration shall commensurate with relevant experience and qualifications.
Candidate will be based at Swaasthya’s Head office in Delhi. Last date for submission of application is 15th March 2009. Applications received after the last date will not be considered.
G-1323, Lower Ground Floor
With the 14th Lok Sabha adjourned sine die, it will be the end of bills pending
in the House.
This list includes the Immoral Traffic (Prevention) Amendment Bill, 2006,
seeking to criminalise sex work. On Monday, 23rd February 2009, the Union
Cabinet failed to approve official amendments to the original bill, which is now
set to lapse. As per the Constitution, a
bill pending in the House of People or having passed by the House of People but
pending in the Council of States, shall lapse on dissolution of the House. The
ITPA bill was introduced in the Lok Sabha in May 2006.
This is a major victory for sex workers and sex work rights advocates, who have
been lobbying against the bill since its conception by the Ministry of Women and
Child Development ("WCD") in 2005.
The bill intended to shift legislative policy on sex work from tolerance to
prohibition. This was sought to be done through the introduction of a new
offence of visiting a brothel, which would penalise clients. It also sought to
broaden the meaning of prostitution to include all transactional sex, as opposed
to acts involving exploitation on a commercial scale.
By inserting a definition of trafficking for prostitution, the bill attempted to
criminalise poverty induced sex work. Other changes included lowering rank of
Police authorized to arrest, search and raid brothels and extending detention of
sex workers to seven years. Sex workers vehemently opposed these measures which,
they believed, would offset any positive effect of decriminalizing soliciting.
After its introduction in the Lok Sabha, the ITPA Amendment Bill was
referred to a Parliamentary Standing Committee. The Committee submitted its
findings in November 2006 after consulting with NGOs, lawyers, Women's
Commissions, and sex workers themselves. It suggested further changes besides an
overhaul of the entire law.
In May 2007, WCD moved additional amendments, which were referred to a Group of
Ministers (GoM) after objections by the Health Minister, who apprehended that
the bill would push sex work underground and weaken efforts to prevent HIV. The
GoM concluded its deliberations in April 2008, amidst dissent from two
The bill not only divided the political class; it also saw polarization within
the U.N. While UNAIDS denounced the move to criminalise clients, the UNODC,
under its anti human trafficking programme, distributed posters to punish
clients to end demand for sex work.
The Commission on AIDS in Asia, which presented its report to the Prime Minister
last year, recommended decriminalsation of commercial sex to reduce sexual
transmission of HIV.
The campaign to repel the ITPA Amendment Bill is not insignificant.
Modeled in Sweden, law penalizing purchase of sex is being adopted in many parts
of the world, particularly Europe and America. In Asia, South Korea criminalized
buying or attempting to buy sex in 2004.
In 2007, Nepal approved criminal sanctions against prostitution and last year,
Cambodia witnessed serious abuse of sex workers' rights under the Law on
Suppression of Human Trafficking and Sexual Exploitation. India would have gone
the same way but for the resilience of sex workers.
For more information, visit
The struggle against criminalization continues; the bill may have faded, but not
mindsets that propagated it.
Lawyers Collective HIV/AIDS Unit
Ludhiana, February 26
The Punjab State Aids Control Society has sounded an alarm bell in the districts
of Ludhiana and Amritsar that have the maximum number of HIV/AIDS cases in the
state and have been put under Category A.
Despite the efforts to control AIDS in the district, the health authorities have
failed to evolve a foolproof system. A separate AIDS wing had been set up in
Ludhiana under the guidelines of the National AIDS Control Programme (NACO)
under the district programme officer.
Ludhiana and Amritsar are the only districts where these special wings had been
The Integrated Counselling and Testing Centre (ICTC) at the civil hospitals in
Ludhiana, Samrala, Payal, Raikot, Jagraon, the DMCH and the CMCH, despite being
the last resort for HIV/AIDS patients, is unable to reach out to a large number
Counsellors at these centres refused to give the number of positive cases on the
pretext of “confidentiality”. A senior doctor, maintaining anonymity, said: “It
is difficult to ascertain the authenticity of the records as a large number of
positive cases from targeted areas do not come in the open. At the same time
there is no need to hide the number of patients as it invalidates the cause of
helping patients to come out in the open and the general public to treat them
Dr Geetika, district programme officer for AIDS in Ludhiana, said: “There is no
time to lose as it is the need of the hour to tackle the problem. I have already
started holding meetings to deal with emergency. ICTCs, gynaecology clinics,
public and private blood banks and NGOs have been asked to send detailed reports
of positive cases.”
She also spoke of the shocking revelations by the team of experts on “Red Ribbon
Express” that accelerated the process of consolidating the AIDS control
programme in Ludhiana.
Creating awareness was the top priority as slum dwellers, truckers, IV drug
users, commercial sex workers and their clients were among the worst affected,
the district programme officer stated
HIV +ve people to be offered jobs soon
25 Feb 2009, 0443 hrs IST, Shimona Kanwar, TNN
CHANDIGARH: UT's State AIDS Control Society (SACS) intends to provide
counselling to HIV positive persons from those who really know their troubles.
It intends to hire 10 HIV infected people for its integrated counselling and
training centre (ICTC).
The posts will pay Rs 3,000 per month. They will be advertised soon. Those on
the job will provide advice to HIV positive individuals and help them conduct
We have the approval of National AIDS Control Organization for this. These
counsellors will follow up on patients and urge them to continue treatment,â€ť
said UT SACS director Vineeta Gupta. There are 350 registered HIV positive
people in the city and 60% of them are unemployed despite being qualified.
As Pooja Thakur, president of the Chandigarh Network of People Living With HIV,
noted, â€śBasic treatment costs Rs 2,000 per month, though the antiretroviral
therapy comes for free. It is difficult to manage finances. Most of us are
turned out of offices when we disclose our HIV status. Therefore, this will be a
The opening will also be of help for Rakesh Kumar, who is HIV positive. He is
surviving on a meagre Rs 400 per month. â€śI have been writing to all the health
and treasury department officials for the post of a peon advertised a year ago.
I had lost my only source of income when a project dispensary for HIV, where I
was working, closed down,â€ť he said. â€śThe virus makes these people vulnerable
to infections and fatigues them. They would be able to handle this kind of work,
PresidentChandigarh Network of Positive People (CNP+)
Drop In Center - Int. Hotel, Sector 15A,
Madhya Marg, Chandigarh 160 015.
Tel.: +91-172-2784042, Cell: +91-9316177261
Professor Amartya Sen has lots of places he can shed crocodile tears. Why here?
Vice President Releases Book `Hopes Alive: Surviving Aids and
The Vice President of India Shri M. Hamid Ansari released a book
entitled "Hopes Alive: Surviving AIDS and Despair" published by FXB
India Suraksha at a function here today. Addressing on the occasion,
he said that the significance of the serious public health challenge
posed by HIV-AIDS is widely accepted and undeniable.
The challenges multiply when the incidence is in a developing
country, where illiteracy and poverty complicate prevention and
countering of AIDS. Concerted action by the government and civil
society has slowed the spread of AIDS but it would be a long time
before we can take satisfaction that the AIDS epidemic would not
threaten the lives of young men and women and their children.
Following is the text of the Vice President's address :
"It gives me great pleasure to be present today at this function and
to release this book outlining human stories of hope and
encouragement from various parts of the country.
The success of FXB India owes much to the vision and mission of its
international parent and to the commitment and hard work of its men
and women in various parts of India who are supporting the national
mission to fight AIDS and poverty and help those afflicted by them.
The significance of the serious public health challenge posed by HIV-
AIDS is widely accepted and undeniable. The challenges multiply when
the incidence is in a developing country, where illiteracy and
poverty complicate prevention and countering of AIDS. Concerted
action by the government and civil society has slowed the spread of
AIDS but it would be a long time before we can take satisfaction that
the AIDS epidemic would not threaten the lives of young men and women
and their children.
The efforts of FXB India deserve full appreciation because of the
specific focus on reaching out to children who are infected or become
orphans as their parents are infected. Their marginalization not only
ruins their lives but also places an enormous economic, social and
moral burden on our society and polity. They need the hope, caring
touch and commitment that many individuals and civil society
organizations in the country are trying to provide.
As I went through the stories of hope and despair of various children
in the book, I was particularly struck by the plight of the so-
called `platform boys and girls'. They are especially vulnerable
segment among children with no family moorings, survive undertaking
hazardous occupations and become vulnerable to exploitation.
I do hope that more efforts would be focused on addressing the
problems that lead to this phenomenon of platform children and
concerted governmental and civil society actions would succeed in
addressing their plight. I once again congratulate FXB India for
their efforts and wish all its members success in their endeavours."
Dear Monica & Forum,
I must congratulate you for your post. I do agree that the wonderful
work done by STRC and DSACS is learning lessons for TI planners in
various different states. Hotspot wise minute study, understanding and
planning done by all old TI partners is commendable and great work.
TI is changing day by day and Delhi TI partners are also upgrading
their skills and professional commitments gradually. Its good sign
towards a new change.
Yes, NACO, DSACS and STRC Delhi deserve the credit for incredible work
done in Delhi state.
Together in the fight against HIV/AIDS,
9811188949, 22486499, 22485347
Technical Support Facility - India/Nepal
The Technical Support Facility (TSF) is a two year multi-country
project to support effective technical capacity development on
HIV/AIDS in South Asia. It is supported by UNAIDS and will be managed
by ActionAid ( Asia region) in collaboration with its partners, TATA
Institute of Social Sciences (TISS) India and The International
Centre for Diarrhoeal Disease Research, (ICDDRB) Bangladesh. The
project will cover seven countries in the sub region (Bangladesh,
Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka).
The following international staff will be required for the TSF
1. Finance and Contract Management Advisor (Based in Kathmandu ,
2. Monitoring, Evaluation and Accountability Advisor (Based in
Kathmandu , Nepal )
3. Capacity Building Advisor (Based in Kathmandu , Nepal )
4. Programme Development Advisor (Based in Delhi , India )
Finance and Contract Management Advisor. (Based in Kathmandu, Nepal)
Responsible for financial planning and budgeting, recording all
financial transactions, ensuring finance system compliance and
accountability, preparing and providing quarterly and annual reports
to concerned stakeholders and managing contracts.
The candidate will have relevant educational and professional
qualifications; minimum five years' senior managerial experience in a
similar post, with strong financial management skills; good knowledge
of international accounting principles; excellent analytical and
Monitoring, Evaluation and Accountability Advisor. (Based in Kathmandu, Nepal)
Responsible for creating and maintaining the Monitoring and
Evaluation (M&E) systems, undertaking quality assurance of
deliverables including review of consultant deliverables, building
capacity of consultants and partners on the M&E systems developed.
The candidate will have relevant educational and professional
qualifications; minimum five years' senior managerial experience in
planning, management, monitoring and evaluation of HIV/AIDS
programmes; sound understanding of the HIV epidemic in South Asia and
excellent analytical and communication skills.
Capacity Building Advisor. (Based in Kathmandu, Nepal)
Responsible for identifying the training needs of concerned
stakeholder groups, designing training modules, providing training
when required and monitoring progress and country partners capacity
to manage technical assistance and maintain training statistics.
The candidate will have relevant educational and professional
qualifications; minimum five years' senior managerial experience in
capacity building; sound understanding of the HIV epidemic in South
Asia with excellent planning and organizing ability along with
communication and facilitation skills.
Programme Development Advisor. (Based in Delhi, India)
Responsible for effectively marketing the services of TSF to
potential clients and other stakeholders, liaising with government
agencies, partners, donors and other relevant stakeholders and being
the focal person of TSF in India.
The candidate will have relevant educational and professional
qualification; minimum five years' senior managerial experience in
developing and maintaining effective working partnerships with
donors; sound understanding of the HIV epidemic in South Asia and
excellent planning and organizing ability along with communication
and negotiation skills.
The above posts will report to Project Director –TSF. We seek
individuals with ability to facilitate and work in multi cultural
environment; familiarity of working with international donors and
governments and with project management experience. She/He should be
aligned to the values of ActionAid and UNAIDS; have excellent
knowledge of English. Familiarity of the local languages in the sub
region will be an asset.
These posts require travel within the sub region and internationally
and are offered under AAI`s international terms and conditions for a
two year contract initially with possibility of one year extension.
An application letter along with an updated CV including two referees
should be sent to job.asia@... by 20th March 2009.
We will be able to respond only to the shortlisted candidates for the
selection processes. For more information on ActionAid visit:
Whilst all applicants will be assessed strictly on their individual
merits, qualified women are especially encouraged to apply.
Tel: +977 1 4436477
Let us not rejoice too prematurely. There is every possibility that the
dispensation that comes back after the general election will resurrect the bill.
And bad luck if that dispensation is the fascist NDA. Their bill will likely be
worse than the present avatar that lapsed.
- Aditya B
I am making noises since long about Amritsar.Good to hear SACO is
bothered. By the way it is not Amritsar and Ludhaina--the patients
with are from all over the state and by some coincidence to Leprosy
patients of one state prefer treatment at other state and same holds
true for districts.
My services ,as I always said are at the disposal of all including
SACO,in case they are seriously thinking of involving people with
My center is already catering to the needs of rejected by MCA,widows
and orphans.I also provide services for admissions and surgeries etc
(usually Dilly dallied by recognised centers and territory care
hospitals even) thru a network of dedicated physicians and surgeons.
During my visit to USA (presently) and discussions here with physician
friends here,I am sure it is more apt to repeatedly educate the
medical community at a regular interval.
Yes,this can not belittle the importance of awareness programmes.
Rakesh Bharti MD,AAHIVS,
BDC Research center,
27-D,Sant Avenue, The Mall, Amritsar.
Punjab, INDIA1 43001.
The problems of children affected by HIV/AIDS is of varied nature and one cannot
get satisfied by bringing one or two.
Another important observation has been that several organizations - both
NGOs/CBOs and the government have silently been rendering services. Individual
observations and personal experience of the few cannot be generalized.
Instead, evry such person can identify and associate these NGOs/CBOsÂ and help
them to save the AIDS orphans. Particularly, India HIV/AIDS Alliance through its
networkis doing great service in providing different support to these children.
Even their model can be replicated at the least investment with greater
participation of the local community. There is also a research publication on
their models by USAID - Pact - Community REACH. Let us bring solutions and
resources to save our posterity and discuss about these.
Dear Friends and Colleagues,
Registration continues for this yearâ€™s International AIDS Candlelight Memorial
Programme. If you have not registered yet, please visit
where you can register free of cost.
All registrants will be receiving a coordinator packet including
a manual with guidelines on organising and fund raising, posters, web space to
post event details, opportunities to participate in leadership and exchange
activities, and membership to the campaign's global coalition. This year's event
is just 12 weeks away.
The Memorial Program which started in the year 1983 is being
coordinated internationally by the Global Health Council, since 2000.
Today the memorial has grown to be the largest grassroots level event in the
global response to HIV. For the Candlelight Advocacy Platform, this year the
council has narrowed down on Ensuring Access to Treatment, Prevention & Care as
Memorials range from small community vigils to multi-day national
commemorations. In addition to remembrance, many coordinating organizations use
the Candlelight Memorial as an opportunity to promote local AIDS services,
encourage education and community dialogue, and advocate for the advancement of
Memorials often include lighting of candles, marches, speeches, dramatic
performances, spiritual and cultural rituals, and a safe space for interaction
and community engagement.
Please feel free to contact me for any questions or clarifications.
Together We are the solution,
Thanks and Regards,
International AIDS Candlelight Memorial.
Indian Youth Festival Puts Sexy Back in Dialogue About Safe Sex
By Rama Lakshmi/ Washington Post Foreign Service
Monday, March 2, 2009; A12/ NEW DELHI -- A recent youth festival aimed at
raising awareness about health issues and HIV in India did something unique to
draw visitors. Amid all the sobering talk of at-risk communities, safe sex and
health care, the festival invited bashful attendees to talk about pleasure.
At one booth, visitors were urged to leave tips in a drop box under a sign that
asked, "Can safe sex be sexy?" In another booth nearby, the use of the female
condom was demonstrated to curious onlookers.
But talking about sex can be an uphill task in India 's traditional and
patriarchal society. Even though India gave the world the "Kama Sutra," the
ancient Sanskrit text about sexual behavior, open conversations about sex remain
taboo in the country.
"The whole debate about safe sex has been conducted around fear, danger, disease
and death. It is negative. We forgot the pursuit of pleasure. We have to put the
sexy back into safer sex," said Anne Philpott, the British founder of the
Pleasure Project, an international educational program that promotes safe sex
that "feels good."
The program was born out of Philpott's experience promoting female condoms in
India , Sri Lanka , Senegal and Zimbabwe as an "erotic accessory." In the past
four years, she has pushed the pleasure principle at AIDS conferences in Bangkok
, Sri Lanka and Mexico, and she is teaming up with Indian health groups to
re-spin the safe-sex message.
"Health workers often address the issue of safe sex in a clinical manner or like
a teacher wagging their finger. It is more effective when they find creative
ways to incorporate pleasure and desire into the sexual-health dialogue," she
About 2.5 million Indians were living with HIV in 2006, according to a report by
the United Nations, and one-third of them were ages 15 to 24. Fifteen years
after India began a national anti-AIDS program, the government is still
confronting the basic challenge of getting people to even utter the word
"condom." An advertisement campaign called "Condom Bindaas Bol" or "Say Condom
Freely" urges people to say the word without fear of stigma.
"In our culture, there are so many wedding songs that are full of playful sexual
connotations. Women sing it, but when you ask them to talk, they go shy," said
Rituparna Borah, project associate for Nirantar, a group that works on rural
women's health issues in northern India . "But once they begin to speak, the
walls come down."
One area in which Philpott's pleasure principle is being implemented
successfully in India is the promotion of the female condom.
At the youth festival, held last month and dubbed Project 19, the volunteers led
a game in which they asked amused visitors to describe their first impression of
the female condom.
"We tell the sex workers to have fun with the female condom. We tell them, 'You
spend money on makeup, jewelry, jasmine flowers for your hair. This female
condom is another ornament for you,' " said Kavita Potturi, national program
manager with Hindustan Latex Family Planning Promotion Trust, a division of a
company that sells the female condom.
Two years after a limited introduction, India will scale up the distribution of
female condoms among 200,000 sex workers. According to a study by the
governmental National Aids Control Organization, sex workers said they often
persuaded their clients to use protection by citing enhanced pleasure from it.
The number of nongovernmental groups using the pleasure rationale to promote
safe sex is slowly growing in India .
"When we begin to talk about HIV and AIDS, people run away. They think we are
preaching celibacy," said G. Krishna, a gay health worker with a group called
Suraksha Society in the southern city of Hyderabad . "I have now begun
conducting rapport-building exercises by asking people how and what they enjoy."
At the festival, a giggly group of college students who stopped at Philpott's
stall excitedly wrote down tips, drew sketches and asked questions.
"We can totally relate to this. We are tired of moral lecturing about safe sex
all the time," said Swedha Singh, 18, a mathematics undergraduate at Delhi
Health workers said they faced barriers in communicating with young people.
"Talking about disease and fear haven't worked very well. People believe they
are in a safe relationship and that disease does not apply to them," said Arushi
Singh, a resource officer for the International Planned Parenthood Federation,
which trains health educators in South Asia .
"But pleasure," she said, "applies to everybody."
Dr. Ash Pachauri
With the first ever showers of rain for the year arriving along with
the festive spring season – on the fateful rainy mid night of Friday,
the 27th of February 2009 we were seven (7) persons including one
hotel boy sleeping peacefully as usual in rented hotel room which we
normally share our living for the last so many years in a place call
Then, suddenly at around 1:30 am in the middle of the night, we were startled,
surprised and awakened by the loud noises of someone kicking and breaking our
door down. There were four men three
of them are in full Commando attires with Guns and another man dressed
in civilian clothing enter our room and started hitting us in the face
and beating us up without saying anything or giving any reasons.
We were so startled and taken by surprise upon the intrusion and all the sudden
outbursts of both verbal and physical abuses that we were
simply dumbstruck to say or do anything about it. They were also drunk
and they scolded very badly with a violent action saying ‘you whore,
HIV positive’ worthless to survive – who will care if we shoot you all
now, furture said I had more extra bullet on me, I can kill you now!
Then, the four persons ordered and forced us to undress including the
very young (minor under 18 year old boy) and parade before them in
this fashion. We were told to lay down on one bed naked and beaten in
this posture using a cane-stick, using verbal abuses all along.
They also tortured and harassed us physically, fondling our private parts,
putting their handful of fingers inside us and even tried putting the cane-stick
inside our private parts. After being beaten to pulps, we were almost black and
blue from all the torture.
It is also worth mentioning that there is a minor girl among the seven of us.
She is only sixteen (16) and she was almost raped by the four security people if
not for the screams/cries and all the begging/pleading from the rest of us. They
also asked this minor to perform oral sex. Then, they told us to perform oral
sex to the four of them and they will set us free. Since, we declined to this
offer; they tried to have sex with us, the minor in particular.
And at last, after countless efforts and failing to gain our consent, they told
us to give them al lest Rupees (500) Five Hundred for each individual i.e. a sum
of amount Three to four Thousand rupees for all of us to set us free and
threatened us of arrest and kill. Since, we didn’t have or couldn’t afford the
money, we told them honestly that we had only Three Hundred rupees, upon which
they became all the more angry and violent. They ransacked and searched our room
for more money and were infuriated upon their failure. They started to call us
names like “WHORES”, “SHALL WE SHOOT YOU ALL”, “YOU HIV/AIDS POSITIVE WHORES ARE
WORTHLESS AND THERE ARE NO ONE WHO CARES EVEN IF WE KILL YOU ALL RIGHT NOW” etc.
After another round of physical assaults and verbal abuses, we were finally
allowed to get dressed and were led out of our rooms to the main road, kicking
and hitting us all the way till we reach their Police vehicle in which they
came. The vehicle didn’t have any registration plates on it.
We were kicked and forced into the back of the vehicle and drove all
along in the middle of the city and other suburban area for more than
an hour in around 2.30 am, the beatings and abusing didn’t stop even
inside the vehicle at this time.
At last, it was such a relief for all of us when they have ask three options,
whether we want to get down in the suburban area, in the police station or be
We are so afraid and confuse what to be response – finally we requested them to
drop us at any police station thinking at lest there we will be able to find
female police constable. Then almost in early morning about 3.00 am we were
taken inside the Imphal West, Central Police Station and handed over to the
Women Police Personals over there.
When these Imphal west Police personals asked them about their identity, they
answered that they were from the Thoubal Police Commando Unit, and this was the
first time only during the whole incident that we were able to know or hear
anything about the four persons.
After they left, we six female spent at least 9 hours in this Imphal west Police
station until our rent/hotel owner came to free and take us back.
The whole incident has left us with massive fear, countless physical
bruises and insecurities. Such incidents happen very frequently but
the past incidents are nothing compared to the degree of harassment
and violence released upon us in this encounter, simply for being
female IDUs & SWs. We feel helpless in the sense that they were all
from the state law enforcement and don’t know how or where to react.
The whole event has left us with a scar so deep that only time can
heal and we’ll carry this scary memory all through the rest of our
Why we have been humiliated and physically abused? It’s for being female??•
Aren’t there any jurisdictions for the state police agency?•
Why were there no warrants and why were we not given their proper identities by
There are some certain questions which we would like to raise -
‘To whom so ever, may concern’ How, Where, When and to Whom we may seek support?
We are also human being, we want to live with dignity and rights as other
community people do.
Re: Aditya Bondyopadhyay 's posting re: End of move to criminalise sex work.?
No. I do not worry about our government. I Think that the Indian
government has enough sane heads... whichever party. The problem is pressure
from the US. With a new administration hopefully we will move away from
criminalisation as a construct to deal with issues arising out of HIV.
The anti- trafficking advocates who have mixed up sex work and trafficking are
the main proponents of the ITPA amendments. We need to help them understand that
this conflation is not only problematic it is result less.
Today on Sex Worker's Rights Day I would keep the caution aside and
congratulate all HIV/AIDS and sex work activists and advocates on the
effective advocacy with the government and I feel proud of the sex workers who
made it possible. Victory to us.- however small and transient.
Meena saraswathi seshu.
Invitation to Participate: First International Conference on Alcohol and HIV in
India August 3-4, 2009
Pre-conference training workshop: August 1-2, 2009
The International Institute for Population Sciences (Mumbai, India), The
Institute for Community Research (USA) and the National Institute on Alcohol
Abuse and Alcoholism, N.I.H. (USA) are sponsoring the First International
Conference on Alcohol and HIV in India.
This conference will take place in Mumbai, India, August 3 & 4. The conference
will be preceded by a two-day training workshop August 1 2.
For further details go to http://www.alchivconf2009.in/
The conference aims to examine the role that alcohol plays in contributing to
sexuality and sexual risk related to sexually transmitted diseases and HIV by
highlighting the work of current Indian and U.S.-Indian partnership research on
these topics. The outcome is an agenda for continued research in India on
alcohol consumption and its association with sexual risk, violence, unwanted
pregnancies, unwilling sex, and other sexual health problems. Invited keynote
and plenary speakers will provide overviews of issues in alcohol and sexuality
research, research methods and current studies.
South Asian researchers and international researchers working in India are
invited to submit abstracts for posters/oral presentations.
Approximately 40 to 50 abstracts will be chosen for poster presentations, oral
presentations or both; abstracts will be posted on the conference website.
The conference pre-training workshop will provide doctoral students and more
advanced researchers with an orientation to the field of alcohol and HIV
research, both in India and internationally, and methods training in the
collection and analysis of alcohol use data, and qualitative/ethnographic
approaches to data collection on sexual behaviors, gender norms, and alcohol
Approximately 20 candidates for the training workshop will be chosen and
fellowships covering all training expenses will be provided to successful
candidates. Trainees will be expected to attend the conference.
Interested candidates can apply on the conference website.
The conference venue will accommodate a total of 150 - 160 participants
including all keynote speakers, poster and panel presenters and attendees. Up to
70 conference attendees who are non-presenters are invited to register at the
The deadline for all applications is April 30, 2009. Notification of acceptance,
May 31, 2009.
Conference registration costs: Indian residents and nationals, Rs. 3000;
international attendees, $200. Conference materials will be available upon
All meals will be provided to every registrant during the conference.
For further updates about the First International Conference on Alcohol and HIV
in Indiaâ€ť, please visit the conference website:
http://www.alchivconf2009.in/ We look forward to seeing you in Mumbai, India.
Dr. F. Ram*, Dr.. Jean. J. Schensul**, Dr. S. Lahiri*, Dr. Kamala Gupta*, Dr.
Kendall J. Bryant***, and Dr. S.K. Singh* (Organizing Committee)
*International Institute for Population Sciences (http://www.iipsindia.org/);
**Institute for Community Research (www.incommunityresearch.org), ***National
Institute on Alcohol Abuse and Alcoholism (http://www.niaaa.nih.gov/).
Conference Communications Coordinator
Phone number: 785-341-2728
ODISHA-One a consortium of NGOs &CBOs working in the field of Sexual
28 February 2008: in a Red Ribbon Club Meeting held in Mahamayi Womens College,
Berhampur Dr. Ramesh Chandra Chyau Patnaik, MLA Berhampur in his key note
address stated, "People with AIDS should be segregated and should not be allowed
to mix with ordinary people, as that will spread AIDS (Dr. Chyau Patnaik is a
MBBS). The Principal of the College, Kalicharan Panda in his speech said, "why
should State pay expenses of the people with AIDS for the mistakes they commit".
11 February 2009: In Berhampur University a sensitization workshop on HIV and
Migration was held, this was organized by Central Board for Workers Education.
The Vice Chancellor of Berhampur, Dr. Bijoy Kumar Sahoo in his key note address
spoke briefly about HIV&AIDS and said,"
HIV is dangerous and so contagious that it can spread through touch". He further
stated," A few African people killed a monkey and ate the meat of the monkey
resulting in spread of this virulent disease.
In the same meeting Dr. Trinath Behera, the MLA of Gopalpur and retired Chief
District Medical Officer said the following, "if you go and shave in saloon, or
have a haircut then you will get AIDS, he further said, `Prostitutes have been
given certificate that they are not infected with AIDS', and further said, `when
you visit them ask them for their certificate, once you have verified then
In another meeting of the Red Ribbon Club held at Sasana High School retired
CDMO, currently working as contractual Medical Officer in Jagdalpur was invited
as Chief Speaker said, "people say that AIDS cannot be spread through mosquito,
but I don't believe it, AIDS is spread through mosquito".
In PPTCT training facilitated by Aruna and supported by Aruna and OSACS, Doctors
argued that AIDS can be spread through mosquito bites.
Chandrasekhar Sahoo, MP, Berhampur has in several meetings said, People with
AIDS get it because of sins and mistakes they have committed.
In the ART Centres 2 Kg cereals are being provided to PLHIV&AIDS on the packet
it has been stamped, it is only for people living with HIV&AIDS. When PLHIVs in
Berhampur reacted they were asked to give it back or shut up.
All of these campaigns have been undertaken in the high prevalent district of
Don't these incidents say something about Orissa and the HIV&AIDS programme in
Do we still feel that enough is being done to prevent HIV&AIDS in Orissa?
Really sad and sorry to hear about Bangis ordeal but glad Bangkim has decided to
share in this forum.
A copy of your letter should be copied or sent to:
Leading human rights groups in Manipur or Imphal.
Individual NGO's working with IDU's on HIV and AIDS in the area
Heads of the networks of NGO's working on IDU's. HIV and AIDS in
The State AIDS Control Society.
The Minister of Home, Government of Manipur.
The Chief Minister of Manipur.
The major newspapers in Imphal.
The police station in North AOC.
In addition, if there is no network or collective of female IDU's and female
sex workers. You should explore the possibility of forming one. There is always
strenght in a collective.
It will be useful to get the advice of a lawyer who works on issues of human
rights in Manipur or Imphal. On what could be done within the legal framework
and what could be done if such instances reoccur.
I think it will also be useful to learn and educate yourself and your frens
more about your rights (as IDU's).
The fact that you and your frens shared your ordeal in this forum means that you
want something to be done about it. But if this has to lead to action, you have
to take the lead (and you already have) I am sure there will be many who will be
willing to offer support once you take the lead.
I am quite happy to provide you advice and assistance electronically over the
email (if you find some of the suggestions useful). As I do not live in Manipur
Sharing a report from Reuters.
Kinly peruse and opine.
Scientists make HIV strain that can infect monkeys
WASHINGTON (Reuters) - Scientists have created a strain of the human AIDS virus
able to infect and multiply in monkeys in a step toward testing future vaccines
in monkeys before trying them in people, according to a new study.
This strain of HIV, the human immunodeficiency virus, was developed by altering
a single gene in the human version to allow it to infect a type of monkey called
a pig-tailed macaque, the researchers said on Monday.
The genetically engineered virus, once injected into this monkey, proliferates
almost as much as it does in people, but the animal ultimately suppresses it and
the virus does not make it sick, they said.
The strain is called simian-tropic HIV-1, or stHIV-1.
Researchers hope to be able to test possible new AIDS drugs and vaccines in
monkeys before trying them in people.
There is a "cousin" virus to HIV called SIV, or simian immunodeficiency virus,
that causes a disease similar to AIDS in certain types of monkeys.
But this monkey AIDS virus is not identical to the one that infects people and
is not a perfect substitute for testing drugs and vaccines against HIV.
"If our research is taken further, we hope that one day perhaps in the
not-too-distant future, we'll be able to make vaccines that are intended for use
in humans and the very same product will be able to be tested in animals before
human trials," Paul Bieniasz of the Rockefeller University in New York, one of
the researchers, said in a telephone interview.
Scientists have struggled to create an AIDS vaccine.
"If you make a drug that's effective against HIV, sometimes it works against SIV
and sometimes it doesn't. So that basically devalues SIV as an animal model for
doing experiments involved with developing drugs," Bieniasz said.
"Now if you want to develop a vaccine, essentially what you have to do is to
make a parallel vaccine for HIV and for SIV. You can test the SIV vaccine in
animals and then have to make the leap of faith that the same approach would
work equivalently in humans."
Writing in the journal Proceedings of the National Academy of Sciences, the
scientists said in making the genetically engineered virus they removed the HIV
version of a gene, known as vif, and inserted the SIV version. This gene acts to
thwart proteins made by the monkey that that kill viruses.
Bieniasz said the scientists may need to make additional changes in the stHIV-1
to make it better for testing vaccines.
The genetically engineered virus infects the monkeys and during the early course
of infection is a reasonably good mimic of what happens in HIV-infected people,
But after initially spreading in the monkey's body, the animal succeeds in
suppressing the virus -- not completely clearing the virus but driving it to
very low levels.
"The slight problem is the monkeys don't go on to develop AIDS, they don't get
sick," Bieniasz said.
Dr. Rajesh Gopal,MD
Gujarat State AIDS Control Society (GSACS),
O/1 Block, New Mental Hospital Complex,
Meghaninagar,Ahmedabad, Gujarat. PIN 380016 Phone (O)
079-22680211--12--13,22685210 Fax 079-22680214
Even in this days the Government and NACO providing free ART for the benefit of
the PLHIVs in order to improve their quality of life in all aspects, some of the
private practitioners are not allowing their poor PLHIV clients to access this
Government Free ART support because they have the fear of losing their clients
and ultimately money out this.
So I request those private practitioners kindly hand over the treatment histroy
or case book whichever you are keeping with as a hold from the PLHIVs kindly
give it back to your poor clients to access the free ART support at Governnment
Health Service Centers.
Most of the poor clients are not able to bear up the medicine cost and its
related OI treatments as they are not aware about the free services available at
nearst hospitals when they started or forced to start ART even without any
Above all if the spouse is taking treatment in that hospital the particular
hospital insisting their spouse should also enrol and get ART medicines from
Who is going to stop all this inhuman practices?
Greetings from I-TECH India!
The International Training and Education Center on HIV (I-TECH), a collaboration
between the University of Washington and University of California San Francisco,
is a global AIDS training programme working at the invitation of ministries of
health and the U.S. government to increase human and institutional capacity for
care and treatment in countries hardest hit by the HIV and AIDS epidemic.
You may also visit www.go2itech.org for more information on I-TECH
I-TECH has been working in India since 2003 to equip health workers with
enhanced knowledge and skills to care for people with HIV. I-TECH aims to
enhance human capacity for HIV care and support in high-prevalence states in
India through trainings and skill building.
I-TECH's primary activities include:
Assessing needs and capacity for training and clinical care.
Designing management and workforce training systems.
Supporting knowledge transfer through instructional design and on-site training.
Strengthening organizational capacity through development assistance and
As part of its primary focus on training, I-TECH has developed a series of short
training workshops mainly focusing on Training Programme Development &
Implementation, Monitoring & Evaluation, Facilitation Skills and the ADDIE model
for Curriculum Development.
As a prelude to the Monitoring and Evaluation training, we are happy to announce
the commencement of a Training Programme on Epi Info.
This training will be conducted in two phases: Basic level for beginners and an
First Phase - Basic Level : 12th and 13th March 09
Second Phase - Advanced Level : 30th and 31st March 09.
Participants may choose to attend both sessions depending on their requirements.
Objectives of the training:
To provide an introduction to Epi Info as a tool to facilitate data collection
To gain an understanding of how to practically utilize Epi Info as a
research/data analysis/monitoring & evaluations tool through case-study exercise
Two days training programme with 6 hours per day of formal instruction followed
by 1-2 hours of individual instruction as required.
Attendees will also be asked to bring a dataset from their own program that will
be used to demonstrate specific aspects of Epi Info (import, analyze, reports,
The training methodology would include hands on training, using a case study
based approach (CDC-developed case study on Cholera in Rwenshama).
Participants are encouraged to bring their own laptops for the training, but if
they require a system, I-TECH would organize it on prior intimation.
Evaluation instruments will be used to measure the efficacy of the training
(pre/post assessment, final course evaluation, daily course evaluation).
Participant Handbooks including session objectives, handouts and worksheets will
be provided to all participants.
Who Should Attend This Workshop?
Monitoring & Evaluation Leads.
The registration fee is Rs.1000/- per participant for each of the trainings
payable via Cheque/DD drawn in favor of "AROGYAAN". All participants (from
Chennai and outside Chennai) will have to make their own arrangements for travel
Timings: 9 AM -5 PM
GHTM Training Center
Government Hospital of Thoracic Medicine
Chennai- 600 047
Interested participants should send the participant registration form on or
before March 9, 2009 to sudha@....
With warm regards,
I think there is a need to understand a lot of grassroot realities before one
becomes an advisor to any advocate:
-If among the prostituted women a large percentage of them are there due to
force or deception then there is a dire need to look at the complicated chains
of so called "sex work" and trafficking.( I am wary and reserved of this term
sex work...I don't think there is anything like that in the law).
-Among the significant number of so called 'willing' persons if there is
majority who opted for this simply because there was no option,then there is a
dire need to look at the inadequate state and system and relook how this kind of
optionlessness can be permanently plugged.
-I also feel there is a need for all of us who are advocates of something or
other to really introspect whether it is good idea to legitimise a forced option
or invest our energies demanding options that are not demeaning either to the
body or the self.
-Also it is important to understand the proposed ammendments in its entirety and
understand the spirit behind it.
-Finally if people think there is not a connection between so called 'sex work'
and trafficking I strongly would reccomend them to listen to the prostituted
women & girls more carefully especially on how they landed there.
We as anti trafficking advocates continue to be a small minority voices as most
of us not only we face threats and intimidation from traffickers but also from
groups who support the perpetrators to legitimise this human rights violation
and thus less people opt to be doing what we are doing.Ofcourse it goes without
saying less money is here. But the truth in our voices will continue to be a
strong force which will act as detterent for many.
In solidarity with all those who believe that no human being deserves to be
sexual slave in any domain.
Dr Sunitha Krishnan
Thanks to Sarita for raising this extremely pertinent issues regarding the state
of HIV & AIDS Prevention Programme in Orissa
We cannot allow all the sustained efforts for the containment of the dual
epidemics be marred by such statements which evince total lack of perspectives
I am shocked about the utterances,inter alia, of a purportedly qualified
Let us reinvigorate all our concerted endeavours for prevention,care, support
and treatment of HIV/AIDS(with a built in mechanism with zero tolerance for any
stigma ,discrimination and denial of human rights to the PLHIV) by challenging
any such words and deeds at all fora.
All the stakeholders must join hands to do the same lest the concerted
collective action for containing HIV goes back by decades to the stage of denial
(or more harmfully to moralistic judgemental stances).
Today's issue (Thursday,March 2009) of Hindustan Times has a letter to the
editor which deserves a public campaign. It reads:
"We ask the Home minister to decrminalise homosexuality in India. An an
emerging global power, India cannot continue to rely on archaic colonial laws
that are bearly 150 years old and which oppress a group of citizens whose
sexuality is a normal variation of human behavior.
Speaking as representatives of the mentral health profession, we assert that
there is no evidence that homosexuality is a mental illness, now supported by a
large body of research. But as a result of Section 377 of the Indian Penal Code
still being law, there is government sanction of such discrimination.
A group of citizens are being unjustifiably denied essential freedoms, and are
often physically abused and blackmailed by the police and other malicious
It is signed by Dr. E.Mohandas, President-elect, Indian Psychiatric Society,
Dr.Nada Stotland,President, American Psychiatric Association, Prof Dinesh
Bhugra, President, Royal College of Psychiatrists
Let us start a campaign as part of the civil society Charter of Rights that are
non-negotiable for this forthcoming Lok Sabha election.
It will help the gay,lesbian,bisexual and transgender community to add muscle to
their demand for the ongoing fight to reform the anti-sodmy laws in the country.
So write immediately to all your aspiring Lok Sabha candidates a polite letter
asking that this be included as psrt of their election manifesto. Civil Society
and the lGBT community can do it. It should read thus:
Greetings on standing for elections as our representative to the Lok Sabha. We
request you to actively help in reforming archaic laws that oppress our citizens
and take away their legitimate rights. This is with special reference to Section
377 of the Indian Penal Code that continues to oppress members of the gay,
lesbian, bisexual and transgender hijra communities. Please help by revoking and
reforming this law when you become MP. Best wishes for your election campaign.
Ashok Row Kavi
Just address an email to AIDS-INDIA@yahoogroups.com
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