Who is affected by HIV and AIDS in India?

Who is affected by HIV and AIDS in India?

People living with HIV in India come from incredibly diverse cultures and backgrounds. The vast majority of infections occur through heterosexual sex (80%), and is concentrated among high risk groups including sex workers, men who have sex with men, and injecting drug users as well as truck drivers and migrant workers. See our page on affected groups in India for more information.

HIV prevention

Educating people about HIV/AIDS and how it can be prevented is complicated in India, as a number of major languages and hundreds of different dialects are spoken within its population. This means that, although some HIV/AIDS prevention and education can be done at the national level, many of the efforts are best carried out at the state and local level.

Each state has its own AIDS Prevention and Control Society, which carries out local initiatives with guidance from NACO. Under the second stage of the government’s National AIDS Control Programme (NACP-II), which finished in March 2006, state AIDS control societies were granted funding for youth campaigns, blood safety checks, and HIV testing, among other things. Various public platforms were used to raise awareness of the epidemic - concerts, radio dramas, a voluntary blood donation day and TV spots with a popular Indian film-star. Messages were also conveyed to young people through schools. Teachers and peer educators were trained to teach about the subject, and students were educated through active learning sessions, including debates and role-play.⁴⁹

AIDS awareness banners in Sangli, India - 2005

The third stage of the National AIDS Control Programme (NACP-III), was launched in July 2007 and runs until 2012.⁵⁰ The programme has a budget of around $2.6 billion, two thirds of which is for prevention and one sixth for treatment.⁵¹ Aside from the government, this money will come from non-governmental organisations, companies, and international agencies, such as the World Bank and the Bill and Melinda Gates Foundation. ⁵²

As part of its focus on prevention, the government has supported the installation of over 11,000 condom vending machines in colleges, road-side restaurants, stations, gas stations and hospitals. With support from the United States Agency for International Development (USAID), the government has also initiated a campaign called ‘Condom Bindas Bol!’ (Condom-Just say it!), which involves advertising, public events and celebrity endorsements. It aims to break the taboo that currently surrounds condom use in India, and to persuade people that they should not be embarrassed to buy them.⁵³

In one unique scheme, health activists in West Bengal promoted condom use through kite flying, which is popular before the state’s biggest festival, Durga Puja:

"The colourful kites carry the message that using a condom is a simple and instinctive act… they can fly high in the sky and land at distant places where we cannot reach."⁵⁴

This initiative is an example of how HIV prevention campaigns in India can be tailored to the situations of different states and areas. In doing so, they can make an important impact, particularly in rural areas where information is often lacking. Small-scale campaigns like this are often run or supported by non-governmental organisations, which play a vital role in preventing infections throughout India, particularly among high-risk groups. In some cases, members of these risk groups have formed their own organisations to respond to the epidemic.

The government has however funded a small number of national campaigns to spread awareness about HIV/AIDS to complement the local level initiatives. On World AIDS Day 2007 India flagged off its largest national campaign to date, in the form of a seven-coach train called the 'Red Ribbon Express.'⁵⁵A year later the train journey was completed, having travelled to 180 stations in 24 states and reaching around 6.2 million people with HIV/AIDS education and awareness.⁵⁶ Following the success of the campaign, the 'Red Ribbon Express' took off again in December 2009, and now includes counseling and training services, HIV testing, treatment of sexually transmitted diseases (STDS) as well as HIV/AIDS education and awareness.⁵⁷

According to a mid-year report on the progress of the second round of the Red Ribbon Express, NACO estimates that 3.8 million people were reached in the first six months of the campaign.⁵⁸ According to NACO the 'response has been overwhelming', with queues of people waiting to access the services a common sight, and follow up surveys indicating that knowledge of transmission routes of HIV and prevention methods have increased significantly in the areas visited by the train.

PMTCT

In 2004 only 5% of pregnant women living with HIV received antiretrovirals to prevent mother-to-child transmission. By 2009 this had risen to 17% but with such low coverage thousands of children are still infected every year through mother-to-child transmission in India.^{59 60}