By Ashish Joshi
The Telugu states of Andhra Pradesh and Telangana continue to be among the most affected by HIV in the country, followed by Maharashtra. Both these states collectively account for nearly a quarter of the countrys AIDS-related deaths.
What do the numbers say?
The Union Minister J.P. Nadda made the following information public in one of the recently concluded parliamentary sessions that for the 2016-17 financial year, India registered a total of 49,630 HIV-related deaths out of which 12,169 occurred in the states of Telangana and Andhra Pradesh. The death toll although has seen a decline in comparison to the previous years. As per the latest available official data, India has around 21.1 lakh people infected with HIV. HIV prevalence in the countrys adults is around 0.25 percent but the states of Telangana and Andhra Pradesh have almost three times the national average of HIV prevalence amongst adults.
As per the estimates of United Nations, India has the worlds third-largest pool of HIV infected individuals. Manipur is the state with the highest adult HIV prevalence in the country at 1.15% followed by Mizoram and Nagaland at 0.8 percent each. As per the latest report of National AIDS Control Organisation, India continues to portray a concentrated epidemic. Indias HIV prevalence is dominant mostly in certain risk groups like Female Sex Workers (FSW-2.2%), Men who have sex with men (MSM-4.3%), Injecting Drug Users (IDU-9.9%) and Transgender (TG-7.5%). The social stigma around these risk groups makes it difficult for NACO to effectively execute its policies of HIV intervention.
The case of Andhra Pradesh
The Guntur, Krishna and East Godavari districts of Andhra Pradesh constitute 42% of the states HIV positives. These districts are also recording an increment in the cases of new HIV infections which has become a cause of severe concern for the government.
A report in The New Indian Express stated that the AP government and the Chief Minister N Chandrababu Naidu want to make Amaravati a world-class capital and a tourism hub. However, officials feel that the rising number of HIV cases in the region will affect the city’s image.
The health department of the Andhra Pradesh government has been working towards bringing down HIV rates and despite the fact that a marginal drop has been recorded the current numbers still remain very high.
What happened in Telangana
Meanwhile, when there is a nationwide decline in new cases of HIV and HIV related deaths, Telangana has shown a reverse trend. In 2016, the state recorded almost 12000 new cases of HIV. The total population of people living with HIV in the state stands at 1,73,398 as on January 1, 2017, against a total of 1,61,552 cases in 2015. In fact, a third of the states HIV cases are registered in the capital city itself.
According to the official data obtained through a Right To Information (RTI) query posed by the Helping Hand Foundation (HHF), the most common route of transmission of the virus is through heterosexual activity. The state is also recording a very high mortality due to TB in HIV infected patients.
Correlation between HIV and truck drivers
India has registered several HIV high-risk groups, people who are exposed to a greater threat of HIV infection, but one of the biggest most underreported risk group is that of the truck drivers. As per NACO estimations, 2.59% of countrys two million truck drivers are living with an HIV infection. A study in 2012 found that almost 47% of truck drivers have had paid sex in the past with sex workers and only 40 percent of these men report using a condom. Truck drivers act as a bridge between highly infected risk group of sex workers and the community in general.
HIV and AIDS are a serious challenge for a developing country like India. Greater the number of working people living with HIV, the illness that follows will result in a greater number of early labour withdrawal from the economy. This is accompanied by reduced income and savings, liquidation of assets and increased indebtedness of HIV households. Further, the reduction of human capital not only due to death and morbidity of PLWHA but also due to reduced investment in the education of children, only to severe the impact of the epidemic. Further, the children who are born with HIV often face unwanted social stigma and receive a poor quality of education resulting in a national loss of human resource.
In 1997, there were just 67 HIV testing and counselling (HTC) sites in India. By August 2016, there were more than 20,000 facilities offering HTC. Between April and September 2015, 6.85 million general users accessed HTC, suggesting India is on course to meet its annual testing target of 12.4 million. A total of 5.32 million pregnant women received HTC over the same period against a yearly target of 9 million. Despite this progress, around one-quarter of people living with HIV in India (23%) are currently unaware of their status.
Social Stigma related to HIV
Be it social gatherings, workplaces or hospitals. The HIV infected are exposed to discrimination and stigma. In fact, there exists a cyclic relationship between the two phenomena. People who experience stigma and discrimination are marginalised and made more vulnerable to HIV, while those living with HIV are more vulnerable to experiencing stigma and discrimination. The primary reason for this public behaviour is misinformation and myths surrounding the disease. As per a recent report, one person in eight is even denied medical facilities on grounds of the above discrimination.
To tackle the above problem, the government passed the HIV/AIDS Bill in 2014. The legislation seeks to end the stigma and discrimination against HIV positive persons in workplace, hospitals and society, while also ensuring their privacy.
In our bid to establish a truly healthy and progressive society, it is very important to fight the spread of any disease but what is equally important is to fight the social isolation and stigma (if any) that comes along with it. Various government and non-government agencies have stepped up their efforts in both the directions, as a result, the situation regarding HIV treatment and public awareness is rapidly improving but it is no secret that there still is a long way to go for us.
Featured Image Credits: AIDSVaccine on Visual Hunt / CC BY-NC-SA