HIV/AIDS in India

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HIV/AIDS in India is an epidemic. The National AIDS Control Organisation (NACO) estimated that 2.14 million people lived with HIV/AIDS in India in 2017. [1] Despite being home to the world's third-largest population of persons with HIV/AIDS (as of 2018, with South Africa and Nigeria having more), [2] the AIDS prevalence rate in India is lower than that of many other countries. In 2016, India's AIDS prevalence rate stood at approximately 0.30%—the 80th highest in the world. [3] Treatment of HIV/AIDS is via a combination of antiretroviral drugs and education programs to help people avoid infection.

Contents

New HIV infections each year, and AIDS deaths occurring during the year in India Annual India AIDS deaths.svg
New HIV infections each year, and AIDS deaths occurring during the year in India

Epidemiology

HIV prevalence among women attending prenatal clinics, commercial sex workers, and injecting drug users, in India in 2001 IndiaPrenatalHIV.jpg
HIV prevalence among women attending prenatal clinics, commercial sex workers, and injecting drug users, in India in 2001

The main factors which have contributed to India's large HIV-infected population are extensive labour migration and low literacy levels in certain rural areas resulting in a lack of awareness and in gender disparities. [4] The Government of India has also raised concerns about the role of intravenous drug use and prostitution in spreading HIV. [4] [5]

According to Avert, [6] the statistics for special populations in 2007 are as follows:

StateAntenatal clinic HIV prevalence 2007 (%) [7] STD clinic HIV prevalence 2007 (%) [6] IDU HIV prevalence 2007 (%) [6] MSM HIV prevalence 2007 (%) [6] Female sex worker HIV prevalence 2007 (%) [6]
A & N Islands0.258.0016.806.604.68
Andhra Pradesh1.0017.203.7117.049.74
Arunachal Pradesh0.000.000.00......
Assam0.000.502.412.780.44
Bihar0.250.400.600.003.41
Chandigarh0.250.428.643.600.40
Chhattisgarh0.253.33......1.43
D & N Haveli0.50............
Daman & Diu0.13............
Delhi0.255.2010.1011.733.15
Goa0.185.60...7.93...
Gujarat0.252.40...8.406.53
Haryana0.130.000.805.390.91
Himachal Pradesh0.000.00...5.390.87
Jammu & Kashmir0.000.20.........
Jharkhand0.000.40......1.09
Karnataka0.508.402.0017.605.30
Kerala0.381.607.850.960.87
Lakshadweep0.000.00......0.00
Madhya Pradesh0.001.72......0.67
Maharashtra0.5011.6224.4011.8017.91
Manipur0.754.0817.9016.413.07
Meghalaya0.002.214.17......
Mizoram0.757.137.53...7.20
Nagaland0.603.421.91...8.91
Orissa0.001.607.337.370.80
Pondicherry0.003.22...2.001.30
Punjab0.001.6013.791.220.65
Rajasthan0.132.00......4.16
Sikkim0.090.000.47...0.00
Tamil Nadu0.251.33.........
Tripura0.250.400.00......
Uttar Pradesh0.000.481.290.400.78
Uttaranchal0.000.00.........
West Bengal0.000.807.765.615.92

Note: Some areas in the above table report an HIV prevalence rate of zero in antenatal clinics. This does not necessarily mean HIV is absent from the area, as some states report the presence of the virus at STD clinics and among intravenous drug users. In some states and union territories, the average antenatal HIV prevalence is based on reports from only a small number of clinics.

In India, populations which are at a higher risk of HIV are female sex workers, men who have sex with men, injecting drug users, and transgenders/hijras. [8]

Management

People, especially women, visiting the Red Ribbon Express on a tour of India promoting AIDS awareness when it arrived in Chennai in 2012 People specially women visiting the Red Ribbon Express on tour creating AIDS awareness all over India arrived in Chennai on May 27, 2012.jpg
People, especially women, visiting the Red Ribbon Express on a tour of India promoting AIDS awareness when it arrived in Chennai in 2012
"Know AIDS - No AIDS" sign on a road in India Know Aids - No Aids.jpg
"Know AIDS - No AIDS" sign on a road in India

India has been praised for its extensive anti-AIDS campaigning. [9] According to Michel Sidibé, executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), India's success comes from using an evidence-informed and human rights-based approach that is backed by sustained political leadership and civil society engagement. [10]

A 2012 UNAIDS report lauded India for doing "particularly well" in halving the number of adults newly infected between 2000 and 2009 in contrast to some smaller countries in Asia. In India, the number of deaths due to AIDS stood at 170,000 in 2009. It also points out that India provided substantial support to neighbouring countries and other Asian countries – in 2011, it allocated USD 430 million to 68 projects in Bhutan across key socioeconomic sectors, including health, education and capacity building. In 2011 at Addis Ababa, the Government of India further committed to accelerating technology transfer between its pharmaceutical sector and African manufacturers. [11]

The National AIDS Control Organisation (NACO) has increased the number of centres providing free antiretroviral treatment (ART) from 54 to 91 centres, with 9 more centres to be operational soon.[ when? ] Medicines for treating 8,500 patients have been made available at these centres. All the 91 centres have trained doctors, counsellors and laboratory technicians to help initiate patients on ART and provide follow up care while protecting confidentiality. Apart from providing free treatment, all the ART centres provide counselling to the infected persons so that they regularly take their medication. Continuity is the most important factor for the long term effectiveness of the ART drugs, as disruption can lead to drug resistance.[ citation needed ] At present, 40,000 are on ART, which is expected to go up to 85,000 by March.[ when? ]

Responding to a petition made by NGO's, in 2010, the Supreme Court of India directed the Indian government to provide second-line antiretroviral therapy (ART) to all AIDS patients in the country, and warned the government against abdicating its constitutional duty of providing treatment to HIV positive patients on grounds of financial constraint, as it was an issue of the right to life guaranteed under Article 21 of the Indian Constitution. Previously, in an affidavit before the Supreme Court, NACO said second-line ART treatment for HIV patients, costing Rs 28,500 each, could not be extended to those who had received "irrational treatment" by private medical practitioners for the first round, which costs around Rs 6,500. The court rejected both the arguments of financial constraints and that only 10 viral load testing centres were needed for testing patients for migrating from the first line of treatment to the second line, as stated by the Solicitor General representing the government. The court further asked the government to give a clear-cut and "workable" solution within a week's time. [12] [13]

HIV spending increased in India from 2003 to 2007 and fell by 15% in 2008 to 2009. Currently, India spends about 5% of its health budget on HIV/AIDS. Spending on HIV/AIDS may create a burden in the health sector, which faces a variety of other challenges. Thus, it is crucial for India to step up on its prevention efforts to decrease its spending of the health budget on HIV/AIDS in future. [6]

Apart from government funding, there are various international foundations like the UNDP, World Bank, Elton John AIDS Foundation, USAID and others who are funding HIV/AIDS treatment in India. [14] [15] [16]

History

In 1986, the first known cases of HIV in India were diagnosed by Dr. Suniti Solomon and her student Dr. Sellappan Nirmala amongst six female sex workers in Chennai, Tamil Nadu. [17] [18] But actually in 1980's Sellappan Nirmala visited Dr. Kandaraj, a Sexologist, in Chennai. He collected the 30 no of blood samples of HIV disease, patients for Dr. Nirmala. All the patients were sex workers. After the samples are submitted to Dr. Suniti Solomon. She was a microbiologist. She diagnosed with all samples are HIV positive cases and announced by her proper report to the Indian government. 30 HIV patients were affected in India.[ citation needed ]

In 1986, the Government of India established the National AIDS Committee within the Ministry of Health and Family Welfare. [19]

In 1992, on the basis of National AIDS Committee, the government set up the National AIDS Control Organisation (NACO) to oversee policies and prevention and control programmes relating to HIV and AIDS and the National AIDS Control Programme (NACP) for HIV prevention. [20] [21] Subsequently, the State AIDS Control Societies (SACS) were set up in states and union territories. SACS implement the NACO programme at a state level, but have functional independence to upscale and innovate. [22] The first phase was implemented from 1992 to 1999 and focused on monitoring HIV infection rates among high-risk populations in selected urban areas. [19]

In 1999, the second phase of the National AIDS Control Programme (NACP II) was introduced to decrease the reach of HIV by promoting behaviour change. The prevention of mother-to-child transmission programme (PMTCT) and the provision of antiretroviral treatment were developed. [23] A National Council on AIDS was formed during this phase, consisting of 31 ministries and chaired by the Prime Minister. [19] The second phase ran between 1999 and 2006. [19]

A 2006 study published in the British medical journal The Lancet reported an approximately 30% decline in HIV infections from 2000 to 2004 among women aged 15 to 24 attending prenatal clinics in selected southern states of India, where the epidemic is thought to be concentrated. Recent studies suggest that many married women in India, despite practicing monogamy and having no risk behaviours, acquire HIV from their husbands and HIV testing of married males can be an effective HIV prevention strategy for the general population. [24]

In 2007, the third phase of the National AIDS Control Programme (NACP III) targeted high-risk groups and conducted outreach programmes. It also decentralised the effort to local levels and non-governmental organisations (NGOs) to provide welfare services to the affected. [6] The US $2.5 billion plan received support from UNAIDS. [25] The third stage dramatically increased targeted interventions, aiming to halt and reverse the epidemic by integrating programmes for prevention, care, support, and treatment. [19] By the end of 2008, targeted interventions covered almost 932,000 of those most at risk, or 52% of the target groups (49% of female sex workers, 65% of injection drug users, and 66% of men who have sex with men). [19]

Some efforts have been made to tailor educational literature to those with low literacy levels, mainly through readily accessible local libraries. [26] Increased awareness regarding the disease and citizen's related rights is in line with the Universal Declaration on Human Rights.

In 2009, India established a National HIV and AIDS Policy and the World of Work, which sought to end discrimination against workers on the basis of their real or perceived HIV status. [19] Under this policy, all enterprises are encouraged to establish workplace policies and programmes based on the principles of non-discrimination, gender equity, healthy work environment, non-screening for the purpose of employment, confidentiality, prevention, and care and support. [19] Researchers at the Overseas Development Institute have called for greater attention to migrant workers, whose concerns about their immigration status may leave them particularly vulnerable. [19]

No agency is tasked with enforcing the non-discrimination policy; instead, a multisectoral approach has been developed involving awareness campaigns in the private sector. The AIDS Bhedbhav Virodhi Andolan (AIDS Anti-Discrimination Movement) has prepared many citizen reports challenging discriminatory policies, and filed a petition in the Delhi High Court regarding the proposed segregation of gay men in prisons. A play titled High Fidelity Transmission by Rajesh Talwar [27] focused on discrimination, the importance of using a condom, and illegal testing of vaccines. [28] HIV/AIDS-related television shows and movies have appeared in the past few years, mostly in an effort to appeal to the middle class. [29] An important component of these programs has been the depiction of HIV/AIDS affected persons interacting with non-infected persons in everyday life. [30]

As per the UNDP's 2010 report, India had 2.395 million people living with HIV at the end of 2009, up from 2.27 million in 2008. Adult prevalence also rose from 0.29% in 2008 to 0.31% in 2009. [31] Setting up HIV screening centres was the first step taken by the government to screen its citizens and the blood bank.[ citation needed ]

Adult HIV prevalence in India declined from an estimated 0.41% in 2000 to 0.31% in 2009. Adult HIV prevalence at a national level has declined notably in many states, but variations still exist across the states. A decreasing trend is also evident in HIV prevalence among people aged 15–24.

A 2012 report described a need for youth HIV counseling. [32]

According to NACO data, India has had a 57% reduction in estimated annual new adult HIV infections, from 274,000 in 2000 to 116,000 in 2011, and the estimated number of people living with HIV was 2.08 million in 2011. [33] [34]

According to NACO, the prevalence of AIDS in India in 2015 was 0.26%, down from 0.41% in 2002; [35] in 2016, it had risen to 0.30%. [3]

Society and culture

HIV/AIDS (Prevention and Control) Bill 2014

The HIV/AIDS (Prevention and Control) Bill 2014, which sought to end stigma and discrimination against HIV positive persons in workplaces, hospitals and society while also ensuring patient privacy, was introduced in the Rajya Sabha on 11 February 2014, [36] [37] and was passed on 21 March 2017. [38]

Litigation for right of access to treatment

Orphans

Orphans who have lost a parent to AIDS celebrate World AIDS Day in Hyderabad, India. Love for all the other AIDS Orphans.jpg
Orphans who have lost a parent to AIDS celebrate World AIDS Day in Hyderabad, India.

There are 2 million children in India that have lost one or both parents due to AIDS. [43] There are also millions of vulnerable children living in India, or children "whose survival, well-being, or development is threatened due to the possibility of exposure to HIV/AIDS," [43] and the number of these AIDS orphans will continue to grow. [44]

Due to the negative treatment and lack of resources for these children, AIDS orphans and vulnerable children in India are at risk for health and educational disparities. They are also at higher risk for becoming infected with HIV themselves, child labour, trafficking, and prostitution. [45]

Stigma

AIDS orphans are usually cared for by extended family members. [46] These extended family members may be vulnerable as well, as they are often elderly or ill themselves. A study from 2004 found that many AIDS orphans felt that "their guardians felt like they could demand anything of them" [47] because no one else could take them in. These children may be forced to look after a sibling or other family members, so they live in their original home even after parents are deceased. The children may be worried about seizure of land by landlords or neighbours. [48]

Due to the stigma surrounding HIV in India, children of HIV-infected parents are treated poorly and often do not have access to basic resources. A study done by the Department of Rural Management in Jharkhand showed that 35% of children of HIV-infected adults were denied basic amenities. [43] Things like proper food are often not given to AIDS orphans by their extended families or caretakers. [48] This, combined with the abuse that many orphans face, leads to a higher rate of mortality among AIDS orphans. [49] Higher education rates in caregivers has been shown to decrease this stigma. [50] AIDS orphans are often not allowed in orphanages because of the concern that they could have AIDS themselves. [51]

AIDS orphans were more likely to be bullied by friends or relatives due to the stigma against HIV/AIDS in India. [52] People may falsely believe HIV can be contracted by proximity, so these orphans can lose friends. [53] Often, women widowed by HIV/AIDS face blame for the impact on their children, [54] while families face isolation during the time of illness and after. Parents often lose their jobs due to workplace discrimination. [55] The Human Rights Watch has found many cases of sexual abuse among female AIDS orphans, which often result in trafficking and prostitution. [47] Studies have shown that an increase in quality HIV treatment and care can drastically decrease this discrimination. [50]

Mental health

The emotional and social effects on AIDS orphans are very detrimental to their health and future life. Specifically, the mental health of AIDS orphans in India is shown to be worse than that for children who were orphaned for other reasons. [52]

Before becoming orphans, children of people with AIDS face many obstacles. There is "tremendous emotional trauma" associated with having a parent ill with HIV, and the child often worries about resource scarcity, being separated from siblings, and grief over the impending death of the parent. [55] While a parent is ill, a child may experience long periods of uncertainty and episodic crises, which decreases the child's sense of security and stability. [56]

A study done in orphanages in Hyderabad showed that orphans in India who have lost one or both parents to AIDS are 1.3 times as likely to be clinically depressed as children orphaned due to other reasons. [52] In addition, the study showed greater depression among younger AIDS orphans, while in other orphans it was mostly seen in older children. A distinction was also made between genders; girls orphaned due to AIDS had a higher rate of depression than boys. [45]

Education

Because orphans and vulnerable children affected by HIV/AIDS often have many deceased or ill family members, they are often forced into taking jobs at a young age to provide for their family, resulting in lower attendance at school or being forced to drop out of school completely. For example, orphans that have lost their father due to AIDS are often forced to take on high-risk field or manual labour jobs. Orphans that have lost their mothers take on housework and childcare. Girls are more often taken out of school to help with domestic work and care for sick parents. [51] Studies show that 17% of children with HIV-infected parents took on a job to assist with household income. [43]

The cost of treatment for HIV is so high that many families often do not have the means to pay for the care or education of the child. [49] If a child is forced to drop out of school in order to take on additional responsibility at home due to the illness of his parent, the child is named a "de facto" orphan. [43] There has been no correlation found between gender and risk of poor educational outcomes or risk of dropping out of school. [57] Because of stigma, many HIV/AIDS affected orphans are expelled from school. [51]

In a study on the education of orphans in India, the caretaker's health was found to be very important in determining if the orphan was at a target educational standard. [57] When a primary caregiver was in poor health, the odds of the orphan being in the target grade level decreased by 54%. [57]

Responses

While much research has gone into community programming for AIDS orphans, only a few efforts focus on saving the lives of the HIV-infected parents themselves. [58]

When comparing institution-based care and community-based care, studies have shown that there is less discrimination in the former. [50] However, the government of India has used institutionalizing orphans as the norm, and have not fully explored other options like fostering or community-based care for AIDS orphans. [51]

India pledged to provide better resources for AIDS orphans at the UN General Assembly Special Session on HIV/AIDS in 2001. [48] In 2007, India was the first country in South Asia to create a national response to children affected by AIDS. [59] India created the Policy Framework For Children, which has the goal of providing resources for at least 80% of children affected by HIV/AIDS. This policy takes a rights-based approach. However, this policy fails to address many social determinants of care of AIDS orphans, including the social stigma and discrimination, lack of education, and proper nutrition. [43]

The Juvenile Justice (Care and Protection of Children) Act of 2015 was created to provide orphans and vulnerable children in India with necessary resources and care.

See also

Lists of ART centres

These centres provide antiretroviral therapy (ART) to the patients.

Non-governmental organisations

These are NGOs working in India for the prevention of HIV/AIDS and accessibility of treatment and medication. These centres also provide psycho-social support through counseling, acting to function as a bridge between hospital and home care.

Related Research Articles

HIV/AIDS has been a public health concern for Latin America due to a remaining prevalence of the disease. In 2018 an estimated 2.2 million people had HIV in Latin America and the Caribbean, making the HIV prevalence rate approximately 0.4% in Latin America.

<span class="mw-page-title-main">Epidemiology of HIV/AIDS</span> Epidemic of HIV/AIDS

The global epidemic of HIV/AIDS began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), by 2023, HIV/AIDS had killed approximately 40.4 million people, and approximately 39 million people were infected with HIV globally. Of these, 29.8 million people (75%) are receiving antiretroviral treatment. There were about 630,000 deaths from HIV/AIDS in 2022. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa. As of 2020, there are approximately 1.5 million new infections of HIV per year globally.

<span class="mw-page-title-main">HIV/AIDS</span> Spectrum of conditions caused by HIV infection

Infection with HIV, a retrovirus, can be managed with treatment but without treatment can lead to a spectrum of conditions including AIDS.

The Caribbean is the second-most affected region in the world in terms of HIV prevalence rates. Based on 2009 data, about 1.0 percent of the adult population is living with the disease, which is higher than any other region except Sub-Saharan Africa. Several factors influence this epidemic, including poverty, gender, sex tourism, and stigma. HIV incidence in the Caribbean declined 49% between 2001 and 2012. Different countries have employed a variety of responses to the disease, with a range of challenges and successes.

Angola has a large HIV/AIDS infected population, however, it has one of the lowest prevalence rates in the Southern Africa zone. The status of the HIV/AIDS epidemic in Angola is expected to change within the near future due to several forms of behavioral, cultural, and economic characteristics within the country such as lack of knowledge and education, low levels of condom use, the frequency of sex and number of sex partners, economic disparities and migration. There is a significant amount of work being done in Angola to combat the epidemic, but most aid is coming from outside of the country.

<span class="mw-page-title-main">HIV/AIDS in Lesotho</span>

HIV/AIDS in Lesotho constitutes a very serious threat to Basotho and to Lesotho's economic development. Since its initial detection in 1986, HIV/AIDS has spread at alarming rates in Lesotho. In 2000, King Letsie III declared HIV/AIDS a natural disaster. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2016, Lesotho's adult prevalence rate of 25% is the second highest in the world, following Eswatini.

HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions. As of 2016, Eswatini had the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%).

<span class="mw-page-title-main">HIV/AIDS in Mozambique</span>

Mozambique is a country particularly hard-hit by the HIV/AIDS epidemic. According to 2008 UNAIDS estimates, this southeast African nation has the 8th highest HIV rate in the world. With 1,600,000 Mozambicans living with HIV, 990,000 of which are women and children, Mozambique's government realizes that much work must be done to eradicate this infectious disease. To reduce HIV/AIDS within the country, Mozambique has partnered with numerous global organizations to provide its citizens with augmented access to antiretroviral therapy and prevention techniques, such as condom use. A surge toward the treatment and prevention of HIV/AIDS in women and children has additionally aided in Mozambique's aim to fulfill its Millennium Development Goals (MDGs). Nevertheless, HIV/AIDS has made a drastic impact on Mozambique; individual risk behaviors are still greatly influenced by social norms, and much still needs to be done to address the epidemic and provide care and treatment to those in need.

<span class="mw-page-title-main">HIV/AIDS in Zimbabwe</span> Major public health issue

HIV and AIDS is a major public health issue in Zimbabwe. The country is reported to hold one of the largest recorded numbers of cases in Sub-Saharan Africa. According to reports, the virus has been present in the country since roughly 40 years ago. However, evidence suggests that the spread of the virus may have occurred earlier. In recent years, the government has agreed to take action and implement treatment target strategies in order to address the prevalence of cases in the epidemic. Notable progress has been made as increasingly more individuals are being made aware of their HIV/AIDS status, receiving treatment, and reporting high rates of viral suppression. As a result of this, country progress reports show that the epidemic is on the decline and is beginning to reach a plateau. International organizations and the national government have connected this impact to the result of increased condom usage in the population, a reduced number of sexual partners, as well as an increased knowledge and support system through successful implementation of treatment strategies by the government. Vulnerable populations disproportionately impacted by HIV/AIDS in Zimbabwe include women and children, sex workers, and the LGBTQ+ population.

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<span class="mw-page-title-main">HIV/AIDS in Nepal</span>

The first HIV/AIDS cases in Nepal were reported in 1988. The HIV epidemic is largely attributed to sexual transmissions and account for more than 85% of the total new HIV infections. Coinciding with the outbreak of civil unrest, there was a drastic increase in the new cases in 1996. The infection rate of HIV/AIDS in Nepal among the adult population is estimated to be below the 1 percent threshold which is considered "generalized and severe". However, the prevalence rate masks a concentrated epidemic among at-risk populations such as female sex workers (FSWs), male sex workers (MSWs), injecting drug users (IDUs), men who have sex with men (MSM), Transgender Groups (TG), migrants and male labor migrants (MLMs) as well as their spouses. Socio-Cultural taboos and stigmas that pose an issue for open discussion concerning sex education and sex habits to practice has manifest crucial role in spread of HIV/AIDS in Nepal. With this, factors such as poverty, illiteracy, political instability combined with gender inequality make the tasks challenging.

The Philippines has one of the lowest rates of infection of HIV/AIDS, yet has one of the fastest growing number of cases worldwide. The Philippines is one of seven countries with growth in number of cases of over 25%, from 2001 to 2009.

HIV/AIDS in El Salvador has a less than 1 percent prevalence of the adult population reported to be HIV-positive. El Salvador therefore is a low-HIV-prevalence country. The virus remains a significant threat in high-risk communities, such as commercial sex workers (CSWs) and men who have sex with men (MSM).

HIV/AIDS in Jamaica has a 1.5 percent prevalence of the adult population estimated to be HIV-positive. There has been no significant change over the last five years and therefore Jamaica appears to have stabilized its HIV/AIDS epidemic.

In 2016, the prevalence rate of HIV/AIDS in adults aged 15–49 was 0.3%, relatively low for a developing country. This low prevalence has been maintained, as in 2006, the HIV prevalence in Mexico was estimated at around 0.3% as well. The infected population is remains mainly concentrated among high risk populations, men who have sex with other men, intravenous drug users, and commercial sex workers. This low national prevalence is not reflected in the high-risk populations. The prison population in Mexico, faces a fairly similar low rate of around 0.7%. Among the population of prisoners, around 2% are known to be infected with HIV. Sex workers, male and female, face an HIV prevalence of around 7%. Identifying gay men and men who have sex with other men have a prevalence of 17.4%. The highest risk-factor group is identifying transgender people; about 17.4% of this population is known to be infected with HIV. Around 90% of new infections occur by sex-related methods of transmission. Of these known infected populations, around 60% of living infected people are known to be on anti-retroviral therapy (ART).

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year. But, in 2012 and 2013 it increased to about 600 new cases and in 2014 it reached 880 new cases per year. According to UNAIDS 2016 statistics, there are about 11,000 people currently living with HIV in Egypt. The Ministry of Health and Population reported in 2020 over 13,000 Egyptians are living with HIV/AIDS. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

<span class="mw-page-title-main">HIV-affected community</span> Medical condition

The affected community is composed of people who are living with hiv can also die and AIDS, plus individuals whose lives are directly influenced by HIV infection. This originally was defined as young to middle aged adults who associate with being gay or bisexual men, and or injection drug users. HIV-affected community is a community that is affected directly or indirectly affected by HIV. These communities are usually influenced by HIV and undertake risky behaviours that lead to a higher chance of HIV infection. To date HIV infection is still one of the leading cause of deaths around the world with an estimate of 36.8 million people diagnosed with HIV by the end of 2017, but there can particular communities that are more vulnerable to HIV infection, these communities include certain races, gender, minorities, and disadvantaged communities. One of the most common communities at risk is the gay community as it is commonly transmitted through unsafe sex. The main factor that contributes to HIV infection within the gay/bisexual community is that gay men do not use protection when performing anal sex or other sexual activities which can lead to a higher risk of HIV infections. Another community will be people diagnosed with mental health issues, such as depression is one of the most common related mental illnesses associated with HIV infection. HIV testing is an essential role in reducing HIV infection within communities as it can lead to prevention and treatment of HIV infections but also helps with early diagnosis of HIV. Educating young people in a community with the knowledge of HIV prevention will be able to help decrease the prevalence within the community. As education is an important source for development in many areas. Research has shown that people more at risk for HIV are part of disenfranchised and inner city populations as drug use and sexually transmitted diseases(STDs) are more prevalent. People with mental illnesses that inhibit making decisions or overlook sexual tendencies are especially at risk for contracting HIV.

Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection, and stigmatization of people with HIV/AIDS. Marginalized, at-risk groups such as members of the LGBTQ+ community, intravenous drug users, and sex workers are most vulnerable to facing HIV/AIDS discrimination. The consequences of societal stigma against PLHIV are quite severe, as HIV/AIDS discrimination actively hinders access to HIV/AIDS screening and care around the world. Moreover, these negative stigmas become used against members of the LGBTQ+ community in the form of stereotypes held by physicians.

The Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome Act, 2017, often shortened to the HIV/AIDS Prevention Act, is an act of the Parliament of India that provides for controlling and preventing of HIV/AIDS and securing the rights of individuals diagnosed with HIV/AIDS. The bill for the act was introduced in the Rajya Sabha on 11 February 2014 and was referred to a Standing Committee on 24 February 2014, which submitted its report on 29 April 2015. After few amendments to the original 2014 bill, it was passed by the Rajya Sabh on 21 March 2017 and the Lok Sabha on 11 April 2017. It received Presidential assent on 20 April 2017, and became effective from 10 September 2018. The HIV/AIDS Prevention Act originated from a draft bill submitted by Lawyers Collective, a non-governmental organization, to the National AIDS Control Organisation (NACO) in 2006. The act penalises propagation of hate against HIV/AIDS affected persons, ensures the right of HIV/AIDS affected minors to shared household, protects non-disclosure of HIV/AIDS status in the absence of court order and mandates informed consent to disclose HIV/AIDS positive identity, inter alia. However, civil society organisations and HIV/AIDS affected persons criticised the act on certain legal language issues, as it mandates the state to provide HIV/AIDS affected persons with medical services "as far as possible". This aspect was absent from the draft bill submitted to NACO.

References

  1. "NACO Annual Report 2018-2019" (PDF).
  2. "Country comparison: people living with HIV/AIDS". The World Factbook—Central Intelligence Agency. Archived from the original on 11 January 2019. Retrieved 2 December 2019.
  3. 1 2 "Country comparison HIV/AIDS prevalence". The World Factbook—Central Intelligence Agency. Archived from the original on 13 June 2007. Retrieved 2 December 2019.
  4. 1 2 "Source of Infections in AIDS cases in India". Embassy of India. Archived from the original on 4 May 2007. Retrieved 26 April 2021.
  5. "Report" (PDF). www.nacoonline.org. Retrieved 24 February 2020.
  6. 1 2 3 4 5 6 7 "HIV and AIDS in India". Avert. Retrieved 26 April 2021.
  7. "HIV and AIDS in India". avert.org. 21 July 2015. Retrieved 6 April 2018.
  8. "HIV cases in India drop more than 50% but challenges remain". Hindustan Times. 19 January 2018. Retrieved 28 August 2018.
  9. "Clinton lauds India Aids campaign". BBC News. 26 May 2005. Retrieved 6 April 2018.
  10. "HIV declining in India; New infections reduced by 50% from 2000–2009; Sustained focus on prevention required" (PDF). Government of India, Ministry of Health & Family Welfare, Department of AIDS Control, National AIDS Control Organisation. Archived from the original (PDF) on 1 January 2011.
  11. PTI. "New HIV cases decline by half in India: UN report". Deccan Herald. Retrieved 1 February 2024.
  12. "SC forces govt to agree to second-line ART to all AIDS patients". The Times of India . 11 December 2010. Archived from the original on 11 August 2011.
  13. "SC cautions govt over HIV treatment". Hindustan Times. 11 December 2010. Archived from the original on 25 January 2013.
  14. "Grants – Elton John AIDS Foundation". Elton John AIDS Foundation. Retrieved 28 August 2018.
  15. "Funds and Expenditures | National AIDS Control Organization | MoHFW | GoI". naco.gov.in. Retrieved 28 August 2018.
  16. "USAID, AMCHAM join hands to address India's development challenges – Times of India". The Times of India. Retrieved 28 August 2018.
  17. Sternberg, Steve (23 February 2005). "HIV scars India". USA Today.
  18. Pandey, Geeta (30 August 2016). "The woman who discovered India's first HIV cases". BBC News. Retrieved 8 December 2016.
  19. 1 2 3 4 5 6 7 8 9 Samuels, Fiona; Wagle, Sanju (June 2011). "Population mobility and HIV and AIDS: review of laws, policies and treaties between Bangladesh, Nepal and India". Overseas Development Institute . Archived from the original on 18 June 2011. Retrieved 26 April 2021.
  20. "About Us | National AIDS Control Organization | MoHFW | GoI". naco.gov.in.
  21. "The next battleground: AIDS in India". 10 October 1993.
  22. "SACS | National AIDS Control Organization | MoHFW | GoI". naco.gov.in.
  23. Kadri, AM; Kumar, Pradeep (June 2012). "Institutionalization of the NACP and Way Ahead". Indian J Community Med. 27 (2): 83–88. doi: 10.4103/0970-0218.96088 . PMC   3361806 . PMID   22654280.
  24. Das, Aritra; Babu, Giridhara R.; Ghosh, Puspen; Mahapatra, Tanmay; Malmgren, Roberta; Detels, Roger (1 December 2013). "Epidemiologic correlates of willingness to be tested for HIV and prior testing among married men in India". International Journal of STD & AIDS. 24 (12): 957–968. doi:10.1177/0956462413488568. PMC   5568248 . PMID   23970619.
  25. "India: Driving forward an effective AIDS response". unaids.org. Retrieved 6 April 2018.
  26. Ghosh, Maitrayee 2007 ICT and AIDS Literacy: A Challenge for Information Professionals in India. Electronic Library & Information Systems 41(2):134–147
  27. Needle, Chael. "High Fidelity Transmission: Review – A&U Magazine".
  28. "HIV/AIDS: Closing the Legacy". lilainteractions.in. 28 November 2014. Retrieved 6 April 2018.
  29. Pathak, Prachee 2005 "Sterling Towers": A Soap Opera for HIV Awareness Among the Middle Class in Urban India. Dissertations and Theses 2005.
  30. Bourgault, Louise M. 2009 AIDS Messages in Three AIDS-Themed Indian Movies: Eroding AIDS-Related Stigma in India and Beyond. Critical Arts: A South-North Journal of Cultural & Media Studies 23(2):171–189.
  31. "Health care fails to reach migrants". Hindustan Times. 1 December 2010. Archived from the original on 17 December 2010.
  32. Mothi, SN; Swamy, VH; Lala, MM; Karpagam, S; Gangakhedkar, RR (December 2012). "Adolescents living with HIV in India - the clock is ticking". Indian Journal of Pediatrics. 79 (12): 1642–7. doi:10.1007/s12098-012-0902-x. PMID   23150229. S2CID   2346814.
  33. "World AIDS Day: India records sharp drop in number of cases". ndtv.com. Retrieved 6 April 2018.
  34. "India sees 50% decline in new hiv infections: un report". Hindustan Times. Archived from the original on 4 April 2011. Retrieved 2 April 2011.
  35. "World AIDS Day: India records sharp drop in number of cases". ndtv.com. Retrieved 6 April 2018.
  36. "HIV/Aids bill tabled in Rajya Sabha". Deccan Herald. 12 February 2014.
  37. "Bill to end HIV/AIDS discrimination introduced in Rajya Sabha". Zee News. 11 February 2014.
  38. Mishra, Nikita (December 2016). "Decoded: The Good and Bad of the HIV Bill Passed by Rajya Sabha". www.thequint.com. The Quint. Archived from the original on 24 March 2017. Retrieved 23 March 2017.
  39. Writ Petition (Civil) No. 311 of 2003, Supreme Court of India
  40. Writ Petition (Civil) No. 8700 of 2006, High Court of Delhi
  41. Writ Petition (Civil) No. 7 of 2005, Gauhati High Court
  42. Writ Petition (Civil) No. 2885 of 2007, High Court of Delhi
  43. 1 2 3 4 5 6 Kumar, Anant (29 March 2012). "AIDS Orphans and Vulnerable Children in India: Problems, Prospects, and Concerns". Social Work in Public Health. 27 (3): 205–212. doi:10.1080/19371918.2010.525136. PMID   22486426. S2CID   40952372.
  44. Shetty, Avinash (January 2003). "Children orphaned by AIDS: A global perspective". Seminars in Pediatric Infectious Diseases. 14 (1): 25–31. doi:10.1053/spid.2003.127214. PMID   12748919.
  45. 1 2 "An In-depth Study of Psychological Distress among Orphan Children Living in Institutional Care in New Delhi and their Coping Mechanisms". IUSSP – 2017 International Population Conference. 2 November 2017. Retrieved 23 February 2019.
  46. Gilborn, Laelia Zoe (January 2002). "The effects of HIV infection and AIDS on children in Africa". Western Journal of Medicine. 176 (1): 12–14. doi:10.1136/ewjm.176.1.12. ISSN   0093-0415. PMC   1071640 . PMID   11788529.
  47. 1 2 Csete, Joanne (1 June 2004). "Missed Opportunities: Human rights and the politics of HIV/AIDS". Development. 47 (2): 83–90. doi: 10.1057/palgrave.development.1100033 . ISSN   1461-7072. S2CID   86386789.
  48. 1 2 3 Ghanashyam, Bharathi (30 January 2010). "India failing children orphaned by AIDS". The Lancet. 375 (9712): 363–364. doi:10.1016/S0140-6736(10)60151-1. ISSN   0140-6736. PMID   20135747. S2CID   26411019.
  49. 1 2 Mukiza-Gapere, Jackson; Ntozi, James P. M. (1995). "Care for AIDS orphans in Uganda: findings from focus group discussions". Health Transition Review.
  50. 1 2 3 Messer, Lynne C.; Pence, Brian W.; Whetten, Kathryn; Whetten, Rachel; Thielman, Nathan; O'Donnell, Karen; Ostermann, Jan (19 August 2010). "Prevalence and predictors of HIV-related stigma among institutional- and community-based caregivers of orphans and vulnerable children living in five less-wealthy countries". BMC Public Health. 10 (1): 504. doi: 10.1186/1471-2458-10-504 . ISSN   1471-2458. PMC   2936424 . PMID   20723246.
  51. 1 2 3 4 "Future Forsaken | Abuses Against Children Affected by HIV/AIDS in India". Human Rights Watch. 28 July 2004. Retrieved 11 April 2019.
  52. 1 2 3 Kumar, SG Prem; Dandona, Rakhi; Kumar, G. Anil; Ramgopal, SP; Dandona, Lalit (8 April 2014). "Depression among AIDS-orphaned children higher than among other orphaned children in southern India". International Journal of Mental Health Systems. 8 (1): 13. doi: 10.1186/1752-4458-8-13 . PMC   4016624 . PMID   24708649.
  53. Salaam, Tiaji (11 February 2005). "AIDS Orphans and Vulnerable Children (OVC): Problems, Responses, and Issues for Congress" (PDF). Congressional Research Service.
  54. Van Hollen, Cecilia (1 December 2010). "HIV/AIDS and the Gendering of Stigma in Tamil Nadu, South India". Culture, Medicine, and Psychiatry. 34 (4): 633–657. doi:10.1007/s11013-010-9192-9. ISSN   1573-076X. PMID   20842521. S2CID   28534016.
  55. 1 2 Todres, Jonathan (December 2007). "Rights Relationships and the Experience of Children Orphaned by AIDS". UC Davis Law Review. 41.
  56. Children orphaned by AIDS : front-line responses from eastern and southern Africa. UNICEF. 1999. OCLC   59176094.
  57. 1 2 3 Sinha, Aakanksha; Lombe, Margaret; Saltzman, Leia Y.; Whetten, Kathryn; Whetten, Rachel (March 2016). "Exploring Factors Associated with Educational Outcomes for Orphan and Abandoned Children in India". Global Social Welfare. 3 (1): 23–32. doi:10.1007/s40609-016-0043-7. ISSN   2196-8799. PMC   4830269 . PMID   27088068.
  58. Beckerman, Karen Palmore (6 April 2002). "Mothers, orphans, and prevention of paediatric AIDS". The Lancet. 359 (9313): 1168–1169. doi:10.1016/S0140-6736(02)08248-X. PMID   11955530. S2CID   46158295.
  59. Ackerman Gulaid, Laurie. "National responses for children affected by AIDS: Review of progress and lessons learned" (PDF). Unicef.
  60. "AIDS Support Group". aidssupport.aarogya.com.
  61. "NGO for AIDS in India, HIV/AIDS Non Profit Campaign in India | End AIDS India". www.endaidsindia.org.
  62. "Solidarity and Action Against the HIV Infection in India". www.saathii.org.
  63. "Samapathik Trust, Pune - Home". Facebook .