Nearly 98 per cent of  women with HIV have been  infected by their husbands, says the AIDS Society of India Secretary General,  Dr I S Gilada, who has been studying the disease for over 20 years. He revealed this startling statistic on the sidelines of a recent panel discussion on HIV/AIDS held at the American Information Resource Centre.

There are those who would say the  good doctor was exaggerating, but the fact is, he was only fleshing out a study from the world's leading  medical journal Lancet which  attributes the  transmission to unprotected sex between  promiscuous, unfaithful  men and sex workers.  

If that's not bad enough, a new AIDS threat is rising in India's call centres, where young staff are increasingly having unprotected sex with multiple partners, Dr Suniti Solomon, who detected the first HIV case in India in 1986, told the International Congress on Infectious Diseases in Malaysia recently.

Call centres across India employ some 1.3 million people, mostly fresh graduates. Solomon, who runs an AIDS centre in Chennai believes these "call centre Romeos are a major high risk for HIV."

"Mumbai is a good model for the control and care of people from all walks of life, rich and poor,”  observes Dr Gilada even as the National Aids Control Organisation  (NACO) and the World  Bank says most of the HIV affected are  concentrated in certain districts of  Maharashtra, Karnataka, Tamil Nadu and Andhra Pradesh according to reports. Of these 3.8 per cent are children, most of whom have little access to health care. Currently, a pitiful number of children (only 6,500) have access to  medical treatment for the dreaded disease, according to Sarah Badiger, a Programme Coordinator, at the Tata Institute of Social Sciences's Cell for AIDS Research Action and Training (CARAT) in the course of the discussion.  The United Nations estimates there are at least 2.5 million Indians living with HIV and AIDS now, giving India the dubious distinction of  having the second largest number of HIV cases in the world. However NACO suggests that the HIV rate has actually come down, due to condom usage, and better awareness.  Badiger's colleague Nurith Divekar, also a Programme Coordinator, TISS, CARAT, sounds a cautionary note about statistics of doubtful provenance concerning the decrease in AIDS sufferers. The HIV surveillance system collects data from pregnant women in antenatal clinics, patients at STD clinics and high risk groups ( especially  in the states of Bihar, Orissa, Rajasthan and  West Bengal ). But, as Divekar told this writer, "Most pregnant women do not go for their delivery to hospitals, so there is a sizeable number that is not taken into account" .

As things stand, AIDS tests are not compulsory and a government proposal to make pre-marital testing mandatory has been opposed by a number of groups on various grounds including human rights and the morality of compulsion. Badiger said she was inclined to  favour voluntary tests.

Testing kits

Pravin Patkar, Director, Anti-Trafficking Centre, Prerana NGO  was among those resisting the proposal, "but our opposition is based purely on clinical issues. Also, the whole idea of compulsory AIDS tests is illogical, wrong, and impractical," he said, adding that the government's attempt to legislate tests could well be motivated by a captive market for testing kits. 

Health education, safe sex and condom usage were stressed by the AIRC  panelists, none of  whom, interestingly enough, cited abstinence as an important factor in HIV-AIDS prevention.  Intriguingly, male circumcision, which is  known to help inhibit HIV transmission, is being opposed by right wing Hindu activists who have called it a "conspiracy."

The Roman Catholic Church is also opposed to the  use of  prophylactics because they encourage risky behaviour. They contend that condoms have tiny holes through which the virus can pass.