Free Custom «HIV Awareness in India» Essay Paper

Introduction

The prevalence of HIV/AIDS in the world has had immense effects on both the economic and social environment. Sexually active people are prone to the virus and campaigns to increase awareness have been ongoing in different states at different levels. The presence of the virus causes stigma and discrimination against the infected people, a scenario that is detrimental to the productivity of people. On its early days, HIV/AIDS was seen as a consequence of sexual immorality and patients were often regarded responsible for acquiring the virus. They were often isolated and were left to die as people believed the disease was highly contagious and any contact with an infected person would lead to a new infection. Through global and individual state campaigns involving individual citizens, respective governments and other willing organizations, the change of perception has been fairly achieved and people are more aware of the situations that could expose them to the virus. Through research and education, people can now live with infected people without anxiety and fear of getting infected. Different ways in which one can contract the virus and consequent protection methods have been identified.

Despite the increased knowledge and research on the condition, the levels of information vary amongst people across the world. Such awareness is created to ensure reduced number of new infections, as well as allowing the infected individuals to live more freely amongst their peers in the society. While the developed nations such as Europe and the United States can be proud of high levels of awareness, some countries in the developing world cannot say the same. Some Asian countries are also reasonably informed on HIV matters, but the levels of prevalence remain significantly high. One such country that has prided itself on successful awareness of HIV is India.

India has the second largest population in the world, only preceded by China. The country has an estimated population of over 1.2 billion, and with a population growth rate of 2.1%, it is set to overtake China by 2025 (Pulerwitz, 2010). Most of the population in India is young, with over half of it comprising of people aged 25 and below, while about 65% are aged 35 and below. These demographics are highly significant to HIV awareness and intervention because most of people are sexually active and prone to contracting the virus. There is also a large concentration of population in urban areas, which leaves them congested and without adequate infrastructure. This high concentration of people has led to overwhelming of the health system and the government is in the process of revitalizing the same (Bourgault, 2009). The housing conditions are poor and the general living does not provide good environment to young people. However, high literacy levels provide the nation with an advantage as the awareness campaigns have led to a significant reduction in new HIV infections over the last decade (Pulerwitz, 2010). This is an indication that the population, despite being sexually active, is more knowledgeable about different protection methods and procedures, which was not the case in the previous decade. Further, the number of deaths resulting from HIV/AIDS has reduced over the last decade, which again is an indicator that the people who have already contracted the virus live better. They are more comfortable in the society and are less stigmatized and consequently able to follow medical and dietary requirements to increase their longevity. This is an indication of better knowledge of the disease (Bourgault, 2009). This paper will examine different at-risk groups and HIV awareness methods that have been used in India over the last two decades, and their effects on the population and prevalence of the virus.

HIV Epidemiology Levels in India

India has the third largest number of people infected with HIV/AIDS after Nigeria and South Africa. However, with the relatively high population, the prevalence rate is small, and India, despite having 2.1 million infected people had a prevalence rate of only 0.3%, ranking 89^th globally. The government has partnered with several organizations and the country is today praised for its awareness campaigns. The virus is mainly spread and prevalent in the North-Eastern and Southern regions of the country. The trends are also uneven due to certain sections of urban centers in North East India (Ramesh, 2008). Between 2008 and 2009, the prevalence increased from 0.31% to 0.32%. Reports also indicate that there was a gradual decline in prevalence among adults from 0.41% to 0.36% to 0.31% in 2000, 2006 and 2009 respectively (Bourgault, 2009). There has also been an emerging trend where the rate of new infections among young people aged 15- 24 reduced by over 50% between 2000 and 2009. The prevalence of the disease among married couples has also declined, but research shows that men are more promiscuous than women (Pulerwitz, 2010). While married women can retain one partner and stay away from the risky behavior, the same cannot be said about men, who are usually the source of infection in married couples due to their engagement in risky behavior and failing to commit to one sex partner (Ramesh, 2008). The government of India has highlighted five main groups that act as the main transmitters and incubators of the virus.

Five Main Risk Groups and Their Awareness Levels

The first group, which is arguably the largest, comprises of truck drivers. It totals to about 2 million and has a HIV prevalence rate of 2.6% (Singh & Joshi, 2012). Intervention efforts from different sources, which mainly include awareness campaigns, reach out to about 48.4% of this at-risk population. Reports estimate that truckers are at a higher risk of infections, as they account to 36% of all customers of sex workers in India. They have fairly good income, consume alcohol, spend long periods away from home and spend most of their time at work. These factors expose them to reckless sexual activities (Singh & Joshi, 2012). Truckers act as the main bridge that transmits HIV from urban centers to rural areas.

The other group responsible for HIV prevalence in India is migrant workers, whose population is about 7.2 million, and have a HIV prevalence of 1%. Efforts to raise awareness among migrant workers reach about 41.3% of this population (Bourgault, 2009). The group is responsible for transmission of HIV from high risk urban populations to low risk rural populations. Their mobility and often shaky family life lead to the risk of them being transmitters. However, some studies exonerate this group from being among the most at-risk groups, with findings indicating that only five percent of sex workers felt exposed to HIV from the immigrants, against sixty percent who felt that residents posed more risk.

The third group consists of commercial sex workers. This group totals to about 0.85 million and has a HIV prevalence of 2.7% (Boily, 2013). Awareness campaigns have reached about 84.5% of this population. However, sex workers are often segregated from the society, making them avoid healthcare services. This leaves them as a main incubator of the virus. Some use condoms, but the male sex workers face more risks as 13% have never used a condom. Despite the group being well furnished with sex information, sex workers engage in risky behavior, especially men who engage in anal sex (Boily, 2013).  The prevalence of HIV is as high as 38% in some of the states of the country.

The gay population is another at-risk group in India. They amount to about 427,000, with a HIV prevalence of 4.4% (Kumar, 2011). Intervention and awareness efforts reach about 70.6% of this population. Same sex sexual interactions had been criminalized in India, but the Delhi High court reversed the decision in 2009. In 2013, however, the India Supreme Court re-criminalized intercourse between same sex adults, which, according to experts, was a step that would hinder access to both information and healthcare among gays. This group is highly stigmatized, hindering their access to information and its consumption whenever it is available.  About half of the gay population has female partners, and less than half of the entire gay population used protection during sex (Kumar, 2011).

Drug use is common in India, with a population of about 177,000 being involved in the practice. The prevalence rate of HIV is 7.1%, yet the information reaches 80.7% of this group (Maitrayee, 2007). Although the general prevalence level has not increased since 2006, it has not reduced either despite a high population of this group having access to AIDS information. However, it is notable that despite a decline in prevalence among the group in the Northeast, the same is increasing in some of the states located in the Northwest of India.

Efforts to Raise HIV Awareness in India

The declining prevalence levels of HIV can be attributed to different methods that collaborative bodies have been using to create awareness about HIV among the population. The government of India, alongside other organizations, has had many campaigns and awareness practices that have been successful in passing AIDS information (Ramesh, 2008). These methods can be split into two main categories: government initiatives and initiatives of other organizations. The latter could represent collaborations between the government and other organizations, while the former solely focuses on government intervention methods.

Government Interventions in India

After the first case of HIV was reported in India in 1986, the Indian government created National AIDS Committee, controlled by the Ministry of Health and Family Welfare National (Maitrayee, 2007). It was later modified to become National AIDS Control Organization (NACO). Today, NACO manages almost all issues related to HIV, including education, testing and numerical researches. Furthermore, the government mandated NACO with formation of another council, the National Aids Council, which included all government ministries and is chaired by the Prime Minister, a move that showed the importance of the matter to the government held. In 2010 the agency approved material that would be used in teaching and creating HIV awareness, both in institutions and out of them. The material dissociated sex education from AIDS education, and was eventually approved by some state governments and distributed to over 50 million scholars. In other efforts, NACO has increased the number of ART centers, which are designated to treat HIV patients and to provide information (Bourgault, 2009). The constant work of the centers increases awareness of the virus among people. They act as messages warning people of the existence of the virus amongst them and their need to be more careful. The awareness process is itself ingrained into people in a careful but compulsory way because people cannot ignore the presence of such a center.

The government further established the National HIV and AIDS Policy and the World of Work with a goal to end stigma and discrimination against HIV patients. Further, the government passed the HIV / AIDS Prevention and Control Bill in 2014. The Act requires that HIV patients are treated equally in private and public sectors (Ramesh, 2008). However, the policy is incomplete since there is no one designated institution that would handle non-compliant organizations. Discrimination against HIV patients is risky because it prevents people from seeking information, lest they be perceived as patients. Such perceptions present campaigners with setbacks and a general social rebellion against the strategies.

The government also formed a framework stating that recognition of HIV was an essential to economic and social growth, rather than just being considered as a medical and health aspect. Consequently, efforts to promote awareness have been incorporated in all government activities through its ministries and departments. These efforts increased the level of awareness across the whole population and not just the risk groups.

Other Organizations Involved in Promotion of HIV Awareness

Different bodies have collaborated with the Indian government to increase the awareness of HIV. While some of the efforts are directed to the general population, there are certain efforts that are specifically targeted at the identified high risk groups. The facilitators have a target to cover 80 % of all the groups identified as risk groups. These groups appreciate the fact that despite having reached out to many people, there is still more that needs to be done to ensure that the population is safe. By focusing on the risk groups, through awareness and prevention, they can easily control the groups, which spread the disease, and eventually manage to contain the virus both in long and short runs. Some of the projects that target at-risk population are highlighted below.

Project Pehchan was launched to provide information and create awareness among gay, Hijra and transgender population. The project has a goal of reaching over 450,000 members of the three categories, across 17 states within five years. They will work with over 200 community organizations, while enabling these groups to have access to health care and HIV information (Bourgault, 2009). The project also aims at reducing discrimination and stigma from the rest of the population, to ensure that the group engages in safe sexual activities and that the members are not criminalized for their sexual orientation.

The Avahan project was implemented in 2003 with a broader focus on sex workers, gays and transgender groups (Dandona, 2005). The main aim of the project was to provide at-risk groups with education on HIV to help them increase vigilance to protection methods. The project also promotes condom use as well as the management of other STIs. It will also create awareness on communication change, mobilize communities and increase its advocacy efforts. Since its inception, Avahan has been lauded for its success and has been attributed to the aversion of about 36-68% of new infections between 2003 and 2007. By 2013, the project was reported to have successfully averted about 57% potential HIV infections in Southern India (Dandona, 2005). Its cost effectiveness and efficiency renders it more likely to be used in future.

The Sonaguch project was started in 1992, with a special focus on sex workers. Its main aim is to increase awareness on HIV, advocate for behavior change and encourage people to visit health centers. This would help the sex workers update their knowledge about modern protection and prevention methods, while allowing them to known their status. They would be encouraged to use condoms during sex, and have more information about their proper usage (Shinde, 2009). The project has been successful since its inception in 1999. Through the project the group created a recognized organization that demanded rights and recognition. Such an exposure provides other sex workers with a platform to gain more information and raise HIV awareness.

The Project Kavach was started in 2004 aiming at raising HIV awareness among truck drivers. It also had a secondary objective of reaching other high risk groups, but the emphasis was laid on truckers. It is designed to reach approximatelt 21,000 truckers every year, through informal plays, shows and peer education. It encourages the use of condoms, HIV testing and counseling among truckers, while helping in treatment of other STIs.

Link worker scheme is a strategy supported by UNDP, which focuses on provision of HIV information that would help in care, treatment and prevention. It is modeled to involve communities in the execution of its objectives (Shinde, 2009). Furthermore, the project distributes condoms and expounds on their proper use. Due to its intervention, there has been increased testing and identification of individuals living with HIV over the last decade. This project operates in 17 states.

Red Ribbon Express is a campaign run by the Indian Railways. It had reached over 10 million people in 23 states since its inception in 2007 (Shinde, 2009). The campaign focuses on young people and provides them with HIV counseling and testing, while also providing extra services in treatment of other STIs.

Condom Social Marketing Program increases access to condoms and their use in order to eventually promote safer sex. It employs mass media, especially social media. The most recent campaign focuses on the younger population through social media. Multilingual campaigns have already been established, with an emphasis on Hindi and several regional languages. The program distributes condoms, as well as raises HIV awareness (Maitrayee, 2007). It also encourages behavioral change among vulnerable people, who are in this case sexually active population.

Conclusion

The strategies employed by the Indian government have been appreciable and successful in preventing the spread of the virus in the last two decades. It is commendable that the rate of new infections, especially among young people has been declining, despite the fact that this population amounts to over 65% of the total national population. These statistics show that the government in collaboration with other players has been able to identify the key channels that would lead to reduction of the spread of HIV, which is the key indicator of success of the awareness campaigns. With the use of strategies such as the Avahan project it is possible to state that the rates will continue to decrease. With the vibrant education system, young people have access to information about HIV. Furthermore, a reduction in the risk of transmission of the disease of 30% is an indicator of successful intervention strategies. In order to win the war against the spread of HIV, the Indian government should introduce in rural areas the methods that have worked in urban centers, but with a few changes to correspond to this new setting. Furthermore, the gap in the discrimination policy should be filled up by proper designation of the institution that would prosecute non-compliance. Poor punitive systems could lead to abuse of otherwise productive policies and creation of social gaps that destroy the desired outcomes. Such strategies are correct as they will safeguard the health of the population that is expected to be the highest in the world within the next two decades.