HIV Infection in India

India, or at least certain states in India, experienced a rapid rate of economic development and growth after 1991, when the country underwent changes from state socialism to the economic policy that welcomes foreign investments. Several consequences of this rapid development, such truck transportation, industrialization and urbanization, have contributed to the AIDS epidemic.

The country has a network of national highways and an extensive system of track transportation. For example, some 200,000 trucks arrive in Mumbai every evening (trucks are banned from the roads in most Indian cities during the day). There are a mind-boggling 3.5 million truck drivers in India, and they are a key means of HIV transmission. Truck drivers come mainly from Punjab and other northern Indian states, and are absent from their families for lengthy periods. Commercial sex workers are found at every truck stop in India. Often, providing female commercial sex workers is as regular a service offered by the truck stop as providing food, drink, gas, oil, and truck repairs.

Another result of India’s rapid economic development in recent years is the inflow of foreign capital and a proliferation of manufacturing plants, many owned by multinational companies. These plants are located not only in India’s major metropolitan centers, but also in rural market towns, especially in the economically booming states of Kerala, Kamataka, Andhra Pradesh, Maharashtra, and Tamil Nadu. It is no accident that the latter two states have particularly high HIV infection rates. Wage employment at construction sites and factories serves as a magnet, attracting millions of able-bodied men who migrate from distant villages.

These migrant workers leave their wives and families behind, returning home once or twice per year. Commercial sex workers, following the demand for their services from the factory workers, often set up business in temporary tents near the factories. In 2002, an estimated 200 million migrant workers and military servicemen in India represented a prime target for commercial sex work.

The spread of HIV in India rocketed upwards during the 1990s. There may be over 100000 prostitutes in Bombay. It has been obvious since the early 1980s chat these unhappy women would become heavily infected with HIV once the virus reached India, but prevention was begun 100 late and too link was done. By the end of the 1990s sex workers all over India had become heavily infected with the AIDS virus and the potential for further spread is mind boggling. By the early years of the new millennium more people may carry the virus in India than have been infected in the whole of the rest of the world since AIDS was first recognized.

HIV can cross the placenta and infect the fetus directly, the baby may become infected at birth by contact with the mother’s blood, or it may acquire the infection from her breast milk. 30 per cent of infants born to HIV-positive mothers will be infected in this wav. The drug AZT has recently been shown tube very-effective in reducing the risk of an HI v-infected woman passing the virus to her fetus, but it is so expensive that it is beyond the reach were to abandon breastfeeding from fear of HIV transmission, the powdered milk would kill more babies than the HIV would have done. So, vertical trans¬mission in developing countries will remain a fact of life – or death – since usually all infected children will be dead before the age of 5.

Studies in India show that HIV infection spreads by sexual contact in 74 percent of cases, by injection drug use in 7 percent of cases (in the poverty-stricken north-eastern state of Manipur, 86 percent of drug users are HIV-positive), 7 percent are infected by blood transfusions, and 12 percent by other means (including mother-to-child transmission). From 1986 to 1991, however, many HIV’ prevention activities in India (representing an estimated 60 percent of the funds spent) were devoted to cleaning up die blood supply.

HIV prevention programs among truckers have used a wide range of informational education and communication (IEC) activities and materials. Cassettes with songs in local languages are used to encourage drivers, migrant workers, and sex workers to change their altitudes regarding STIs, including HIV. Radio has been found to be especially useful since many truckers practically live in their vehicles and listen to the radio to counter the monotony of long journeys. Radio sketches, music, spots and educational cassettes on STIs, HIV and AIDS have been produced by international organizations, and then distributed to radio stations, itinerant traders and NGOs Гот use in peer education activities.

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Oral and visual materials are the most popular modes of HIV communication. Community theaters are located at stopover points to disseminate HIV education among truckers and also to provide them with alternative forms of recreation to sex. Mobile video units are used along the highways. Other tools such as billboards, posters, banners, and stickers are also used to appeal to transport worker. As for written material, small brochures that can be slipped into a pocket may be particularly effective…

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