Thursday, December 22, 2011

Why there is an urgent need for collective action against HIV/AIDS

Recent estimates suggest that the HIV affected population in India lies between 2 million to 3.1 million. This seems like a small proportion but indicates a huge number of people whose lives are threatened , battered or ruined. Surprising is the fact, that a state like Andhra Pradesh has nearly 1/5th of the total cases of HIV incidence in the country. We also find that 118 districts of India have more than 1% people who are HIV positive. 1% is generally taken as the cut off point for a disease to be a 'generalized epidemic'. The population at large believes that the person who has contracted HIV bears the responsibility for his or her own unfortunate condition, since the condition could have been avoided through changing personal behavior. This belief not only exists in a developing country like India but also in advanced nations like US of A. I agree, that many actions that lead to contracting the infection are certainly within personal control and the role of personal ability is an important connection to keep in mind in planning strategies for prevention through greater availability and use of information, more social advocacy and education. However, this is not an 'open and shut' case as it seems as this approach ignores the nine-tenth of the ice berg that lies below the surface. The reasons that this ice berg presents for a need for collective action galore. Some of them are -

  1. The infection can come to a person in ways over which he or she has little or no control. This applies to all those people who get the contagion through blood transfusion, to children who get the disease before they have any control over their lives (both prenatal & post-natal). It also applies to people who get it from their spouses before they realize that they are infected.Women are greater victims of this lack of control. 
  2. Ignorance of the law cannot be taken as a legitimate excuse for a legal lapse, lack of awareness of the ways of transmission of the virus or of prevention measures. 
  3. Individual conduct is often swayed by the prevailing modes of behavior. I would mention here the collective action of the sex workers' union in Kolkatta in moving the highly vulnerable population of commercial sex workers  towards a 100% use of condoms. Personal fight is a big part of the fight against AIDS, but group norms are very important in influencing this. 
  4. People are greatly influenced in their behavior not only by well-reasoned advocacy (as was the case in the Kolkatta case mentioned above) but also by what may be perceived as 'thrilling behavior'. It could be something as simple as smoking or taking drugs. In fact, taking drugs has also hugely contributed to the spread of the syndrome. This is very highly prevalent in Manipur. 
  5. 'Just saying NO' in any situation that could be potentially dangerous, is not a solution. Life often has such actions as a part and parcel of itself, either in the form of needs or wants.
  6. Criminalisation of some types of human relations contributes to driving such queer people underground, making it difficult to bring them into standard public discussion.
We need collective action because its time we stopped blaming the victims and stopped looking for reasons for reasons to leave them to look after themselves. There are many NGOs who work in this field - Care India, Center for Advocacy and Research, Constella-futures, Durbar Mahila Samavay Committee, Family health International, Hindustan Latex Family Planning Promotion Trust, Internation HIV/AIDS alliance, Karnataka Health Promotion Trust, Naz, Pathfinder International, Tamil Nadu AIDS initiative, Transport Corporation of India foundation, Project Orchid, Project Parivartan, etc.A cure for AIDS will soon be found. But we need to mobilize the people not only to spread awareness, but rescue the people who are already infected, while saving the people from contracting the infections in future. This cannot be done by individuals, but it requires groups to be activated. It is indeed a big issue, that somehow people just conveniently tend to ignore.