********************************************************** SAATHII Electronic Newsletter HIV NEWS FROM INDIA Source: 05/01/2008 Posted on: The Telegraph India, Mediforfreedom.com and the Hindu COMPILED BY: Jacob Boopalan, and L. Ramakrishnan SAATHII Chennai Office. Note: this compilation contains news items about HIV/AIDS published in the Indian media, as well as articles relevant to HIV/AIDS in India published internationally. Articles in this and previous newsletters may also be accessed at http://www.saathii.org/orc/elibrary =============================================================== 1. Community response test for circumcision The Telegraph India, January 02, 2008. http://www.telegraphindia.com/1080102/jsp/nation/story_8731128.jsp 2. Trafficking for Sexual Exploitation and HIV/AIDS MediaForFreedom.com, January 02, 2008. http://www.mediaforfreedom.com/ReadArticle.asp?ArticleID=8374 3. Screening of HIV positive persons begins for second line drugs The Hindu, January 03, 2008. http://www.thehindu.com/2008/01/03/stories/2008010353370400.htm 4. A positive life The Hindu, January 04, 2008. http://www.hindu.com/yw/2008/01/04/stories/2008010450010100.htm =============================================================== 1. Community response test for circumcision The Telegraph India, January 02, 2008. http://www.telegraphindia.com/1080102/jsp/nation/story_8731128.jsp New Delhi: A task force of the Indian Council of Medical Research has proposed a study to determine levels of community comfort with male circumcision, a possible method to prevent the spread of HIV. Keeping in view possible impacts that culture and religion might have on attitudes to male circumcision, the task force has suggested a multi-site study to understand community perceptions about the practice. Clinical trials in Africa have shown that circumcision of male adults can reduce the risk of picking up HIV during heterosexual activity by 60 per cent. The protective effect was so strong that a data safety monitoring board stopped the studies and recommended that circumcision should be offered as an option to all participants of the trials. ICMR officials said the task force was set up to identify priority areas for research in the field of male circumcision relevant to India. “We have virtually no data about current practices, facilities available, or the rate of complications in male circumcision in India,” said Nomita Chandiok, the deputy director-general of the ICMR. “Community perceptions are crucial in determining acceptability. But all we know about male circumcision in India is based on hearsay and assumptions. We need studies to understand the ground situation,” she said. How exactly circumcision protects against HIV infection is still unclear, but scientists believe that the male foreskin contains a concentration of cells that serve as gateways for the virus to enter the human body in the earliest stages of HIV infection. Previous research studies have shown that circumcision lowers rates of urinary tract infections in infants and also lowers the prevalence of genital ulcer diseases which are a risk factor for picking up HIV. A global consultation by the World Health Organisation and the UNAIDS earlier this year had said that for countries such as India, where HIV is largely concentrated in specific population groups, there would be little public health benefit in promoting male circumcision in the general population. “This is a sensitive issue. Individuals at high risk of HIV may benefit from it, but only a study on community perceptions will help us determine whether it would be acceptable as a preventive method here,” a community medicine specialist said. =============================================================== 2. Trafficking for Sexual Exploitation and HIV/AIDS MediaForFreedom.com, January 02, 2008. http://www.mediaforfreedom.com/ReadArticle.asp?ArticleID=8374 Trafficking in young girls, children and women is a matter of great concern all over the world. In South Asia, cross-border trafficking, sourcing, transit to destination is a big problem. Even more prevalent is the movement of persons within the countries for exploitation in various forms. There are no definite figures about the number of victims. Trafficking for commercial sexual exploitation is the most virulent form in South Asia. Internal displacement due to conflict in some of these countries, poverty and lack of employment opportunities, increase the vulnerabilities to being trafficked. Bangladesh is a source and transit country for young girls, children and women trafficked for the purposes of commercial sexual exploitation and involuntary servitude. It is also a source country for children - both girls and boys - trafficked for commercial sexual exploitation, bonded labor, and other forms of involuntary servitude. Women and children from Bangladesh are trafficked to India and Pakistan for sexual exploitation. Internally, Bangladeshis are trafficked for commercial sexual exploitation, domestic servitude, and bonded labor. Some Burmese women who are trafficked to India transit through Bangladesh. The movement of young girls from Nepal and Bangladesh into Indian brothels is common. However, most of the trafficking takes place within India itself. There is further movement of these women and girls to the Middle East as well as other destinations. Similar movement from Pakistan and Sri Lanka has been observed. At times of hardship, this starts out as illegal migration and ends up as trafficking. AIDS researcher Mr. Anirudha Alam said, “Trafficking & HIV/AIDS is interrelated, especially women and girls are trafficking for use of sexual industry. Most of trafficking girls would face several physical & sexual abuses. When a girl or women newly enrolls a sex industry, she tries to safe herself heard & soul, but most of the time they couldn’t free her.” The response to combating the crime of human trafficking by the countries of South Asia has been inadequate. There is limited awareness and although knowledge of and the willingness to speak out against trafficking has increased significantly in the past half decade, it is still only at minimal levels. In addition to the lack of awareness, existing anti-trafficking legislation in most countries is inadequate. The law enforcement response – which is meant to provide an effective deterrent to traffickers – is also weak, irresponsive and not victim-friendly. Lack of job opportunities makes people vulnerable and more inclined to migrate in the hope of creating a better life for themselves and their families. Even so, poverty that makes people sell their children to traffickers and that makes women become victims of trafficking. There is a trend for more and more women to be left alone to fend for themselves and their children; this is referred to as the feminization of poverty. Their powerlessness is taken advantage of by traffickers who assure them jobs or necessary facilities, although instead they may end up in prostitution. Though this data is not enough to certify the fact, still South Asia is home to one of the largest concentrations of people living with HIV. Female sex workers (FSWs) – as a group – are an important driver of the epidemic. As has been shown in a very recent research involving repatriated FSWs in Nepal, many of the FSWs who have been trafficked are at a significantly higher risk than “average” women of contracting HIV. The Rainbow Nari O Shishu Kallyan Foundation and ‘Society for Humanitarian Assistance & Rights Protection’ (SHARP) jointly conducted a survey that focuses on the attitude, behavior and practice of FSWs in Goalondo Brothel, this study points out that almost 53% of sex workers enter the profession before the age of 20 years, and 30% enter between 20 to 25 years of age, and some of them have been entangled through instigation of the traffickers. =============================================================== 3. Screening of HIV positive persons begins for second line drugs The Hindu, January 03, 2008. http://www.thehindu.com/2008/01/03/stories/2008010353370400.htm CHENNAI: Tamil Nadu, one of the two centres that will provide second line anti- retroviral drugs as a pilot project, has begun screening of positive people who have become resistant to the first line drugs. While first line drugs are being provided free of cost through ART centres throughout the State, positive people’s networks have been demanding that the government also provide second line drugs to those who have progressed to drug resistance. With the market price of second line drugs still high, most people who require second line drugs are unable to procure them. It is estimated that between two and three per cent of people on ARVs are resistant and would require the second line of drugs. As part of the third phase of the National AIDS Control Programme, two centres have been selected to provide second line ARV drugs – one each in Tamil Nadu and Maharashtra. Good ARV delivery The Government Hospital for Thoracic Medicine in Tambaram, one of the first centres to provide ARVs through the government service, is the nodal centre in the State. Sujatha Rao, Director, National AIDS Control Organisation, said Tambaram was chosen as they have been good at ARV delivery and has had a good patient adherence rate (patients continuing treatment without dropping out). Tambaram GHTM Superintendent S.Rajasekaran said screening of positive persons has already begun, in association with the Tuberculosis Research Centre. The drugs will be provided beginning second and third week of January. Tamil Nadu State AIDS Control Society (TANSACS) project director Supriya Sahu said only those who have had continuous treatment at Tambaram for the past six months would be considered for the second line. Out of the 3000 people on ARV treatment in Tamil Nadu, it is expected that 300-400 patients will require second line treatment, Dr.Rajasekaran said. Tambaram itself will provide treatment to 100 of these people. “It is easy for us to screen people, because we have been treating them for the last three and a half years and we know who is likely to fall in the category,” he added. Campaign Illango Ramachander, former president of the Indian Network of Positive Persons, has spearheaded a campaign to get the government to provide ARVS. He is glad that the community’s long pending demand has come through, but has moved on to analyse the problems that might crop up. “They have said initially two centres will be started. I suggest that it should not be State-bound. It should be looked at as a national programme.” “We are glad that the government has overcome its mental block about providing second line drugs,” says INP+ president K.K.Abraham. Padmaja and her family have been waiting for this for a long while. Her husband and daughter are now on second line treatment and the expenses have been mounting. She has managed to find a sponsor for her daughter’s drugs through the organisation she now works for – Positive Women’s Network. =============================================================== 4. A positive life The Hindu, January 04, 2008. http://www.hindu.com/yw/2008/01/04/stories/2008010450010100.htm Radha’s illness caused her to be ostracised by the villagers. But her courage and pluck keeps her strong in the fight to retain what is hers. No one wanted radha’s story to be told. But when we did hear it, the truth was shocking. Sometime ago, I had gone to the hills with my mother who was doing a project on HIV-AIDS. She had planned an interview with Radha (name changed), a middle-aged woman who was stigmatised for being HIV positive. The place I visited was extremely poor and backward. There was none of the comforts of modern day developing India. Farming is the major occupation and literacy levels are low. When Radha got married, she found that her husband was always ill. It was an arranged and arguably a forced marriage. The man’s health didn’t improve after marriage. Radha thus became the main bread winner. Years passed. They had a daughter. The local dispensaries continued to give symptomatic treatment. After a while, his illness became so severe that they had to come down to the plains for treatment. It was here that he was found to be HIV positive. As a next-in-line measure, Radha’s blood was tested and found to be infected with the retrovirus too. The child, however, tested negative. When they returned, instead of staying in the village, where they knew they would be hated, they stayed at the husband’s sister’s house. The sister was hostile and the treatment they got was indifferent. Very soon, her husband’s condition deteriorated. A priest serving at a nearby missionary centre came to know of it and sent them to Lucknow where they could get proper treatment. Her husband lived for 11 more months. The ignorance about timely treatment cost him his life. Photographs of their stay in Lucknow prove it was the happiest time of their lives. Radha and her daughter came back to the village where they owned a house. They were totally neglected and hated by the neighbourhood. No one talked to them or gave them any help. The society was entirely oblivious to their existence. Radha toiled in her fields and slept at home — she was determined to live on and make her daughter’s life happier than her own. Also, she didn’t want her husband’s family to get the property as long as she lived. Meeting Radha We had the address of her husband’s sister’s house. Once there, we were informed that Radha, whose house was farther up on the hill, had sprained her ankle and would not be able to come down to meet us. (But we later found that her leg was fine and this story was just to stop us from meeting her and hearing her story). We were told a concocted story — one I am sure must have been used to convince many others. However, having come this far, my mother was determined to talk to Radha in person. We walked up the mountain and came to the village where Radha lived. The village Mukhiya and the village ‘wise men’ began evading the topic and started discussing politics and water harvesting instead. They also began telling us about their contacts in Delhi. No one wanted Radha’s story to be told. But our persistence paid off. Several shocking details were uncovered during this meeting with her; including the fact that her husband’s sister had insured her brother’s life and according to the policy she would be getting the insurance money. Also, Radha was fairly certain that she had known of her brother’s condition prior to marriage and yet let the marriage take place. The sister had effectively used her brother’s illness for her own personal gain, Radha’s life being inconsequential. Awareness and sensitisation Now that Radha’s condition has been made known, UNICEF supplies free medicine. Women sarpanches have been sensitising the people by creating awareness through the screening of documentaries. Radha continues to live there — a figure of resilience, an icon of strength, living in her house, working in her farm and taking care of her daughter. She is alone, though a few people have now accepted her and also talk to her. But her aim is, to guard her house for her daughter. However, the older men in the village feel that she and other ‘such’ women should not be allowed to stay in the village. Some have learned to accept her, though most will never learn to co-exist. Despite the circumstances, her strength and hope for the future are unbelievable and inspiring. =============================================================== Disclaimer: Opinions expressed in the above articles are those of the respective newspapers, not those of SAATHII.