The Government of India estimates that about 2.40 million Indians are living with HIV (1.93 ‐3.04 million) with an adult prevalence of 0.31% (2009). For the readers, there is a popular myth that HIV, or AIDS is an urban disease. As per the HIV Sentinel Surveillance (HSS) of 2007, it was identified that 57% of the HIV-positive persons in India are estimated to be living in rural areas.
Under the NACP III, Link Worker Scheme was designed for rural prevention and NACO implemented this program with the financial support of Global Fund through Lead NGOs. Link Worker Scheme was launched to saturate the reach of HIV-related services to high-risk groups based in rural areas. The scheme aims to build a rural community model to address the complex needs of rural HIV prevention, care, and support requirements. Under this scheme, a person who has been trained and has been made responsible for carrying out specific activities is called a Cluster Link Worker. I visited the field office of Humana People to People India (HPPI) in Lucknow on a learning tour about the Link Worker Scheme. A Red Ribbon Club (RRC) in the villages has been formed to prevent AIDS. This was done due to the dormant village health committee and uneasiness among village elders to take up issues related to sexual health. I observed that women from higher caste and men are reluctant to talk openly. Cluster Link Worker told me about the few cases referred to STI services under this intervention. Information materials & commodities (condoms, needles/syringes) through collaborating with the nearest government health facilities have been distributed among the youth in the community.
Numerous NGOs and CBOs are working on HIV/AIDS issues in India at the local, state, and national levels. The events organized by NGOs are limited to shouting slogans and carrying placards depicting various messages related to HIV/AIDS. They also help in social marketing (SM) of condoms. The campaign uses targeted ads and community engagement opportunities to change the way men and women think about HIV/AIDS. The major reasons for AIDS can be attributed to Unsafe Sex and Low Condom Use. But it arises from the Low levels of literacy leading to myth and misconception. STIs very often go untreated due to both a lack of information and healthcare facilities. Stigma towards people living with HIV is widespread among urban and rural communities. Sex workers are hiding in plain sight.
The high-risk group (HRG) among the population includes Female Sex Workers (FSW), Men Who Have Sex with Men (MSM) & Injecting Drug Use (IDU). The Bridge Population is truck drivers, male and female migrants while the vulnerable Population constitutes migrant spouses, HRG spouses, and trucker's spouses. Youth migrating for work and trafficked women form a critical group because of their ‘mobility with HIV’. Migration for work leads them to new living and working conditions without family support. Sexually active age and separation from regular partners for extended periods predispose them to paid sex or sex with non-regular partners. Movement is not a necessary element in the trafficking process, with the mechanisms of deployment, payment of advances, and wages bearing a striking similarity across the country. The various reasons for trafficking are a result of a complex set of Gender discrimination, illiteracy, No sex education, violence against women, vulnerability and ignorance of girls, and finally lack of opportunity.
People have not suddenly understood the old arguments spread by social workers. There is a lot of awareness now of HIV than a decade ago and the attitudes about AIDS changing gradually. The HIV-positive population needs the provision of safe spaces and support systems to overcome shameful anxieties, fragile hopes, and guilt. I saluted the guts of the social worker who works in the community on such a taboo issue. Much moral courage is required to meet an outcast and convince a socially rigid community. With consistent awareness, the masses get used to the message, and AIDS loses its disgust value. And the new generation is just much more open.
