In the past decade, the media has focused primarily on the HIV/AIDS issue in Africa, but now India is at a critical juncture of the HIV/AIDS pandemic. The actual numbers of HIV infections is difficult to determine in India as estimates are based solely on surveillance conducted at public sites. The number of people living with HIV in India is estimated to be over 5.13 million and the numbers are expected to rise to 15 million in the coming decade.

This estimate places India second only to South Africa as the country with the highest population of people living with HIV/AIDS. Given India’s large population, a rise of just 0.1 percent in the prevalence rate would increase the number of persons who are HIV positive by 500,000. United Nations has estimated that there have been 2.7 million AIDS deaths between 1980 and 2000. These figures are more than just statistics. Each number counts for a life that is valuable to God.

Modes of transmission

Sexual contact is the highest mode of transmission at 85 percent. There are many groups of people who are considered at “high risk” of HIV transmission including commercial sex workers (CSWs), truck drivers, and drug users. However, the spread of HIV is not longer limited to these high risk groups as the disease is already prevalent and spreading throughout the general Indian population.

Research in 2004 has shown that twelve percent of pregnant women in India are HIV positive. UNICEF estimates that 30,000 babies are born HIV positive every year in India. Tragically, pregnant women can pass on the infection to their unborn child, or after birth by breastfeeding, an otherwise recommended practice. These women are then left with the hard choice between taking the chance of breastfeeding their baby, which greatly increases the chance of the child contracting HIV, or using cow milk, which risks the chance of malnutrition and diarrhea quickly leading to death.

Awareness and Education

As in most places around the world, HIV/AIDS is perceived as the disease of “others” - those living on the margins of society, with lifestyles that are considered “sinful.” The social reaction to AIDS in India is extremely negative. Because HIV/AIDS awareness and education is scarce in India, there is widespread fear and a stigma towards this disease. It is debatable as to whether there is sufficient commitment to combating the epidemic at government level. Many Indians in positions of power refuse to accept that their country faces a grave threat from the epidemic.

High rates of infection among those with less education show the importance of HIV/AIDS education and prevention. Women tend to have a much lower exposure to mass media than men and thus are much more likely to have little or even no knowledge of HIV/AIDS awareness and prevention.

Women and HIV

About two million of India’s 500 million women are HIV positive. Women with HIV/AIDS suffer much discrimination from their society. They are often denied employment and therefore have no means necessary to sustain and support their family. Outcast by society and their own relatives, they are left with nothing and no one.

Women who belong to marginalized groups - low income, low caste - are particularly vulnerable to HIV infection because of their impoverished living conditions and lack of education. These women have poor access to treatment or information on HIV/AIDS issues.

There are many cases in which women don’t even know they are infected with HIV. Early in 2006, a woman named Renuka came to House of Hope for a short time. Renuka had never heard of HIV and was not even aware that she had been infected. She was pregnant and found out her HIV status from a blood test taken at the hospital. Sadly, Renuka’s story is true for many Indian women. Often times, a husband is unfaithful to his wife, become infected unknowingly, and then infects his wife, who only learns of her HIV status if she happens to get a blood test. 

Children and HIV

Fourteen percent of all HIV/AIDS cases in India are under the age of fourteen.  Most of these children have a life of discrimination to look forward to from their own families to the education and healthcare systems. Many schools refuse to grant admission to a child who is HIV positive. A failing healthcare system (both government and private) will often refuse treatment or even touch HIV positive children. 

AIDS Orphans

India is expected to be home to the largest number of AIDS orphans in the world and the number is expected to double in the next five years. There are no government figures in the country for the number of children affected by AIDS, but the World Bank estimates that the number of children in India orphaned by AIDS is reaching 2 million.

“The odds against AIDS-orphaned children are staggering. These children are vulnerable to a number of risks ranging from social exclusion and economic deprivation to illiteracy, malnutrition and exploitation. They are also at increased risk of contracting sexually-transmitted diseases, abuse and drug use, with many young girls turning to prostitution in order to survive. AIDS orphans are often shunned by their communities; many are denied property rights and rights to inheritance. Those who cannot be taken in by their relatives end up living on the streets.” - from InfoChange India on children orphaned by AIDS.