India-Health Care Acquired Immune Deficiency Syndrome

Data as of September 1995

The incidence of AIDS cases in India is steadily rising amidst concerns that the nation faces the prospect of an AIDS epidemic. By June 1991, out of a total of more than 900,000 screened, some 5,130 people tested positive for the human immunodeficiency virus (HIV). However, the total number infected with HIV in 1992 was estimated by a New Delhi-based official of the World Health Organization (WHO) at 500,000, and more pessimistic estimates by the World Bank in 1995 suggested a figure of 2 million, the highest in Asia. Confirmed cases of AIDS numbered only 102 by 1991 but had jumped to 885 by 1994, the second highest reported number in Asia after Thailand. Suspected AIDS cases, according to WHO and the Indian government, may be in the area of 80,000 in 1995.

The main factors cited in the spread of the virus are heterosexual transmission, primarily by urban prostitutes and migrant workers, such as long-distance truck drivers; the use of unsterilized needles and syringes by physicians and intravenous drug users; and transfusions of blood from infected donors. Based on the HIV infection rate in 1991, and India's position as the second most populated country in the world, it was projected that by 1995 India would have more HIV and AIDS cases than any other country in the world. This prediction appeared true. By mid-1995 India had been labeled by the media as "ground zero" in the global AIDS epidemic, and new predictions for 2000 were that India would have 1 million AIDS cases and 5 million HIV-positive.

In 1987 the newly formed National AIDS Control Programme began limited screening of the blood supply and monitoring of high-risk groups. A national education program aimed at AIDS prevention and control began in 1990. The first AIDS prevention television campaign began in 1991. By the mid-1990s, AIDS awareness signs on public streets, condoms for sale near brothels, and media announcements were more in evidence. There was very negative publicity as well. Posters with the names and photographs of known HIV-positive persons have been seen in New Delhi, and there have been reports of HIV patients chained in medical facilities and deprived of treatment.

Fear and ignorance have continued to compound the difficulty of controlling the spread of the virus, and discrimination against AIDS sufferers has surfaced. For example, in 1990 the All-India Institute of Medical Sciences, New Delhi's leading medical facility, reportedly turned away two people infected with HIV because its staff were too scared to treat them.

A new program to control the spread of AIDS was launched in 1991 by the Indian Council of Medical Research. The council looked to ancient scriptures and religious books for traditional messages that preach moderation in sex and describe prostitution as a sin. The council considered that the great extent to which Indian life-styles are shaped by religion rather than by science would cause many people to be confused by foreign-modeled educational campaigns relying on television and printed booklets.

The severity of the growing AIDS crisis in India is clear, according to statistics compiled during the mid-1990s. In Bombay, a city of 12.6 million inhabitants in 1991, the HIV infection rate among the estimated 80,000 prostitutes jumped from 1 percent in 1987 to 30 percent in 1991 to 53 percent in 1993. Migrant workers engaging in promiscuous and unprotected sexual relations in the big city carry the infection to other sexual partners on the road and then to their homes and families.

India's blood supply, despite official blood screening efforts, continues to become infected. In 1991 donated blood was screened for HIV in only four major cities: New Delhi, Calcutta, Madras, and Bombay. One of the leading factors in the contamination of the blood supply is that 30 percent of the blood required comes from private, profit-making banks whose practices are difficult to regulate. Furthermore, professional donors are an integral part of the Indian blood supply network, providing about 30 percent of the annual requirement nationally. These donors are generally poor and tend to engage in high-risk sex and use intravenous drugs more than the general population. Professional donors also tend to donate frequently at different centers and, in many cases, under different names. Reuse of improperly sterilized needles in health care and blood-collection facilities also is a factor. India's minister of health and family welfare reported in 1992 that only 138 out of 608 blood banks were equipped for HIV screening. A 1992 study conducted by the Indian Health Organisation revealed that 86 percent of commercial blood donors surveyed were HIV-positive.

Health Care

Data as of September 1995