2.1 million people in India are living with HIV, making up 0.22% of our population and the third largest HIV epidemic globally. In 1986 when AIDS was first detected in India, Tamil Nadu, measures were taken to ensure detection, prevention and awareness regarding HIV and AIDS in India. From 2001 to 2017, India has managed to successfully reduce number of new infections by half. However, there are still impediments on our way to becoming a HIV free country, among them the top obstacles are: social stigma and discrimination, and lack of access to quality healthcare.
National AIDS Control Organisation (NACO) has created and implemented the National Aids Control Policy with focus on ‘test and treat’ and generating awareness about HIV, AIDS, detection, prevention, treatment, etc. In the efforts to further their mission, we have debunked the top 5 myths about HIV in India.
Myth #1: HIV can be transmitted through social interactions
Studies indicate that HIV is not spread through touch, tears, sweat or saliva. HIV cannot be transmitted by:
- Breathing the same air as someone who is HIV positive
- Touching a toilet seat or door knob handle after an HIV positive person
- Drinking from the same water fountain as an HIV positive person
- Hugging, kissing or shaking hands with someone who is HIV positive
- Sharing utensils with an HIV positive person
- Using exercise equipment at the gym
- Mosquito bites
The only bodily fluids that are known to transmit HIV are semen, vaginal fluids, anal fluids, breastmilk, and blood (including menstrual blood).
Myth #2: HIV is a ‘homosexual disease’
Upto 80% of HIV transmission occurs through heterosexual sexual intercourse. It is important to understand how the disease spreads in both men and women. Women are easily infected with the chances of 1-in-200 contracting HIV from a single sexual intercourse (the probability of men contracting HIV is 1-in-700). Biology plays the major role: semen, which has a high concentration of HIV, is deposited into a woman’s uterus and stays there for at least three days, increasing her chances of infection. Also, the mucous membrane in the area where the penis enters a woman’s body has many CD4 cells, which HIV latches on to, again making her more likely to contract the virus.
That being said, in India, sections vulnerable to risk of HIV include men who have sex with men, and the transgender community. Until 2018, when the Supreme Court decriminalised homosexuality in India, there was a lot of social stigma which prohibited individuals from stepping up to seek help. Lesbians, although at a lower risk, can also pass HIV through vaginal fluid or menstrual blood.
Myth #3: HIV cannot be transmitted through oral or anal sex
Albeit is less risky, you can get HIV by having oral sex with either a man or woman who is HIV positive. HIV is contracted much more easily through anal sex as the anus is prone to cuts and bleeding, which raises the risk of infection. So both men who have sex with men and heterosexuals who have regular anal sex without condoms are particularly vulnerable. It is advisable to use condoms or latex barriers during oral and anal sex to mitigate the risk of contracting or transmitting HIV.
Myth #4: HIV positive couples cannot have children
Women who are HIV positive, pregnant and do not undergo HIV treatment or Anti-Retroviral Treatment (ART), have a 30% chance of passing on the HIV infection to their baby, in the womb, during birth or breastfeeding. However, the risk of transmission is reduced to 2% in women who undergo the recommended treatment. Expectant mothers must however ensure that:
- They inform their doctors, healthcare providers of their HIV status at the earliest stages of pregnancy;
- They deliver through C-section as the chances of transmission to the baby during a vaginal delivery are high; and
- Avoid breastfeeding.
Myth #5: HIV can be prevented by male circumcision
Although studies and field reports indicate that male circumcision has reduced the likelihood of infection by 60%, it in no way signifies that circumcision can prevent HIV altogether. When a man has sex, the penis gets micro cuts from friction, which is generally how HIV enters a male’s body. The foreskin has millions of CD4 receptors, the type of white blood cells that HIV latches on to. The co-relation between circumcision and spread of HIV infection is still being studied.
HIV and AIDS Awareness in India: Penetrating the masses
Although India has seen a marked decrease in the number of new HIV cases since 2001, in 2018, we saw a slight increase in the number of incidences. In 2018, 88,000 new cases were detected (as opposed to 80,000 in 2017) and 65,000 AIDS related deaths were reported (62,000 in 2017). Critics estimate governmental policies and priorities affect the numbers.
Vulnerable groups in India, identified as those more likely to contract and transmit the HIV infection are: sex workers, men who have sex with men, people who inject drugs, transgender people, and bridge populations (migrant workers and truck drivers). In India, the geographical axes also seem to play a role in the spread of the infection.
The prevalence of HIV in Mizoram, Manipur and Nagaland has been found within the ‘people who inject drugs’, whereas in Maharashtra ‘sex workers’ reportedly had higher incidences of HIV. In Andhra and Telangana, ‘men who have sex with men’ formed a large part of the total affected state population. New pockets of the HIV infection have been reported in states including Gujarat, Rajasthan, Goa and Delhi. This trend has been attributed to the increase in number of the bridge populations and inter-state migration. This tells us that our approach to spreading awareness regarding HIV and AIDS must be tailor made to each location, after consideration of intersectionality of issues.
HIV and AIDS Awareness in India: What can we do
- Practice safe sex – whether you are in a monogamous relationship or have multiple partners, using a condom is 99% effective in preventing the spread of STI’s including HIV. Amongst the youth of India, 41% of unmarried men have reported not using protection during sex; the number is higher for married men. This puts the women at risk, especially in sections of the society where women do not have sexual autonomy.
- Testing – there is still not enough awareness amongst the youth regarding HIV and AIDS. You may not notice the symptoms of the infection until it’s too late and may unknowingly be the carrier of the virus and infect your partners. It is important to get tested and break the misconceptions around testing.
- Treatment – Today, an HIV positive test result is no longer a death statement. With treatments such as ART and PeRP, the expectancy and quality of life of those infected with HIV has been improved. Researchers are also working on an HIV vaccine to prevent all new infections, however, a vaccine has not yet been approved by the FDA.
- Spread the word – educate others around you, do your part to remove the stigma from HIV and AIDS patients, and practice what you preach – get regularly tested and use protection!