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In India, AIDS Risk Crosses Political Borders

"India’s AIDS epidemic has decreased drastically in the last decade. Yet... the deadly virus is highly concentrated in urban poor communities . Most vulnerable are sex workers and migrant laborers as well as their home
communities—often in rural areas or neighboring countries."
"Sex workers, largely teenage girls or younger from Nepal, are trafficked to the streets of India’s cities . One study found that more than 40% of Nepali sex workers tested HIV positive and that the number of the infected has increased 24-fold in the decade 1992-2002.
According to the Indian government, “…clients of sex workers are the single most powerful driving force in India’s HIV epidemic,” quotes Avert, an international HIV/AIDS charity based in the UK . These clients, says the site, are primarily long-distance truckers and male migrants.... Despite this risk, migrants have the lowest perception of risk in all high prevalence states... 60 percent of female sex workers believe they are at risk of HIV infection, compared with only five percent of male migrants .”

The international community has been responsive:
"the June 2011 United Nations’ Security Council Resolution on
HIV/AIDS and General Assembly Political Declaration on HIV/AIDS announced that policy will “…reflect renewed political engagement and a changed strategy that focuses on highest risk populations, even though this may be more politically sensitive .”

The NGO Nirman has launched a successful and sensitive campaign called Aaruyir:
"Aaruyir is a uniquely designed initiative and one of the few that operates in collaboration with a source-point NGO—in the migrants’ home district—as well as in the destination area, such as Mumbai . Nirman’s outreach activities address some of the key challenges in the fight against HIV/AIDS in India: behavior change communication that is sensitive to the often conservative communities through street plays, posters and hand-outs; sensitizing the community to dealing with a person living with HIV; and developing messaging that is careful not to stigmatize the migrant workers as carriers of the virus but as a group that has increased vulnerability to HIV/AIDS."

Implications from Intellicap:
"the government will need to lend greater support to private
partners to develop micro-insurance schemes for people living with HIV... Schemes for poor HIV patients will not only need to be made available but developed with particular sensitivity to a virus with a major stigma."

"Nepal is estimated to have only 75,000 cases—less than half the numbers in India—but health officials fear that without the services and counseling needed for these young girls as they repatriate, they could potentially spread the virus."

"In an area devoid of services and counseling for people exposed to HIV—particularly in slum areas—NGOs such as Nirman and Population Services International have been pioneers . The Indian government will need to devise more collaborative approaches with these organizations"

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