Maharashtra was one of the earliest states in India where the disease manifested itself, registering its first AIDS case in Mumbai, in 1986. Lack of awareness, a large migrant population and a thriving sex trade have made it extremely difficult to combat the spread of HIV in the state. The National AIDS Control Organisation (NACO) has drawn up a list of 49 districts in India with a "high prevalence" of HIV/AIDS, of which 14 are in Maharashtra.
According to a study conducted by Population Foundation of India, a Delhi-based NGO funded by the Bill and Melinda Gates Foundation, workers in the hotel and tourism industry had the highest HIV prevalence among groups tested in the state, followed by drivers and the unemployed. Truck drivers, who travel long distances, brought the infection with them, often to areas where the disease had not yet penetrated.
What is worrying is that in Maharashtra, HIV is not confined to high-risk groups such as sex workers, but has entered the general population. Moreover, the disease is no longer an urban phenomenon, but has spread to rural areas as well. Now, even places like Latur, Jalgaon, Chandrapur and Sangli fall under NACO's list of "high prevalence" districts.
Experts say this is because "bridge groups" contribute to the spread of the virus, referring to husbands who use the services of sex workers and then infect their wives with HIV, who in turn pass on the infection to their babies.
Since 2007, 10,371 persons have succumbed to the disease in Maharashtra, second only to Andhra Pradesh, where 12,879 people have died due to AIDS.
Public health experts say the disease can only be fought through proper counseling, awareness-raising measures, and accurate testing. J J Hospital in Byculla is one of 10 centres of excellence that are battling the advent of AIDS in India. And Maharashtra has 30 anti-retroviral treatment centres—the most in the country.