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AIDS victims and family are still social pariahs
Most of us are far removed from the grim realities of AIDS. But for those who are affected life can be an unimaginable torture. Like it was for Aruna who is in her early twenties and a widow. The loss of a husband is not the only tragedy to have hit her life. She lost her husband to AIDS and that has changed her life immeasurably. For not only did she have to deal with loss of income as her husband fell ill, but also had to live with the cruelty of discrimination.

Aruna lives in the slums of Yerwada and it was the AIDS status of her husband that changed everything. Says Aruna who has two sons, aged 9 and 7, Since my husband could not go to work because of the TB caused due to AIDS, I took up a job as a maidservant. We had to leave our jhopadpatti and came to live with my in–laws. But my mother–in–law and her son made life hell for us. As it is I had to shunt from home to work to Naidu hospital. But because he was a full blown victim of AIDS they refused to touch him, refused to give him food, clean him up or help him go to the toilet. My husband in fact told me that it would have been better if he died. The discrimination Aruna had to put up with did not stop with her immediate family. Soon the neighbors came to know of Hari’s HIV status and announced a dictate. Aruna was not allowed to draw water from the municipal tap till all the women had finished doing so. Says she It was so humiliating. My husband died a thousand deaths when he came to know of this. Mostly because the neighbors were told of his illness only by my mother–in–law. As it is I had trouble with money, now I had become an untouchable because of my husband.

Aruna’s tragedy did not end even with the death of her husband. When he died, no one in the family was willing to touch his body. No one was willing to do the last rites. Finally it was Roger Khuma, a social worker with Sahara Alhad a project that helps AIDS victims, who did the last rites. Says Khuma, People fear not just the fact that they may contract AIDS, but this also becomes an issue with the family members to abandon such people, as they did with Hari. To help such victims, Sahara Alhad has started a creche that looks after children of HIV infected parents. Aruna has been given a job as she has been thrown out of her marital home upon her husband’s death. Had it not been for Sahara, like the many nameless women, Aruna too would have been on the streets, victimised for no fault of her own.
(Names have been changed to protect their identities)

Commercial Sex Workers
Pune has 4000 residential Commercial Sex Workers (CSWs) and 2000 who make up the floating population. Since sex and AIDS are so intrinsically linked, it makes sense to see how this spreads in the red–light areas. According to Dr. A. N. Joshi, assistant director, Health services, Pune circle, the chance of infection through sex is very low. “Just 0.1% to 1%, whereas from blood transfusion this chance is 95 to 100%. Yet 90% of HIV infections are transmitted through sex. This is because blood transfusions are few and far between and utmost care is taken at such times”. But the story is altogether different, when it comes to sex. According to Joshi, 60% of CSWs are HIV positive. Each CSW gets about three to four clients a day, which means that the daily transmission of HIV in Pune’s red–light areas is anywhere from 12 to 120 persons.

Despite the fact that almost all CSWs know that condoms are the only way to save their lives, its use is limited to just 50%. Says Nitin Bora, director, Kayakalp, “This is because Condom use does not just depend on awareness. It depends a lot on attitudes. If a woman is dying of AIDS, asking her to use Condom to protect the life of another does not make sense to her. She is more worried about the food she needs for her next meal, about her children, so Condom use is last thing on her mind”.

But unless she does not use condoms, the HIV sword will continue to dangle over our heads. And obviously awareness has not worked. But Kayakalp has managed to overcome this hurdle in a unique way. This is evident in the fact that in March STD infections were down to 5 per 1000 wherease in January the clinics in the redlight areas reported about 40 per 1000 CSWs. Says Bora, “You cannot just hand condoms to the CSW and expect her to use it. By just creating awareness, the CSW will not start using condoms, you have to ensure its use. We feel that this is because she is so depressed and feels so hopeless that she lacks a health seeking behaviour. The doctors in the redlight areas do not treat them right. If a customer is charged Rs 20, he will charge a CSW Rs 50. Then he is the man repsonsible for their poor health, many a time. This is because most of the time they are given third degree antibiotics and often they develop an immunity to them. You have to understand that she is a human being and more than just a CSW. She has feelings, she has children and in my experience I have seen that a CSW has generally lost all hope and has become totally apathetic. The only thing she cares for is her child”. By showing her how she can help herself, her child, the CSW begins to feel an interest in life, she begins to see hope. Then she becomes amenable to adapting health seeking behaviour. We do not talk about condoms, rather we emphasise on her child’s health, her anemia and she is the ready to listen to what you tell her. Therein lies the key to Condom use.

These women are either addicted to alcohol and need To tackle this problem the WHO introduced the Syndromic Intervention Programme, herein four NGOs have been alloted the acre of 1000 CSWs each.




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