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Migration Spreading HIV Epidemic

Times of India
13 January 2012
By Kounteya Sinha
New Delhi India
Virus 10 Times Prevalent Among Migrant Than General Population

Migration is fuelling India’s HIV epidemic. National AIDS Control Organization’s (NACO) figures show that besides high–risk population like sex workers and men who have sex with men, the highest burden of HIV is among migrants at 3.6%, which is 10 times than that of the HIV prevalence among the general population.

According to the 2001 Census, 30.1% of the population was considered to have migrated (314 million) – a considerable increase from 27.4% in 1991.

Migration Spreading HIV Epidemic

NACO has identified 75 transit railway stations, where migrants board trains to reach destinations. They have also identified 107 source districts across eight states – Jharkhand, Bihar, Chhattisgarh, Madhya Pradesh, West Bengal, Odisha, Uttar Pradesh and Rajasthan – that the focus of nationwide anti–HIV fight.

The Red Ribbon Express (RRE), which chugged out of Delhi on Thursday, will focus on testing migrants for HIV besides carrying out counseling and spreading anti–HIV messages. During its year–long journey, the RRE will travel through 23 states, covering 30,000 km and stopping at 162 stations.

A NACO official said, “Migrants are one of the major focus areas for the RRE. Last year, the RRE had stopped at 152 stations and reached out to 8 million people directly. We have identified 122 districts with high outmigration across 11 states that are on priority for starting community–level interventions.“

The RRE has been recognized as the world’s largest mass mobilization drive against the HIV. Last year, around 81,000 district resource people were trained, 36,000 got themselves tested for HIV and 28,000 received health check–up services.

Impact assessment of the RRE indicated that the comprehensive knowledge of routes of HIV transmission, methods of prevention, Condom use, STI prevention and treatment was significantly higher among respondents exposed to the RRE project as compared to those not exposed.

Studies on the relation between migration and HIV conducted by NACO in three popular migration corridors – Ganjam–Surat, Darbhanga–Delhi and Azamgarh–Mumbai – threw up shocking findings. It showed that two to four times more informal workers have non–regular partners or visit sex workers with only 25% using condoms. Around 5% male migrants and 13% female migrants reported sexually–transmitted infections, nearly double the national average. According to NACO, the risk of HIV infection for migrants seems to arise from multitude of factors – risky sexual behaviour, lack of social and economic security and involvement in peer driven risktaking activities.

In a recent study by UNDP (through Population Council), the risk of the HIV among migrants was reported to be 1.68 times more likely than non–migrants. Majority of migrants are often poorly educated, many having less than five years of formal education. This contributes to limited knowledge of HIV transmission.

Going by popular perception that migrants are at risk only at destination sites when they are away from home and their spouses, recent evidence debunks the belief. Returned migrants continue to fuel the epidemic since the infected tend to return to source when they fall sick.

Union health minister Ghulam Nabi Azad and railway minister Dinesh Trivedi at the launch of Red Ribbon Express in New Delhi on Thursday

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