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| Gender inequalities across India | | MEN & MATTERS | | B L KAK
The two most dreaded diseases: AIDS and HIV. And the two have exacerbated gender inequalities across India. India is a traditionally male-dominated society where women bear the brunt of the epidemic--spychologically, socially and economically. as estimated 2 million women account for 39 per cent of India's 5.2 million people with HIV/AIDS.
If you meet Ramamani Sundar, author of the recent rfeport 'Gender impact of HIV/AIDS in India', and discuss just basics of the epidemic, you will straightaway be told: "The stigma attached to the disease is so high that over 70 per cent do not disclose they are HIV positive for fear of losing their jobs or their respect in the community". The most worrisome aspect, according to Ramamani, is that women marry HIV posiotive men unknowingly, get infected and are becoming widows at a young age.
As HIV/AIDS infections rise rapidly among women in India and China, some experts are urging the world’s two most populous nations to learn from the experience of Thailand. Social stigma, lack of empowerment, poverty, poor education, labour mobility and trafficking are the main factors behind the soaring numbers of Indian and Chinese women infected with HIV/AIDS. Most of these HIV-infected widows are driven out of their marital homes, denied a share of family property, and fall into poverty.
Lack of education and gender discrimination have also raised the vulnerability of Indian women to HIV infections. Kalyani Subramaniam of the Delhi-based Naz Foundation, which provides health care facilites for women and children infected with HIV, has gone on record saying: “Women are more prone to HIV because of the gender bias; they are not in a position to negotiate condom usage by their partners, or refuse sex".
In China, the government estimates that there are 180,000 women, or 28 per cent, out of 650,000 people infected with HIV/AIDS. But the ratio of new infections in men and women is now 1:1 in some areas of China, raising similar concerns to those in India. The Chinese government, according to latest media reports from Beijing, has recognized an “alarming shift” in the pattern of new infections since the 1990s, when about 85 per cent of infections occurred in men.
The issues driving the change are the familiar ones of poverty forcing women into the sex industry, with poor education limiting employment prospects and knowledge of safe sex, said Edmund Settle, HIV/AIDS programme manager for the United Nations Development Programme (UNDP) in China. “It’s common globally; you see the same trend,” Settle has just been quoted as saying in a media interview.
One difference in China is that some women were infected through illegal blood plasma donation in poor areas, or through intravenous drug use. But most newly infected women are sex workers or part of the general population. With very low condom usage, even among sex workers, UN experts have warned that 10 million Chinese could be HIV-positive by 2010 if the government fails to expand its education, prevention and anti- discrimination campaigns.
Following Thailand, the Chinese government, UN and non- governmental organizations have all started programmes to distribute free condoms and educate women in the most vulnerable groups. Yet as the number of sex workers in China has grown to an estimated 6 million or more, the government continues to marginalize them by criminalizing their economic activity. Such policies are “not only ineffective, but inhibit those who are actively trying to reach the individuals most vulnerable to HIV/AIDS,” Settle has also been quoted as sayings. A failure to address this contradiction between health and legal policies “may contribute to an uncontrollable HIV/AIDS epidemic in China, by directly contributing to a substantial increase in sexual transmission rates among sex workers and the general population”, he said.
History bears tetimony to the fact that prostitution was a major factor in the spread of HIV/AIDS in Thailand, which detected its first HIV/AIDS case in 1984 and has since lost 551,505 people to the pandemic. HIV/AIDS has been predominantly transmitted heterosexually in Thailand. In the initial stages most infections were among male homosexuals and drug users, but Thai men and women are now equally affected.
The Thai government’s initial anti-HIV/AIDS programmes targeted sex workers and included winning strategies such as passing out free condoms to brothels, awareness campaigns and free check-ups at public clinics. Many of these programmes fell victim to Thailand’s universal health-care policy, initiated by Thai Prime Minister Thaksin Shinawatra in 2001.
The health programme has helped poor Thais, but it has led to cuts in HIV/AIDS programmes for sex workers, and the stigma attached to their profession means they are unlikely to attend public hospitals. Settle believes another social programme pioneered in Thailand can at least help women infected with HIV in poor areas of China, India and other developing nations where HIV/AIDS is rising.
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