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HIV AIDS

Debates

Sex education: need acknowledged, programme ignored

By Shabnam Minwalla

With 34% of all HIV cases occurring in the 15-24 age group, imparting sexuality education to adolescents could be crucial for containing HIV/AIDS. But in India, where sexual taboos are strong, neither teachers nor parents are happy discussing the facts about sexuality with youngsters, writes Shabnam Minwalla.

The enemy may be tinier than a speck of dust, but the resources gathered to battle it are enormous. Despite the media blitzes, poster campaigns and drug onslaughts, however, the virus remains undefeated—and an estimated 2.4 million people in India today live with HIV.

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Related Articles

»Hard questions about HIV/AIDS By Sandhya Srinivasan
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»Sex workers demand a voice at international forums By Ranjita Biswas
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»Dangerous distortions? By Mariette Correa and David Gisselquist
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Media

How one newspaper thinks positive

By Papri Sri Raman

Positive+, the eight-page bi-lingual free HIV-AIDS newspaperPositive +, a free bilingual newspaper brought out on a laptop from Asma Naseer’s living room is India’s first newspaper on HIV/AIDS. The paper’s commitment to building up a friendship with the reader and its innovative design have made it popular in and around Chennai where it already faces a demand for more copies than the 5000 it can afford to print.

Maragatham, 35, is a daily passenger on the train to Chennai, which stops at Karur, a textile town, 430 kilometres south of the metropolis.

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Related Articles

»From candid camera to condemned By R Induja
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»AIDS Jaago: Beyond pamphlets and preaching By Indira Maya Ganesh
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»HIV and the grand narrative recast By Nirupama Sharma
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Books & Reports

The tragedies and triumphs of living with HIV/AIDS

By Shabnam Minwalla

Some experiences of HIV-positive people are horribly negative – young children abandoned by families, old men left to die on rubbish heaps – but thanks to better treatment options and public information, there are also stories of lives lived fruitfully and with courage. Shabnam Minwalla reviews three books that tell these stories

“I have a successful career. I enjoy music. I like to work out at the gym. I miss my flights sometimes. I am also-HIV positive for the last 11 years.”

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Related Articles

»Overstating the case for blood-borne transmission By Anant Phadke
Read More

»Ensuring equity in access to ART
Read More

»Report of the Commission on AIDS in Asia
Read More

Response

Friend, guide and councellor

By Rimjhim Jain

Members discussing positive living and nutrition in DLN get-togethersOrganised networks of HIV- positive people have penetrated to the districts where they are active in reaching out to identified positive people. Most prevention and care programmes by both national and international bodies closely liaise now with DLNs to ensure the success of their projects. Rimjhim Jain looks at their achievements in different states.

When the first case of HIV was identified in India in 1986, the infected person, Dominic D’Souza of Goa, was arrested and kept in isolation by authorities. In the 24 years since then, there has been a massive change in the way positive people are treated.

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Related Articles

»Ethics in human resource management
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»Challenges in facing the HIV epidemic in Pakistan By Sandhya Srinivasan
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»'UNAIDS will continue to fight to ensure that laws reflect the rights of people' By Rashme Sehgal
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HIV & Human Rights

If the patients decide not to tell what can we do?

Partner notification is an important component of HIV counseling. However, counsellors are often frustrated by the reluctance of HIV-positive patients to voluntarily notify their sexual partners. Barnabas N Njozing, Kerstin E Edin, Miguel San Sebastian and Anna-Karin Hurtig report on interviews with TB/HIV counselors and legal professionals in Cameroon, to explore their perspectives regarding confidentiality and partner notification.

Read More

Related Articles

»HIV/AIDS Activism Reaches Beyond Health Issues By Sandhya Srinivasan
Read More

»The power of community in advancing the right to health: A conversation with Anand Grover
By Alec Irwin
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»Legalising gay existence: the Delhi High Court verdict By Vivek Raj Anand
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Vulnerable Groups

Children and women with HIV face destitution and violence

By R Meera

Fifteen per cent of India’s 2.5 million HIV-positive are children. That’s 375,000 children, with 50,000 being born infected or becoming infected each year. The government has woken up to the tragedy and held a series of public hearings across the country recently. Sandhya Srinivasan spoke to R Meera who attended the hearings.

“HIV has been addressed for more than 20 years but there has not been enough focus on core areas such as the needs of women and children.”

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Related Articles

»Insurgency makes health care dangerous By Chitra Ahanthem
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»Violence, sexual minorities and two continents By B Jayashree
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»‘Denial of education most common problem faced by HIV affected children’ By Anosh Malekar
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Treatment

When should HIV treatment start?

By Ajithkumar K

Scientific evidence is mounting for ART to be started at an earlier stage than currently recommended by WHO/NACO. But for healthcare systems in the developing world already struggling to meet existing demands, is this a viable option, asks Ajithkumar K

When should a person with HIV be started on anti-retroviral treatment (ART)? The controversy has erupted once more with the publication of studies indicating that starting treatment early will extend a person’s life. These findings question NACO’s current guidelines and also raise some important issues of public health and ethics.  Should we change our guidelines on the basis of these reports?

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Related Articles

»The hidden costs of treatment By Ranjita Biswas
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»Access to ART in a rural setting By Sandhya Srinivasan
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» HIV/AIDS in India: The wider picture By Rupa Chinai
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Research

A vaccine for AIDS – hope, caution and opportunity

By Shahid Jameel

Senior scientist Shahid Jameel says the partially successful HIV vaccine trial in Thailand has offered a direct opportunity to understand the correlates of protection in humans. The initial trial results, though modest, will surely energise HIV vaccine research towards a more complete analysis of the successful immune response

The human immunodeficiency virus (HIV), which causes AIDS, has been a difficult target for vaccine developers.
Vaccines are substances that mimic a disease-causing agent (pathogen) in order to raise immunity in the host (human), which disables (neutralises) and clears the pathogen from the host in the event of a natural infection.

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Related Articles

»Biomedical research on HIV/AIDS in India By Sheela Godbole and Sanjay Mehendale
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»Vaccine development: Still a shot in the dark By Sandhya Srinivasan
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»What are the challenges of conducting clinical trials for an HIV vaccine? By Sandhya Srinivasan
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Living with HIV

Duped and exploited: Orissa’s migrant workers

Desperate Migrants

Close to 2 million people migrate out of Orissa in search of work every year. Only 50,000 of them are registered with the authorities, making it difficult to protect these desperate migrants from tricksters and exploitative employers.

Thousands of migrant Indian workers landed in New Delhi during the last week of April this year, forced to leave Middle East and North African nations that have witnessed people’s movements for democracy. The unrest in Libya in particular threw many Indian labourers out of work.

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Related Articles

»An HIV epidemic fuelled by drugs, guns and underdevelopment By Dilnaz Boga
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»Elopement adds to the HIV burden in Manipur By Anjulika Thingnam
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»Occupational exposure to HIV: A personal story
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Interventions

Implications of migration on the health of communities

By Manjima Bhattacharjya

Diseases such as HIV/AIDS and the current swine flu pandemic have highlighted the connection between the large scale movement of people and health. With more than 200 million migrants in the world, migration - internal and across borders - is here to stay. It thus makes sense for all countries to put a migrant-friendly health system in place, argues Manjima Bhattacharjya

Over the last few weeks, the panic of swine flu has led to a new addition in the regular ‘check in-security check-boarding’ and ‘disembark-baggage claim-customs’ routine of international air travel.
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Related Articles

»Bridging the education gap By CHitra Ananthem
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»Sexuality, politics and HIV  By Padma Govindan
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»In this powerloom town, knowledge about HIV is power By Pankajkumar Bedi
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Global Scenario

A global assessment of AIDS prevalence

By Agrima Bhasin

According to the 2007 UNAIDS Global AIDS Report there was a 16% drop in HIV cases over the previous year mainly due to revised estimates in several countries.

  • According to UNAIDS' 2007 Global AIDS report, an estimated 33.2 million (30.6 million–36.1 million) people worldwide were living with HIV in 2007. Of these, 30.8 million were adults (28.2–33.6 million), 2.5 million (2.2–2.6 million) were children under the age of 15 years. Of the adults, 15.4 million (13.9–16.6 million) were women.
  • An estimated 2.5 million (1.8 million–4.1 million) became newly infected with HIV in 2007 – of which 2.1 million (1.4–3.6 million) were adults and 420 000 (350 000–540 000) were children under 15 years
  • An estimated 2.1 million (1.9 million–2.4 million) people and lost their lives to AIDS in 2007. Of these, 1.7 million (1.6–2.1 million) were adults and 330 000 (310 000–380 000) were children under the age of 15 years.

Short Notes

Draft HIV/AIDS bill leaves out key provisions

Positive people's networks have protested the deletion of 38 key provisions in the latest version of the HIV-AIDS Bill which is being discussed by the law ministry and health ministry.

The bill was drafted by the health ministry and the Lawyers' Collective in 2006 after discussions with individuals and organisations representing various concerned sections of society, including people living with HIV, sex workers and injecting drug users. It was then sent to the ministry of law and justice for vetting.

In the versions sent back by the ministry, many important provisions were missing. One of the provisions not included is to guarantee emergency health services for people with HIV.

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»Mandatory testing of pregnant women for HIV
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»Undernourished women get food support
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»Panchayat wants AIDS care centre to be moved out
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Resources

Funding

Announcements for funding/aid/grants by various organisations for HIV/AIDS related activities

For home-based care providers

AIDS has changed the fabric of communities around the world and placed a   burden on the lives of many people, especially girls and women, young and  old. With health systems failing and people living longer with HIV thanks to   access to antiretrovirals (ARVs), mainly poor women are increasingly forced   to devote their time, energy, skills and the little resources to care for   their family members at home and provide their services to the wider   community, often at great expense to themselves. This invisible   task-shifting is insufficiently recognised, valued and validated as work.

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»HIV/AIDS Seminar report
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»HIV/AIDS Seminar audio presentation
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»Publications
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HIV in India

Sentinel surveillance and the 2007 HIV estimates

By M Prasanna Kumar

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The HIV/AIDS scenario in India

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Sex education: need acknowledged, programme ignored

With 34% of all HIV cases occurring in the 15-24 age group, imparting sexuality education to adolescents could be crucial for containing HIV/AIDS. But in India, where sexual taboos are strong, neither teachers nor parents are happy discussing the facts about sexuality with youngsters, writes Shabnam Minwalla

Read more...

Hard questions about HIV/AIDS

Though HIV/AIDS has generated more attention than any other healthcare issue in India, we’re still struggling with many basic questions. For example, do we really know the relative importance of the different means of HIV transmission? Does the focus on sexual transmission and injecting drug use shift the responsibility of prevention to individuals rather than the system? How can a prevention programme work if it is targeted at people involved in practices that are seen as illegal? Sandhya Srinivasan gives some answers

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Sex workers demand a voice at international forums

At the recently concluded international AIDS conference in Mexico, and other forums, organisations of sex workers have demanded a greater say in AIDS policy formation. Ranjita Biswas reports

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Dangerous distortions?

UNAIDS's Redefining AIDS in Asia: Crafting an Effective Response, a comprehensive review of the realities and impact of AIDS in Asia, misses some vital causes of the spread of the epidemic such as unsafe practices in public health services and makes some faulty assumptions about Asia’s HIV epidemics, say Mariette Correa and David Gisselquist

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Male circumcision: a cut above?

Recent studies in Africa have suggested that male circumcision can halve the risk of HIV infection and a WHO meeting declared that male circumcision should now be recognised as an important intervention to reduce the risk of HIV. Mariette Correa assesses the evidence and the implications to public health and cultural concerns if this intervention is widely implemented in India

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20 million or 2 million?

In 2006, UNAIDS declared that India had 5.7 million HIV-positive people. NACO put the figure at 5.2 million. And, finally, NFHS-3 put the HIV burden at 2.5 million. M Prasanna Kumar demystifies the numbers game

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Is HIV/AIDS skewing the priorities of the public health system?

By T K Rajalakshmi

The bulk of health problems facing Indian people are simple -- malnutrition, malaria, diarrhoeal diseases, etc – and they require simple solutions -- food, mosquito control and clean water. But the government’s approach to public health increasingly focuses on vertical programmes to tackle each disease instead of comprehensive healthcare. The AIDS control programme is another vertical programme that reinforces our misplaced priorities, and also puts more pressure on an already crumbling public health infrastructure

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Why do less than half of those who require ART get treatment?

Despite the fact that India is a major producer of cheap generic HIV and AIDS drugs, India’s ART programme is poorly conceived, implemented and monitored, with a shortage of drugs, equipment and personnel. Such an unprepared public health system is in no position to handle such an intensive programme, say Sandhya Srinivasan and T K Rajalakshmi

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Criminalising high-risk groups such as MSM

All three core groups affected and infected in the HIV epidemic -- men having sex with men, sex workers and injecting drug users -- are criminalised in India. How can any intervention work amongst groups whose behaviour is criminalised? Ashok Row Kavi calls for basic structural changes, including the deletion, or at least reading down, of Section 377 of the Indian Penal Code on sodomy, decriminalising sex work and curbing narcotics trafficking instead of punishing end-users

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Moving beyond detoxification

The prevalence of HIV amongst injecting drug users in India could be more than 5%. But the only government intervention for these hidden, marginalised people is detoxification. Those who cannot obtain treatment and continue to inject drugs, or those who relapse, need other methods for reducing the risk of HIV transmission, including community outreach, the provision of new needles and syringes, condom provision and drug substitution therapy, says Eldred Tellis

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Why are AIDS drugs unaffordable in India?

The big question facing HIV-positive people in India is access to affordable antiretroviral drugs. Already, second-line drugs cost over Rs 1 lakh per person per year in India, compared to approximately Rs 50,000 in 66 other developing countries. K M Gopakumar outlines some measures the government can take to rein in prices

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Prevention of HIV transmission: Do we know what works and what doesn't?

We know that HIV prevalence has stabilised or dropped in some parts of the country and amongst certain groups of the population. But do we know why? Mariette Correa analyses prevention efforts in India, the successes and failures

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Falling through the cracks: PPTCT in India

Parent to child transmission of HIV in India infects 56,700 children every year. The third phase of the National AIDS Control Programme aims to reach 7.5 million women and give prophylactic treatment to 75,600 infected mother-baby pairs. The task is ambitious: in 2005, just 2.9 million women were reached, though the target was 6.9 million. Maya Indira Ganesh explains what more needs to be done

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Do we need a separate law on HIV/AIDS?

Stigma and discrimination lead to significant human rights violations for persons living with HIV/AIDS and are the greatest barriers to preventing further infection and providing care, support and treatment. Yet India has no existing legislation which would cover discrimination on the grounds of HIV, says Kajal Bharadwaj

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Is premarital HIV testing feasible – or desirable?

Three states are considering legislation on compulsory HIV testing before registration of marriage. Public health activists point out that premarital counselling and life skills education, not compulsory testing, are more likely to ensure behavioural change. Such a law might end up increasing the social ostracisation of the HIV-positive, adversely affecting women, the very group the law sets out to protect, says. Manjima Bhattacharjya

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HIV and breastfeeding

In many countries HIV- positive women are told to prevent transmission of the virus to their newborn child by giving them food other than breast milk. But in India, infants denied breast milk may be at risk of malnutrition as well as serious food borne infections. Jayashree A Mondkar looks at the risks and benefits of breastfeeding

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Blood safety and informing donors of their HIV status

In order to provide safe blood for donation, blood banks must test each unit for HIV as well as a number of other infections. Since banks thus obtain information on a donor’s HIV status, should this information be given to the donor? S N Misra explores this controversial issue

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4 lakh AIDS deaths in India: 'It is pure mathematics'

In an interview with Rashme Sehgal, Denis Broun, country representative of UNAIDS, defends a recently-published report by his organisation that states that over 4 lakh AIDS-related deaths occurred in India in 2005 -- the highest in the world

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Why life-saving drugs should be public goods

Rachana Kamtekar counters the argument that if the motivation of high profits is removed, private companies will cease research into life-saving drugs. Most people in the developing world benefit less from privatised medical research than they would from medical research driven by health needs and funded publicly, she says

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Access to AIDS medicine: ethical considerations

AIDS medicines should not be viewed as private property from which huge profits can be derived, argues Omar Swartz. To fail to reduce the suffering of people afflicted with AIDS on the grounds that one person 'owns' the medicine and another has no right to it without payment of a premium is so completely reprehensible that it should be beyond acceptance and legal protection in civilised society

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From candid camera to condemned

The use of a picture of a healthy mother and child in an HIV/AIDS campaign triggered a reaction that undid much of the good work the campaign was trying to achieve. The case should act as a wake up call for those working in sensitive areas where stigma and discrimination are still very strong, says R Induja

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How one newspaper thinks positive

By Papri Sri Raman

Positive +, a free bilingual newspaper brought out on a laptop from Asma Naseer’s living room is India’s first newspaper on HIV/AIDS. The paper’s commitment to building up a friendship with the reader and its innovative design have made it popular in and around Chennai where it already faces a demand for more copies than the 5000 it can afford to print

Read more...

AIDS Jaago: Beyond pamphlets and preaching

When Farhan Akhtar, Vishal Bhardwaj, Santosh Sivan and Mira Nair make films on HIV-related themes you don’t get standard fare about struggling prostitutes or helpless drug abusers. You get films about hunger – sexual and emotional – and the sex we have but cannot always voice, says Indira Maya Ganesh

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HIV and the grand narrative recast

AIDS Sutra: Untold Stories from India, a collection of 16 essays on HIV-related themes by some of India’s top writers, combines lucid writing and rich detailing with thorough research, says Nirupama Sarma

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Stories from a crisis

There is a whole body of literature and cinema about HIV/AIDS in the West since the 1980s. Why has so little attention been focused on the epidemic by Indian writers and filmmakers, asks Jerry Pinto

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AIDS in the Kannada press: a new subject, a new vocabulary

HIV/AIDS has a definite presence in the Kannada press today, as training, information and sensitisation for journalists has improved, discovers Shangon Das Gupta

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The tragedies and triumphs of living with HIV/AIDS

Some experiences of HIV-positive people are horribly negative – young children abandoned by families, old men left to die on rubbish heaps – but thanks to better treatment options and public information, there are also stories of lives lived fruitfully and with courage. Shabnam Minwalla reviews three books that tell these stories

Read more...

Overstating the case for blood-borne transmission

There is a definite case for curtailing the spread of blood-borne HIV by medical practitioners and bringing the prevalence of this iatrogenic spread of HIV to zero. But the authors are overstating the case when there is no need to do so, says Dr Anant Phadke

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Ensuring equity in access to ART

A national consultation organised by the Indian Network for People living with HIV/AIDS yielded five reports on various aspects of access to antiretroviral drugs by marginalised groups

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Report of the Commission on AIDS in Asia

A comprehensive study of the AIDS epidemic in Asian countries, what drives it, who is most at risk, how intervention programmes must be designed and resources allocated.

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Study assesses Indian response to male circumcision

This small study carried out in Mysore found that 81% of mothers polled were agreeable to having their male children circumcised.

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Monitoring HIV/AIDS treatment for children

By 2010, at least 80% of pregnant women globally who need it should get PMTCT treatment, and 80% of children who need it should be on ART. This report assesses what progress has been made in this direction

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The long climb to universal access

A WHO Progress Report on HIV/AIDS finds that the price for second-line treatment is unaffordable, that the vast majority of pregnant women in need of PMTCT services are not receiving them, and that the global coverage of HIV testing and counselling remains unsatisfactorily low.

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Gaps in the ART programme

A critique of the ART programme through a scrutiny of the working of the programme and interviews with positive people.

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Why second-line ARV treatment is essential

The paper, commissioned by Indian Network for People Living with HIV/AIDS, argues vigorously for the introduction of an affordable second line ART regimen in India and makes recommendations for the programme’s effective functioning.

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NACO spends less than half its funds: CAG

A recent audit of the National AIDS Control Organisation (NACO) by the country's Comptroller and Auditor General uncovers serious gaps in the performance and attitudes of both the organisation and the Indian health ministry.

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'Silence about AIDS is death'

By Lalitha Sridhar

The World AIDS Campaign this year focuses on combating HIV-related stigma and discrimination. A recent ILO study covering Tamil Nadu, Maharashtra, Delhi and Manipur revealed just how extensive discrimination against the affected and infected is

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Treating 3 million AIDS patients by 2005 a challenge: report

Though hundreds of thousands of poor AIDS patients in the developing world are now on life-saving anti-retroviral drugs, the majority of the 3 million people targeted by the WHO initiative have not yet been reached. With only a year to go for the programme’s deadline, obstacles to the global AIDS treatment effort remain.

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15 million and counting: growing numbers orphaned by AIDS

Fifteen million children under the age of 15 have been orphaned by AIDS till date, reversing the effects of better health and nutrition standards worldwide, says a new Unicef report.

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Injection drug use responsible for rapid spread of HIV/AIDS: UNAIDS report

A new UNAIDS/WHO report expresses concern about the spread of HIV/AIDS in China, Indonesia, Papua New Guinea, Vietnam, several central Asian republics, the Baltic states and north Africa.

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Hunger and poverty are key catalysts in the spread of HIV

AIDS and poverty are mutually reinforcing negative forces. An excerpt from ActionAid-Asia’s report ‘Time to Act: HIV/AIDS in Asia’.

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Children shunned, placed at high HIV risk

By Max Martin

Human Rights Watch’s report ‘Future Forsaken: Abuses Against Children Affected by HIV/AIDS in India’ tells a damning story about the number of children in India affected by HIV/AIDS and the discrimination they face in schools, at medical institutions and at home.

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Women, HIV/AIDS and the world of work

A new document by the International Labour Organisation discusses the effects of the spread of AIDS on women, both at home and in the workplace, and the factors that render working women particularly vulnerable to HIV.

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A road map for the battle against AIDS

The UNAIDS Report on the Global HIV/AIDS Epidemic, released in July 2002, tracks the spread of the disease, points out why HIV constitutes a severe development crisis, and chronicles the hits and misses in the battle to control the epidemic. A summary.

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Undone by HIV-AIDS

By Swapna Majumdar

An ILO (India) study on the socio-economic impact of HIV on infected persons finds that the HIV-positive face the maximum discrimination within their families.

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One-third of all countries lack anti-discrimination laws for HIV-positive

A summary of the UNAIDS 2008 Report on the Global AIDS Epidemic, released on July 29, 2008 in advance of the International AIDS Conference in Mexico.

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Ethics in human resource management

Healthcare providers for people with HIV/AIDS are faced with the dual burden of the physical and the emotional risks of providing care. The physical risk is addressed to some extent by post exposure prophylaxis. But the emotional risk is largely left to the individual and there is little by way of institutional responsibility for minimising this

Read more...

Friend, guide and counsellor

Organised networks of HIV- positive people have penetrated to the districts where they are active in reaching out to identified positive people. Most prevention and care programmes by both national and international bodies closely liaise now with DLNs to ensure the success of their projects. Rimjhim Jain looks at their achievements in different states

Read more...

Challenges in facing the HIV epidemic in Pakistan

Social taboos and a weak public health infrastructure have combined to prevent an effective response to the HIV epidemic in Pakistan. The epidemic is largely restricted to groups at high risk but it is feared that, in the absence of a comprehensive programme, it will move into the general population.

Read more...

'UNAIDS will continue to fight to ensure that laws reflect the rights of people'

The solidarity of India's gay, lesbian, bi-sexual and transgender community played a key role in the Delhi High Court's judgement reading down Section 377 of the Indian Penal Code, said Michel Sidibe, Executive Director of the United Nations Joint Programme on HIV/AIDS (UNAIDS)

Read more...

“The epidemic is feeding on the faultlines of inequality and discrimination”

Geeta Rao Gupta, currently a co-convener of the Social Drivers Working Group of aids2031, an international initiative to chart a course for a global response to AIDS over the next 25 years, spoke to Ranjita Biswas about new trends in AIDS strategy to address gender inequality

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Universal access to antiretroviral drugs: Asia is far from reaching its target

Ranjita Biswas reports on the proceedings of the Ninth International Congress on AIDS in Asia and the Pacific, which heard strong calls for increased access to treatment to women and children who were left out of the loop

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‘Nobody is denied ART in any part of the country’

Dr B B Rewari heads the National AIDS Control Organisation’s (NACO) antiretroviral treatment (ART) programme that provides free ART through government health centres. A senior physician at the Ram Manohar Lohia Hospital in Delhi, he has been working in this field for nearly two decades. He speaks to Rashme Sehgal about the implementation of the ART programme and its future scale-up

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“There is a crying need for adolescent education across the country”

Sujatha Rao, director-general of the National AIDS Control Organisation, explains in an exclusive interview with Rashme Sehgal why it is important as part of the HIV/AIDS programme in India to promote life skills education amongst young people.

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Access to antiretrovirals: Patents and the way forward

The strict patent regime that India has embraced is bound to make new ARV drugs more costly. We must therefore decide now how to make HIV drugs affordable, says Priti Radhakrishnan

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2031 Outlook: More promises

By Kirstin Palitza

A massive up-scaling of the treatment programme, an AIDS vaccine, and professionally run prevention programmes were listed as important targets to be achieved by 2031, at the conclusion of the International AIDS Conference in Mexico City.

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How ART survival rates compare in developing countries

Though ART programmes are doing well in most countries, there are significant disparities between and within different geographical areas and populations, the International AIDS Conference in Mexico City heard.

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Injecting drug users deprived of treatment

Injecting drug users comprise almost 10% of people living with HIV but face many obstacles in treatment, noted Dr Paul Nunn of the WHO at the release of treatment guidelines for injecting drug users at the 2008 International AIDS Conference in Mexico City.

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The Invisible Men

The HIV epidemic in Asia and Africa among men who have sex with men is similar to the epidemic in the 1980s in the US and Europe, said Peter Piot, retiring director of UNAIDS, at the satellite meeting on gay men/MSM preceding the 2008 World AIDS Conference in Mexico City.

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'HIV/AIDS is not taking money away from other diseases': Sujata Rao

Sujata Rao, head of the National AIDS Control Organisation, explains in an exclusive interview with Rashme Sehgal, why the HIV/AIDS programme in India should be considered very successful.

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Still a long way to go: Overview of the UN High Level Meeting on HIV/AIDS

Once every two years a high level UN meeting is held to assess the status of HIV/AIDS countrywise. This year, the report card showed some gains in access to treatment and increasing awareness, but emphasised that there was a long way to go to provide affordable drugs, universal access to treatment and gender equality, reports Ranjita Biswas

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Call for action on HIV TB

As preparation for the first meeting of the HIV TB Global Leaders' Forum at the United Nations on June 9, 2008, the Forum has put out a ‘call for action’ that reminds governments of the seriousness of the HIV-TB link and what actions they must take.

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The National AIDS Control Programme (1, 2, 3)

Each of the three phases of the National Aids Control Programme in India has focused on, or emphasised, different aspects of the HIV epidemic in efforts to contain the spread of the disease. M Prasanna Kumar traces the evolution of the programme over the years

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HIV prevention costs and programme scale: data from the PANCEA project in five low and middle-income countries

HIV prevention costs and programme scale: data from the PANCEA project in five low and middle-income countries

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Obstetric practices related to HIV in Kerala

Lincoln Priyadarshi Choudhury and V Raman Kutty reveal the findings of a survey of obstetricians' knowledge and practices in two districts in Kerala. The study, finds, among other things, that most providers are unaware of the value of the rapid screening test for HIV; they do not give pregnant women the option to refuse testing, and testing is done without counselling

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The future of AIDS and the ethics of seclusion in the face of an impending danger

If the developed world does not put in more resources to contain AIDS in resource poor countries, the epidemic will grow to unmanageable proportions, affecting everyone, says Mpho Selemogo

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Challenges confronting the WHO/UNAIDS 3x5 Initiative

Ruth Macklin discusses how selection for treatment can be fair, equitable and accountable

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If the patients decide not to tell what can we do?

Partner notification is an important component of HIV counseling. However, counsellors are often frustrated by the reluctance of HIV-positive patients to voluntarily notify their sexual partners. Barnabas N Njozing, Kerstin E Edin, Miguel San Sebastian and Anna-Karin Hurtig report on interviews with TB/HIV counselors and legal professionals in Cameroon, to explore their perspectives regarding confidentiality and partner notification.

Read more...

HIV/AIDS Activism Reaches Beyond Health Issues

When the Delhi High Court ordered the decriminalisation of gay sex in July the credit went to HIV/AIDS activists seeking a better deal for those living with the virus.

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The power of community in advancing the right to health: A conversation with Anand Grover

Anand Grover was appointed by the UN Human Rights Council as Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. In this interview with Alec Irwin, co-managing editor of Health and Human Rights, Grover explains what the office involves

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Legalising gay existence: the Delhi High Court verdict

By ruling that Section 377 of the Indian Penal Code violates provisions of the Constitution, the Delhi High Court has taken the first step to legalise the existence of the gay community in India and specifically recognise that gay people have equal rights in accordance with the Constitution of India, says Vivek Raj Anand

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Women’s property rights and HIV & AIDS: evidence from India

Women’s limited ability to own property is a manifestation of gender inequity that has grave implications for them in the context of HIV/AIDS. Hema Swaminathan, Nandita Bhatla, and Swati Chakraborty present findings from a research study that locates women’s experiences of property conflicts within the larger context of being HIV-affected

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Seeking a more equal Bill

The law ministry’s changes to the draft HIV/AIDS Bill have been roundly criticised by lawyers, activists and networks of people with HIV/AIDS. It ignores people's views and dilutes principles of democratic governance, they said in a memorandum of protest submitted to the law minister. Ranjita Biswas looks at the issues involved

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Is the right to treatment legally enforceable?

Under the constitutionally guaranteed right to health, the Indian government has to do more to ensure that the most effective treatment is available to all HIV-positive people who need it, say Atiya Bose and Kajal Bhardwaj of the Lawyers Collective

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HIV and military recruitment

Making testing for HIV mandatory for military recruits, and denying HIV-positive persons jobs in the armed forces, could be open to constitutional challenge. Atiya Bose and Kajal Bhardwaj of the Lawyers Collective cite international cases where courts have ruled that rejection of applications to the military based solely on HIV status is discriminatory.

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Rights of children and young persons

The paternalistic approach to children and adolescents in India impacts adversely on the rights of young persons to receive accurate, scientific and timely information related to sex and sexual health, on their right to confidentiality and to make other decisions on their own. This needs to change, say Atiya Bose and Kajal Bhardwaj of the Lawyers’ Collective

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Legal issues that arise in the HIV context

Stigma and discrimination triggered by HIV and AIDS lead to significant human rights violations for persons living with HIV/AIDS. Atiya Bose and Kajal Bhardwaj of the Lawyers Collective look at how the Indian courts have handled these and other issues such as confidentiality and consent to testing

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Marginalised populations: outside the pale

It is difficult for preventive and harm reduction strategies to reach marginalised populations - who are often most at risk - because the law sees them as criminals. Atiya Bose and Kajal Bhardwaj of the Lawyers Collective argue for a change in such laws regarding MSM, sex workers and injecting drug users

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Wanted: A special law on HIV

Atiya Bose and Kajal Bhardwaj of the Lawyers Collective explain why a specific statute to address HIV/AIDS - its prevention, its treatment, and the manner in which we respond to the people most affected by it - is necessary. The HIV/AIDS Bill 2007, that is to be presented to Parliament, covers all these aspects

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Liability for transmission

It is an offence under the Indian Penal Code to knowingly transmit the HIV virus. But greater clarity is required to determine that criminal sanctions are warranted and to specify the cases in which they may be imposed, say Atiya Bose and Kajal Bhardwaj of the Lawyers Collective

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Gender inequities

Women, who have little ability to negotiate a safe and healthy life for themselves are more disadvantaged than men when it comes to HIV infection, and the law does little to protect them. Atiya Bose and Kajal Bhardwaj of the Lawyers Collective explain

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In the absence of a law, how do the courts decide?

Protecting the rights of those affected and most vulnerable to HIV will create an environment in which stigma, violence and inequity will be lessened, thereby bringing the disease into the open and making it easier to treat and control. In India there is no law or statute that specifically addresses the issues that are raised in the HIV context. Both appellants and the judiciary make their complaints, decisions and rulings by extrapolation from a variety of law sources. Atiya Bose and Kajal Bhardwaj of the Lawyers Collective detail these sources of law

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Children and women with HIV face destitution and violence

Fifteen per cent of India’s 2.5 million HIV-positive are children. That’s 375,000 children, with 50,000 being born infected or becoming infected each year. The government has woken up to the tragedy and held a series of public hearings across the country recently. Sandhya Srinivasan spoke to R Meera who attended the hearings

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Insurgency makes health care dangerous

In the state with the highest prevalence of HIV in the country, insurgency has added to the difficulties of people accessing health care. Health teams cannot operate freely in areas where the insurgents’ writ runs large, and bombs, bandhs and curfews prevent people from getting timely medication. Chitra Ahanthem reports from Manipur

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Violence, sexual minorities and two continents

Violence against transgenders and sex workers occurs in different parts of the world. Two community based organisations, based on two continents, that protect and help sexual minorities came together to exchange their similar experiences, reports B Jayashree

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‘Denial of education most common problem faced by HIV affected children’

The UNICEF study of Kerala that revealed this and other findings says that 88% of children in the state have not revealed their HIV-positive status in school for fear of dismissal or discrimination. Many of those who have done so speak about the problems they encounter, though a small positive change is discernible. Anosh Malekar details the findings of the report

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Health and HIV in Jammu and Kashmir

In Jammu, people fleeing a conflict situation survive in congested refugee camps. In Kashmir, the population is under siege by the army and by militants. Their common ground: vulnerability to sexual abuse, abysmal healthcare, and the absence of any public awareness programme. This is the perfect breeding ground for epidemics of all sorts - including HIV. Anju Munshi reports on how conflict and displacement impact health

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Unequally yoked: Women highly vulnerable to HIV in Pakistan

Women are at high risk of contracting HIV from their husbands whose risky behaviour they cannot control or resist. Even female sex workers lack the power to negotiate for safe sex. Sehrish Shaban reports from Islamabad on how their lack of knowledge and empowerment ruined the lives of three women

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Children and HIV: Treatment options

Every year, 33,000 new-borns in India get HIV from their infected mothers. Though it is well known that early ART will prevent illness and death in infants, the lack of early testing, paediatric formulations and access to basic healthcare facilities come in the way of effective prevention and treatment, as Mariette Correa explains

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Children and HIV: Vulnerability and burden

There are no laws for the protection of children who are orphaned by HIV/AIDS or who may have contracted the virus themselves. Without family and social support, they are at risk of being sexually abused or trafficked into prostitution, says Mariette Correa

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Pakistan’s marginalised communities have limited access to HIV-TB treatment

The number of patients suffering from the lethal combination of tuberculosis and HIV/AIDS in Pakistan is increasing. A majority of those affected are marginalised communities such as sex workers and injecting drug users who have limited access to prevention and treatment, reports Aroosa Masroor

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Children and HIV: Neglecting the young

Every day, nearly 1,800 children under 15 are infected with HIV worldwide. About 21,000 children in India are infected with HIV every year. Yet even today, the emphasis of prevention, care and treatment is on adults – the productive and reproductive age-group, says Mariette Correa

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Which lessons do we want to learn?

A survey of sex workers by the Delhi Commission for Women has thrown up some interesting data on trafficking and HIV that could make the government’s policies more effective. But since the data suggests that the government’s current approach is wrong, will anyone want to learn the lessons it teaches, asks Manjima Bhattacharjya

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Street children and AIDS: a hidden time bomb

No one knows how many street children are at risk of contracting, or have died of, HIV/AIDS. They are not even listed as a vulnerable group, like commercial sex workers and homosexuals. Yet the sexual exploitation and drug abuse that is an inevitable part of their lives, points to a serious problem in urgent need of attention, says Charumathi Supraja

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Violence against women and HIV/AIDS

HIV-positive women face violence of various kinds such as denial of information, discrimination, and lack of security, but this gets little attention. Ranjita Biswas reports on a workshop in Kolkata, ‘Understanding Violence against Women and its Implications for our Struggle against HIV/AIDS’, that discussed this problem based on the findings of a six-month study

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New approaches to contain HIV risk among IDUs

Injecting drug use is an important risk factor for HIV in India. The entire South Asian and South East Asian region has shown an alarming increase in injecting behaviour. While voluntary abstinence is the best cure, it has a poor success rate. We need to look at more innovative and effective approaches being successfully tried out elsewhere, says Eldred Tellis

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The female face of AIDS

By Max Martin

World leaders and policymakers are concerned that an increasing number of women are getting infected with the HIV virus. Latest trends show that nearly half of all people living with HIV/AIDS worldwide are women

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Sexual taboos hamper India's fight against AIDS

 With talk of sex in Indian society taboo, male to male sexuality is hardly recognised in HIV research and policy-making. And yet, the country's male homosexual population is estimated at a considerable 50 million. Keya Acharya assesses the implications of this situation

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The 'new' face of HIV/AIDS

The increasing number of women with HIV/AIDS in India, most of them not from groups traditionally considered high risk, has presented government and NGOs with a new challenge. Manjima Bhattacharjya explains

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When should HIV treatment start?

Scientific evidence is mounting for ART to be started at an earlier stage than currently recommended by WHO/NACO. But for healthcare systems in the developing world already struggling to meet existing demands, is this a viable option, asks Ajithkumar K

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The hidden costs of treatment

Free anti-retroviral therapy at government-run centres has improved things for people living with HIV/AIDS. But there are hidden costs, very few centres, and poor quality of service, which state governments must take note of, says Ranjita Biswas

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Access to ART in a rural setting

The government provides free anti-retroviral treatment, but when government run services are so poor and inadequate, people have difficulty accessing it. Sandhya Srinivasan travels to Chhattisgarh which has just one ARV centre, and to Sewagram in Maharashtra, where patients prefer to pay for treatment rather than avail of free treatment at a government hospital

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HIV/AIDS in India: The wider picture

Increasingly, voices across the world are questioning the narrow approach to a single disease, especially the huge financing for AIDS over all else in basic healthcare. Though welcome and long overdue, this debate must now move further, to examine sustainable solutions that promote health and prevent AIDS, writes Rupa Chinai

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