This blog contains material I wrote and posted on between the years 2005 and 2011 only. It does not contain any new material. For newer writing, please check my main blog (Bill the Butcher).

Wednesday, 28 November 2012

The Battle Of Numbers: The Politics of HIV

June 2007


What do you do if you have a rampaging HIV epidemic in your country?
I'll come to that in a second. But first let's see just why there is an HIV epidemic ravaging the country.
Well, first, there is the compulsion to pretend sex does not exist. Not that the population isn't climbing through the roof, but one doesn't talk of that in polite society. One, rather, bans sex education in schools, since it's against Indian culture (and don't talk of temple prostitutes who used to initiate young men into sex). Never mind that kids are experimenting and (since due to your anti-sex ed sensibilities they don't have the slightest idea of safe sex) doing so without the slightest attempt at caution.
And as a corollary to pretending sex does not exist, it follows logically, of course, that when sex is thrust into your face, and you have to admit it exists, you claim it's dirty and/or unnatural. Accordingly, those who buy and sell sex are criminals. And - according to the Indian Penal Code - homosexuality is illegal as well. So, since prostitutes and their clients, not to mention gays, are all criminals, one can't exactly try and ensure they learn safe sexual practices (or at least anyone who does so is aiding and abetting a crime).
Then, lest we forget, since sex is dirty and against Indian culture, one can't set up condom vending machines where people, especially young people, can get them. Anyone who goes to a pharmacy in India to buy condoms had better be ready to face sly looks and giggles behind hands - and if you are a woman, you are automatically a hooker, depend on it.
And of course, India's trucking community mustn't be forgotten. This is the very large number of men who - fuelled by alcohol, virtually untrained, and away from home and family most of the time - pick up prostitutes from roadside restaurants, drop them off at other stops, and pick up more, all without any pretence at safe sex or condom use (much of the time they're too drunk to use them anyway). So they carry along HIV from one end of the country to another, and share it freely with each other via hookers, and take the  virus back as a present to their wives.
Of course, it's not just sex, either. Now that our government has seen fit to ban hashish (marijuana) - despite its deep cultural roots in this country - injectable drugs have taken over the market. And addicts have this wonderful habit of sharing syringes with each other...
Also, of course, let's not forget our medical faculty. When you have doctors who literally don't know how HIV is spread, and I am notkidding here, you don't exactly have a wall of medical defences up against HIV either. When HIV positive patients are not treated, are shoved around from hospital to hospital, when social ostracism is the only reward of those who go public with their HIV status, the desire to keep one's HIV status a secret is completely logical and understandable.
Did I, by the way, talk about HIV status? If you're tested for HIV, you won't, by standard Indian practice, be informed of your status unless you ask. Believe it or not.
Now  do you understand why we have an HIV epidemic?
OK, so we have an HIV epidemic. So what are we doing about it?
Introducing condom vending machines? Sex education in schools? Legalising marijuana in order to cut down on intravenous drug abuse? Launching in depth public education programmes to destigmatise HIV positive people?
Forget it.
What we are doing is ... fighting over how many HIV positive people live in this country.
The non-governmental organisations say one figure.
Nonsense, says the government, it's a cool million less. Maybe two million less. That still makes between two and three million HIV positive people - more than the entire population of many countries. So what? As long as by playing around with numbers you can hide the enormity of the problem...
Personally, I do go along with the theory that some of the organisations deliberately inflate their figures for funding. But, at the same time, I am convinced that their "inflated" figure is still far short of the actual figure.
The reasoning is this:
In the first place, HIV has a long incubation period, sometimes extending to years.
Then, unless the individual is specifically tested for HIV, his status will never be known, and mostly they are not tested for HIV. If he is tested positive for HIV and not told, he will merrily go spreading it around, unknowingly - though he can also go spread it around knowingly if he so chooses.
And with our woeful rural and even urban healthcare, patients who actually die of AIDS can easily die either untreated or  treated for the symptoms - pneumonia, tuberculosis, or whatever - without the doctor's even suspecting HIV. The majority of HIV cases will fall under these categories - no doubt about it at all, at all.
Of course, these problems can be fixed, but that's kind of troublesome.
It's far easier to fight over numbers instead. 

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