The HIV crossroads

Even as infections decline, India confronts widening prevention gaps and newer HIV hotspots. Ahead of World AIDS Day (Dec 1), let's take a look at what can be done

- Harsh Kabra

Much of Jyoti Dhawale’s early adulthood was an unforgiving trial, inflicting new scars before the old ones could heal. Born into a peripatetic military family, she was already battling partial deafness and the hardships of growing up with a stepmother when in 2005, she was diagnosed with HIV, resulting in violence, lost custody of her only son, and homelessness.

Bengaluru-based Dhawale’s triumph at turning her pain into purpose to become an HIV change-maker and global ambassador may well evoke the rise of a phoenix, but the stigma hasn't disappeared completely. “The emotional and social battle remains, even if today's environment offers far better tools, community and understanding at our fingertips,” she says.

In her two decades with the virus, a lot has changed for thousands like her. “Medical care, awareness and access to therapy have greatly improved,” she says. “People like me can live long, healthy lives. While a ‘cure’ is still distant, our daily pill protects our dream of a future.” Her story mirrors India’s own fight against HIV.

India’s HIV Response

Back when the Human Immunodeficiency Virus was first detected in India among female sex workers in Chennai in 1986 — a few years after unusual immune deficiency was first reported globally — the country was still learning the language of public health.

Because of the strong taboo surrounding its triggers and the mistaken view that it was limited to “high-risk” groups, the threat largely eluded public and political imagination, failing to gain attention as rapidly as the surge in infections among sex workers, truck drivers and later the general population. By 1996, HIV had erupted into a full-blown national health crisis, earning India the dubious distinction of being one of the world's fastest-growing HIV hotspots.