HIV rates are down but discrimination continues for Indian sex workers

HIV and AIDS rate among female sex workers came down from 2.75% in 2013 to 1.6% in 2017.

The proportion of Indian sex workers with HIV/AIDS declined over four years to 2017, more use condoms than ever before and funding to control the disease rose 21% over the period, according to an IndiaSpend analysis of national health data.

But there appears to be little change in violence, stigma and discrimination against sex workers, how Indian states treat them varies, and funding and drugs are not always available when and where they should be.

Over 91% of Indian sex workers used condoms in 2018, and no more than 1.6% of female sex workers had HIV (human immunodeficieny virus) and AIDS (acquired immunodeficiency syndrome) in 2017, down from 2.75% in 2013, mirroring a decline reflected among the general population, according to the latest available data.

Over four years to 2017, the “HIV prevalence rate”, the percentage of people tested and found infected, among men who have sex with men also dropped from 4.4% to 2.7%, said a 2018 report from UNAIDS, a United Nations organisation, and India’s National AIDS Control Organisation (NACO).

As of 2017, India had a total of 2.17 million people living with HIV. New infections dropped 27% over seven years to 2017--from 120,000 to 88,000.

“This indicates that HIV prevalence is reducing among sex workers,” said a NACO representative, speaking on condition of anonymity.

Female and transgender sex workers and men who have sex with men are considered high-risk groups in determining HIV/AIDS prevalence.

“Globally, sex workers are 13 times more at risk of contracting HIV, when compared to the general population, because they are economically vulnerable, unable to negotiate consistent condom use, and experience violence, criminalisation and marginalisation,” said a 2018 study by UNAIDS.

The new data do not mean that sex workers now lead better lives.

Adorned with red lipstick and dressed in a long skirt with shiny earrings, Ramkali Kumar, 26, a transgender sex worker from the western Uttar Pradesh city of Noida, spoke about violent clients.

Business Standard

A cure for HIV? Case studies show feasible treatments not yet realised

The treatment involves destroying a person's own immune system with high doses of chemotherapy or radiation. Then the patient receives a transplant of new stem cells from either themselves or a donor.

Business Standard : This week a team of scientists and physicians from the U.K. published news of a second HIV positive man, in London, who is in long-term (18-month) HIV remission after undergoing treatment for Hodgkins lymphoma. The unexpected success has launched a new round of discussion about a potential cure for HIV.

Since 2008, scientists have been trying to replicate the treatment that cured the “Berlin patient” of HIV. At the time, many in the field of HIV research were excited to learn that this man, who tested positive for the human immunodeficiency virus in Berlin and had recently undergone treatment for acute myeloid leukemia, appeared to have been cured of his HIV. Until now, success in replicating that cure has been limited.

What is HIV?

HIV is the virus that causes AIDS. Since the virus was first discovered in the 1980s, more than 75 million people worldwide have been infected with HIV. Today, almost 37 million people live with HIV. Of these, about 1.1 million live in the U.S.

Infection with HIV almost always led to AIDS, which in turn was almost always fatal. The field was revolutionized in 1996 with the introduction of HIV anti-retroviral therapy medications. These drugs halt HIV from replicating and allow an infected person to regain a functioning immune system. These medications are so effective that today a person living with HIV has almost the same life expectancy of someone without HIV infection. However, these medications must be taken every day, have multiple distressing side effects, and can cost thousands of dollars each month.

Yet even with this life-extending treatment, a functional HIV cure, defined as when someone with HIV no longer tests positive for the virus and does not need to take these medications, has remained elusive.

The ‘cure’ treatment

All of that seemed to change when in 2008 at the Conference on Retrovirus and Opportunistic Infections in Boston, Massachusetts, the news broke of the Berlin patient, named Timothy Ray Brown, who seemed to have been cured of his HIV. In order to achieve that serendipitous “cure,” Brown had to undergo aggressive treatment for his acute myeloid leukemia that involved two hematopoietic stem cell transplantations – in which a patient’s bone marrow is damaged – and full body irradiation.

This complex treatment involves destroying a person’s own immune system with high doses of chemotherapy or radiation. Then the patient receives a transplant of new stem cells from either themselves or a donor.

This is a difficult treatment that carries a high risk of infection and other complications, such as graft-versus-host disease, blood clots and liver disease.

Blood not needed if you're gay: The stigma attached to Mumbai blood banks

Both the donor questionnaire and health check-up are administered to every prospective donor.

Despite a landmark verdict on Section 377 by the Supreme Court, which decriminalised gay sex in the country, the Maharashtra arm of National Blood Transfusion Council (NBTC) recently issued a newly-updated blood donor screening questionnaire to Mumbai-based blood banks. The new questionnaire, designed on the lines of developed nations, will now mandate the blood collectors to ask the male donors about their sexual behaviour and whether they have multiple partners or engaged in the male-to-male sexual activity. 

For decades, the ban on homosexuals to donate blood exists in India and those who are at high risk of suffering from prolonged diseases such as cancer, allergies, respiratory ailments and organ failure are also not allowed to donate blood.

For the first time after the apex court judgment, a government-body has chalked out a clear ban on homosexual men and women donating blood. According to blood banks, earlier questionnaires asked donors whether they have any reason to believe that they might have been infected by HIV, hepatitis, malaria or other illness.

ALSO READ: Blood banks gasp for oxygen, India sees shortage of 1.9 mn units in 2016-17

NBTC’s 2017 revised guidelines, on the selection of blood donors reiterate that transgenders, bisexual men and female sex workers can never donate blood as they have a higher risk of contracting HIV and Hepatitis B and C.

Both the donor questionnaire and health check-up are administered to every prospective donor to enable a quick history taking, physical examination and blood test.

Dr Shobhini Rajan, in charge of blood safety at National Blood Transfusion Council, told The Times of India, “The new questionnaire aims to reinforce pre-donation screening as blood units are subjected to tests only after collection. The donors cannot be at high risk of contracting infections and donate blood.”

Ashok Row Kavi of Humsafar Trust emphasizes the need to address the confidentiality in a better way. He says, “How are homosexuals supposed to give away such intimate details? Though such questions are necessary for screening, but the donors are to be made comfortable to share their information. Most importantly, blood banks must seek gay community counsellors’ help before questioning the male donors, reported the TOI.

Business Standard

How the SC judgement on Section 377 ties constitutional values with emotion

Supreme Court's decision to decriminalise homosexuality is incredibly heartfelt and vindicates the dignity of LGBT people.

What does it mean to love in law? On Thursday 6th September, my social media feeds lit up with heart emojis, #lovewins hashtags, and status updates expressing love in response to the Supreme Court of India’s unanimous decision to decriminalise gay sex. There was a collective sigh of relief as the court lifted the weight of criminality from those who lived in the shadow of India’s law criminalising homosexuality, specifically section 377 of the Indian Penal Code 1860 – a vestige of British colonialism.

Section 377 criminalises “carnal intercourse against the order of nature”. Broadly drafted, the law codifies Victorian morality to criminalise a range of consensual and non-consensual (“unnatural”) sexual behaviours, including homosexuality, bestiality, paedophilia, and rape. While very few people were prosecuted for same-sex sexual activity under the criminal law, it left sexual minorities vulnerable to extortion, harassment, and abuse. Thursday’s decision means that gay sex is now excluded from its reach.

In 2001, the Naz Foundation, an organisation working to end HIV/AIDS, petitioned the courts to “read down” the law to exclude consensual sexual activity between adults. The Delhi High Court agreed and held that criminalising gay sex violated rights to equality (Article 14) and privacy/liberty (Article 21) guaranteed by the Indian Constitution. However, the Supreme Court overruled this decision in 2013, holding that only parliament could change the law.

ALSO READ: Section 377 read down: When lovers of liberty rose to the occasion

This protracted litigation history culminated last Thursday when a newly constituted bench of the Indian Supreme Court repudiated their previous decision and decriminalised gay sex. And it did so with an endearing emotional depth.

Loving jurisprudence

Spanning almost 500 pages, the court’s jurisprudence is a valentine to India’s LGBT community. The court’s four judgments (from five justices) tie expansive constitutional values of inclusion, democracy, and dignity to emotional claims about compassion, respect, empathy, hope, and love.

Chief Justice Dipak Misra observed that punitive laws eroded the “right to choose without fear” a partner and realise “a basic right to companionship”. Citing one of the court’s prior decisions about privacy, he noted: …Read More

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