HIV is human immune deficiency virus which causes HIV infection, and AIDS is acquired immune deficiency syndrome which is the advanced stage of HIV. HIV virus breaks down the in-built defence system of the body. AIDS was first clinically recognised in the USA in 1981. In India, the first case was identified in May 1986. The Government of India established the National AIDS Committee within the Ministry of Health and Family Welfare after registering the first HIV case in India. HIV virus spread through attacking and destroying the CD4 cells (T cells) of the immune system. Scientists found that the source of HIV infection in humans was a type of chimpanzee in the Central Africa. India is the third largest country in the world with higher percentage of identified HIV-infected patients. To analyse that how much HIV has infected Indians, the health authorities of the government of India has organised the screening of high risk groups in October 1985. The HIV/AIDS is not confined to any one class, community, religion, age-group, sex or profession, in fact, the HIV infection is spread over all religions and all groups. According to the Indian Health Organisation, women and children are believed to be more infected with AIDS. In India, National AIDS Control Organisation (NACO) is responsible for preparing and implementing programmes for the prevention and control of the HIV disease.
HIV is not easily transmitted through the environment like air, water food etc. although HIV is an infectious disease and the main reasons through which the virus enters the body are:
1. Sexual intercourse with an infected person.
2. Through the transfusion of HIV infected blood, the blood products or through infected blood in needles, syringes and other such instruments.
3. Transmission from an infected mother to her newborn.
According to a study conducted by the Directorate of Health Services, Manipur in 1991, in the analysis of 6,680 specimens of HIV, the highest risk factor (93.9%) in spreading HIV was found among the drug addicts followed by blood donors (2.93%) and homosexuals (2.61%). Prostitutes infect their customers and in turn also get infected by them. Drug addicts who take drugs by injection carry the possibility of spreading the HIV infection through shared infected needles. According to one approximation, the level of HIV infection increased from 1% to 30% among the sex workers in Mumbai during 1989–1991. In Manipur, 40 to 50% of intravenous drug-users are HIV positive and many of them are sent to jail in some crimes even by their own parents.
The transmission of HIV infection is also possible by the blood donors. There are estimated 2000 blood banks in India which supply about 20 lakhs bottles of blood every year and half of these blood banks are government banks and the remaining half is unlicensed.
The devastating effect of the disease in our lifetime and beyond is very difficult to imagine. Initially, the disease appeared confined to few homosexuals who later has affected millions of men, women and children worldwide. AIDS is not only a health issue rather it is a societal problem who affects important social, cultural and economic dimensions and it threatens the basic social institutions at the individual, family and community levels. If the needs of AIDS patients are not meet fully then its economic consequences will equally serious as it could claim up to half of the national expenditure for health. Not only HIV patients but families of HIV patients too suffer economically, psychologically and socially.
Programmes that provide information, condoms and HIV testing to persons in highrisk groups are extremely important to prevent the further spread of the disease. In its official policies and statements, the Indian government has realised the importance of reaching out to women in prostitution and homosexual men as an essential element of its HIV/AIDS response. The national AIDS program led by AIDS control society of India, financed largely through a $200 million World Bank loan, invests in programmes that target persons in high-risk groups. Bill and Melinda Gates Foundation assured international funding amounting to $ 200 million for battling the disease but still the potential costs of battling the disease are staggering. However, the services available for the care of AIDS patients are sadly insufficient.
To help the patients in overcoming fear and hysteria, effective strategies have to be designed and developed. Counselling families, neighbourhoods and members of socialsupport networks are also an important need because ultimately they have to bear a major responsibility for the sick and the survivors. The trained medical staff can provide information about AIDS to the patients and to their relatives. Since persons suffering from STDs are also a significant risk factor, so it is important to give high priority to the programmes for the prevention and control of STDs.
The blood or blood products should be tested for HIV before transfusion and HIV tests should be made free and confidential for persons who indulge in high-risk activities. The medical staff should make sure the use of disposable syringes and other operation equipment. The condoms should be freely distributed and its use should be encouraged among the sex workers who are the most susceptible group. The drug users should be convinced to not using intravenous drug abuse and voluntary organisations should aware the people using innovative and community-based approaches.
Affect of HIV/AIDS on Women
HIV/AIDS have an adverse impact on women worldwide. Indian women are already economically, culturally and socially needy lacking access to treatment, financial support and education. They have no power and right of decision making and even they lack the opportunity of participating equally within the community and are subjected to punitive laws, norms and practices exercising control over their bodies and sexual relations. Women are supposed as the main sources of Sexually Transmitted Infections (STIs) referred generally as women diseases. The traditional beliefs about sex, blood and other type of disease transmission have become fertile ground for the stigmatisation of women within the context of HIV/AIDS
The route of transmission of HIV infection in women is similar as men. Few women become infected through artificial insemination from an infected person, and lesbians do get HIV/AIDS by using drugs, sharing needles and sharing sex toys with an infected partner without washing. Unborn baby also get infected by their mother during pregnancy, birth and breastfeeding.
Misconceptions
There are few misconceptions related to HIV disease:
• Withdrawal during intercourse
• Douching
• Birth control pills and diaphragm does not protect from being infected with HIV/ AIDS
• HIV can be spread through casual contact with an HIV infected individual
• Mosquitoes can transmit HIV
• Homosexual men and drug users can be only infected through HIV
HIV/AIDS and Pregnancy
Women with HIV can transmit the virus to their babies before, during and after birththis is the important biological difference between men and women that leads to additional social and cultural consequences with regard to HIV/AIDS and this type of transmission is referred as vertical transmission. Only a minority of children gets infected during early pregnancy and most infected infants acquire their infection during delivery when the infant exposed to large amount of infected maternal blood and secretions. The additional risk of transmission of HIV/AIDS is through breastfeeding.
Why Women Do Not Seek Treatment
The reasons why women do not seek treatment are as follows:
• Low self-esteem and abusive relationship.
• Fear of being recognised and ostracised from the community.
• Distrust in health care system. • Partner’s failure to disclose status.
• Women are restricted by household responsibilities and lack of mobility.
• There is restricted access to prescribed treatment due to poverty.
• Women oriented health services do not include STD related services.
• Services that only focus on STD treatment carry a greater stigma than integrated services.
Awareness and Empowerment of Women To prevent HIV, there is a need to aware women on this topic and at the right age also. Here are few points mentioned below:
• Women have the right to say ‘NO’ to unsafe sex and they can even refuse to share needle and syringes.
• Women can insist their male partner to use condom always for sex.
• To have sex with one partner but the partner should not be infected with HIV/ AIDS and who is not engaging in high risk behaviour.
• To prevent STDs, women should go for regular sexual health care check-ups.
• They must use disinfected needle and syringe each time to inject.
• Women should freely talk with their partner on the topic of HIV/AIDS prevention.
There is the need of counselling for women to make them aware on reproductive health issues, family planning and safe infant feeding and also need for active networking for complete healthcare and social support for positive women and their family. Pregnant women and infants who are in high-risk category should be tested. There should be quick assessment for anti-retro viral therapy and other additional supportive treatments should be given side-by-side for their recovery.
Drug Abuse in India
International Day against Drug Abuse and Illicit Trafficking is celebrated on June 26 every year. This day is celebrated by the world community to alert the people in general and youth against the negative effects of drug. If data are collected worldwide on the drugs scenario, then result would be very grim. Next to petroleum and arms trade, it is the third largest business in the world with a turnover of around $500 billion which is huge. Approximately 190 million people worldwide consume one drug or the other. The result of drug addiction would be immense human distress and the illegal production and distribution of drugs have produced crime and violence all over the world. Presently, there is no part of the world that is free from the curse of drug trafficking and drug addiction, and Millions of drug addicts worldwide are leading miserable lives, between life and death.
India too is affected by the drug abuse, and the numbers of drug addicts are increasing day by day. According to a UN report the registered number of heroin addicts is one million in India, and unofficially there are more than five millions. Inhalation of heroin alone has given way to drug use, that too in combination with other narcotics and painkillers and has increased the intensity of the effect, speeded the process of addiction and made difficult the process of recovery. The most frequently abused drugs in India are Cannabis, heroin and Indian-produced pharmaceutical drugs. Due to the association with some Hindu deities, Cannabis products often called charas, bhang or ganja, are abused throughout the country because it has achieved some amount of religious holiness. The International Narcotics Control Board in its 2002 report released in Vienna stated that Indian persons addicted to opiates are changing their drug of choice from opium to heroin. The medicinal products containing narcotic drugs are also and intravenous injections of analgesics such as dextropropoxphene etc. are also reported from many states, as it is easily available at 1/10th the cost of heroin which is very less. Drug abuse is the habit of taking illegal drugs which has many social, cultural, biological, geographical, historical and economic characteristics. Some of the reasons behind the drug abuse are: the disintegration of the old joint family system, absence of parental love and care in modern families where both parents are working, decline of old religious and moral values etc. These reasons are the cause to an increase in the number of drug addicts who take drugs to escape from the hard realities of life. The nature of the drug abused, the personality of the individual and the addict’s immediate environment are the major reasons of drug use, misuse or abuse. The processes of industrialisation, urbanisation and migration have led to loosening of the traditional methods of social control, rendering an individual vulnerable to the stresses and strains of modern life. The fast changing social environment, among other factors, is largely contributing to the increase of drug abuse, both of traditional and of new psychoactive substances. The use of synthetic drugs and intravenous drug has led to HIV/AIDS has added a new dimension to the problem, especially in the northeast states of the nation.
Society has affected a lot due to drug abuse and it has led to increase in the crime rate. Addicts choose the way of crime to pay for their drugs. Drugs remove shyness and impair judgment encourages one to commit offences. The incidences of drug abuse are of eve-teasing, group clashes, assault and impulsive murders. In addition, addiction increases conflicts and causes indefinable emotional pain for every member of the family. With most drug users being in the age group of 18–35 years, the loss in terms of human potential is infinite and damage to the physical, psychological, moral and intellectual growth of the youth is very high. Adolescent drug abuse is another area of concern in adolescent and young people’s behaviour. It is estimated that, in India, by the time most boys reach the ninth grade, about 50 per cent of them have attempted at least one of the gateway drugs, however, there is a wide regional variation across states in term of the incidence of the drug abuse. For example, a larger proportion of teens in West Bengal and Andhra Pradesh use gateway drugs (about 60 per cent in both the states) than Uttar Pradesh or Haryana (around 35 per cent). The health care system is burdened due to increase in incidences of HIV, hepatitis B and C and tuberculosis due to addiction adds the reservoir of infection in the community. Indian women face greater problems from drug abuse and the consequences include domestic violence and infection with HIV and the financial burden also. Maximum domestic violence is directed against women in the context of demands for money to buy drugs. Eighty seven per cent of addicts being treated in a de-addiction centre run by the Delhi police recognised being violent with family members. At the national level, drug abuse is basically linked with racketeering, conspiracy, corruption, illegal money transfers, terrorism and violence threatening.
The country has faced the threat of drug trafficking effectively at the national and international levels. Several measures involving innovative changes in enforcement, legal and judicial systems have been brought into effect against the threat. The introduction of death penalty for drug-related offences has been a major step taken by the government. The Narcotic Drugs and Psychotropic Substances Act, 1985, were passed with strict provisions to control this threat with minimum term of 10 years imprisonment extendable to 20 years and fine of `1 lakh extendable up to `2 lakhs for the drug offenders. The Act has been further modified by making provisions for the loss of properties derived from illegal drugs trafficking. For the reduction in use of drugs has been developed by the various government agencies and NGOs and is further improved by measures like education, counselling, treatment and rehabilitation programmes and India has bilateral agreements on drug trafficking with 13 countries, including Pakistan and Burma. Before 1999, extradition between India and the United States occurred under a 1931 treaty signed by the United States and the United Kingdom, which was made applicable to India in 1942. However, a new extradition treaty between India and the United States entered into force in July 1999 and In October 2001, a Mutual Legal Assistance Treaty was signed by India and the United States. India also is signatory to the following treaties and conventions:
1961 U.N. Convention on Narcotic Drugs
1971 U.N. Convention on Psychotropic Substances
1988 U.N. Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances
2000 Transnational Crime Convention
There is a need to prevent the spread and entrenchment of drug abuse, as the cost to the people, environment and economy will be colossal. Moreover, the spread of such unacceptable habits among the relatively youth segment of society ought to be arrested at any cost. To find the solution of drug addiction issue, there is a need for the government enforcement agencies, the non-governmental philanthropic agencies, and others to collaborate and supplement each other’s efforts through education and legal measures.