India
Click on an image to view that person's photographs and stories
India is at a crossroads in its efforts to control HIV. Although adult HIV prevalence is still relatively low at 0.9%, infection is spreading rapidly – the number of HIV-infected people has increased tenfold in the past decade to 5.7 million.
There are a number of things that make India’s HIV epidemic unique. India’s size and diversity have resulted in multiple local epidemics which has made a uniform approach to prevention challenging. Populations that are key to the epidemic across India are dispersed and mobile, making it very difficult to set up programmes. Extreme stigma, apathy and denial work towards keeping the epidemic hidden, allowing it to spread unchecked.
The resources available to fight HIV in India are also far below what is needed. The total annual allocation to fight HIV in India is US$146 million, while a fully funded prevention and care programme in India would cost closer to US$1 billion a year.
In the state of Andhra Pradesh, one of India’s highest prevalence states, the Alliance has been implementing the Frontiers Prevention Project. Focusing on men who have sex with men, sex workers and people living with HIV, the project is working to expand access to proven HIV prevention programmes.
The establishment of a network of Mythri clinics designed to treat sexually transmitted infections, which are a significant co-factor in the transmission of HIV, has been coupled with behaviour change and condom promotion. Community mobilisation directed at empowering members of key population groups to participate in and lead HIV prevention efforts and challenge stigma and discrimination, is also central to the project.
The term MSM is used throughout the following pages by the participants to refer to themselves and to other men who have sex with men in their photos. The widespread use of the term in HIV programming has influenced the language locally, and MSM is now used by same sex attracted men to describe both their identity and practice.
Similarly key population, which is abbreviated to KP, is used by the Alliance to refer to groups who are significant to the dynamics of the epidemic and to responding to it in a particular context. It has been adopted by these communities to refer both collectively and individually to themselves.
The terms rowdy and goonda are used in the following pages. They refer to local ruffians or street thugs.
