From Stephanie McMillan‘s blog.
5.7 million Indians are reportedly HIV positive. Of these, nearly 40% are women. And no, they are not sex workers. They are mainly young, married women, more than three-fourths of whom have had sexual contact only with their husbands. As Breakthrough puts it: the greatest risk of HIV/AIDS for many girls and women is marriage.
Read around recently that the HIV numbers may be overstated. Do you how they estimate these numbers?
Actual reported cases are really no indicator, as you can imagine, since stigma prevents many from being reported. The other issue is that in India, people can easily pass under the radar for diagnosis of HIV, and the cause of death can be attributed to an opportunistic infection, like tuberculosis, pneumonia or jaundice.
The estimates are generally based on projections of prevalence, based on surveys of pregnant women attending ante-natal clinics. This is purportedly fairly reliable, and maintains the confidentiality of the data. Studies show that this data tends to mirror the prevalence of HIV in an adult population, with some adjustments made for issues like under-reporting in rural areas and differences between rates of infection between men and women. It is of course possible that sentinel surveillance of this kind can accurately show trends, but not so much absolute numbers.
The issue is though that problems of estimation should not undermine the seriousness of the epidemic. Even if, as one study puts it, the number is as ‘low’ as 3.5 million, it’s still huge in absolute numbers – and very clearly, by all evidence, in the general population, not in ‘high risk’ groups. Frankly, we are all high-risk today.
When so many of the problems of HIV are around sensitivity in reporting, in treatment and care, in our attitudes towards positive people, and in prevention, the absolute numbers are not as much of an issue (at least to me) as relative awareness. For many women and children, for instance, it becomes an issue of structural violence.
For more on this, have a look at http://www.avert.org/indiaaids.htm
http://www.avert.org/statistics.htm