Essay Paper on HIV Infection in India (Project Proposal)

Although it is estimated that there are fewer than 4 million cases of HIV infection in India, the general consensus is that there are growing localized epidemics. The challenge to the country’s infrastructure to respond to this epidemic and the issues of stigma and discrimination faced by HIV-infected persons appear daunting. After initial denial, the government set up the National AIDS Control Organization, which initiated a large-scale surveillance program for prevalence of HIV infection throughout all the states of India. The National AIDS Control Organization also brought significant improvements to blood supply safety in the country. The nongovernmental sector is active in prevention and care; people living with HIV are beginning to organize themselves for advocacy and activism; epidemiologic, interventional, and clinical research have moved forward; yet more could be done. Diagnosis of HIV infection remains a challenge. There are unresolved ethical, technical, and programmatic issues around voluntary counseling and testing. Availability of highly active antiretroviral therapy is not an issue since antiretro-viral drugs are manufactured in the country and exported elsewhere, but their affordability and the feasibility of monitoring patients taking the drugs are in question. Almost none of those living with HIV infection receive these medications from the government, except when nevirapine is provided to prevent mother-to-child transmission, or from the nearly nonexistent health insurance sector.

This commentary offers a perspective on the current status of the HIV epidemic in India, focusing on epidemiology, the government response, and diagnosis and treatment.

We often hear 2 different descriptions of the HIV epidemic in India. The official version is that the total number of HIV infections in the country is still fewer than 4 million and that the efforts by the government and other public agencies to prevent a rapid escalation of HIV infection are effective. However, a second version asserts that the official account does not present the true picture of the magnitude of the epidemic and the efforts to address it.

No matter which school of thought one believes, those who know India as a country that is populous, large, culturally complex, and economically diverse will agree that HIV adds to its woes. In 1978, India joined other nations in signing the World Health Organization’s Alma Alta Declaration, which set the goal of “Health for All by the Year 2000. Although India has not realized this goal, the failure leaves valuable lessons for the health sector to learn about HIV infection.

HIV has yet to cause dramatic, visible turns in the Indian economy or the health sector. Such good fortune may not continue. The first documented HIV infection was among sex workers in Chennai, Tamil Nadu, in 1986, and the 15-odd years since this initial report may have been the best opportunity for response. This first case report and subsequent reports, including those from northeastern India describing HIV infection among injection drug users (IDUs), were received with skepticism and denial by academicians, politicians, and sociologists, thus diluting the promise for an effective response. Some speculate that India is now on the verge of a catastrophe.

The aim of this project is a full investigation of the HIV threat in India. Moreover, the project will focus on social and demographic causes of the problem. Also, the project aims at stressing that India can become the center for HIV in Asia. The general objective of this project is to strengthen the response to HIV/AIDS in India through the application of information communications technology. ICT will be used to build the capacity of service-providing organizations, particularly in rural and semi-urban areas, facilitate best-practice sharing and collaborations; and provide tailored support aimed at enabling access to specific technical resources…

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