HIV/AIDS In Punjab and India: The Impact on Women

According to the World Health Organization at the end of 2005 there were 5.7 million adults and children living with HIV/AIDS in India with a population of approximately 1.1 billion. India is the second largest country behind South Africa with the highest number of HIV/AIDS patients. red-ribbon.thumbnail.jpgIn India, Mumbai is generally viewed as the Indian city with the most HIV/AIDS patients. However, the state of Punjab is not immune to the epidemic, even though the numbers are relatively small compared to major urban centers such as Mumbai. Numbers aside, the primary source of transmission of the HIV/AIDS within and outside of Punjab is heterosexual intercourse and intravenous drug use. Prof. Sehgal S. of the Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh states, that 80.5% of HIV/AIDS patients contracted the virus heterosexually in Punjab, while Indias National AIDS Control Organization (NACO) believes that the bulk of HIV infections in India occur during unprotected heterosexual intercourse. Furthermore, the International Womens Health Coalition cites that one of the highest risk factors for women contracting HIV/AIDS is marriage with 4/5 of new infections in women resulting from having a sexual relationship with their husband. Hence, women, particularly, those in rural areas are one of the fastest growing populations of HIV/AIDS patients in India as well as other countries. A CBS News report states that for Dr. Solomon, 90% of female patients [at his AIDS hospital in Madras] are not prostitutes, but monogamous women who’ve contracted HIV from their husbands. Many of these women are like Periasamy Kousalya whose husband from an arranged marriage was a trucker. He had HIV before they got married.

I think there are many women in Punjab who like Periasamy Kousalya are contracting HIV/AIDS through their husbands. The Sukh Sansar Health Education and Awareness Centre, Ludhiana believes:

“The AIDS scare in Punjab has hit the transport sector in a big way. The scourge of AIDS is silently killing the productive workforce of this sector and those close to them.”

“The vulnerability of the transport sector to HIV/AIDS is due to many factors: high mobility, difficult working conditions with low salaries, long working hours, limited societal/familial contact and control when on roads and peer pressure. All these pressures take the drivers and cleaners to sex-workers, easily available in cities and on highways. Multiplicity of sexual partners exposes them to HIV/AIDS and Sexually transmitted infections.”

Many of these men are not using sexual contraceptives with sex-workers of both genders, let alone with their wives. Therefore, HIV/AIDS is being heterosexually transmitted by husbands to their wives.

However, I would not limit this issue to only those involved in the transport sector, but also the growing number of men going to sex-workers for their first sexual experience and those using intravenous drugs (21% of intravenous drug users are HIV-positive) in Punjab. For example, an article on the UNODC website cites the example of two men in Punjab:

“HIV? AIDS? What’s that?” asked 23-year-old Jasvinder, who can barely move his right arm because of his injecting habit, at the sole drug rehabilitation centre in the town, 130 km northwest of New Delhi.”

“I know AIDS is a disease that can cause death but I never dreamed it can come through a needle,” said 23-year-old Jagdev Singh, a farmer who regularly shoots morphine into his veins with the same needle his friends use.”

Regardless of how these men contract HIV/AIDS, many of their wives are innocently contracting it through them, particularly in rural areas. With the general patriarchal nature of Punjabi gender dynamics, women once again have become innocent victims. Generally speaking in many South Asian/Indian marital relationships, a women believes through marriage that her husband has a right to her body whenever he desires and however he desires (with or without contraception) that is why there are such low rates of married women reporting sexual violence in their relationships in the Diaspora (I dont know about India or other South Asian countries, but I assume it’s similar). Hence, I doubt that many Punjabi/Indian women have enough power in their relationships to demand answers and actions from their husbands (i.e. refusal of sexual intercourse or the use of contraceptives). Many of these women are not only silenced by gender issues, but also poverty.

I wonder what role religion should have in fighting this particular issue that has a strong gender element in Punjab and India, particularly as we have seen in the past the gross disconnect between the gender equality advocated in Sikhi and its actual practice by not only Sikhs, but our leaders and organizations. In what ways can the Punjabi Sikh Diaspora be involved in the activism to fight HIV/AIDS, particularly among women in Punjab and India? How can we bring men into this activism and not just leave it as a womens issue for womens organizations to handle? Men and women function in the same social system riddled with issues, such as poverty and human rights abuses. Womens bodies for the most part receive the brunt of mens anger and frustrations caused by this system. How can both genders be part of the same conversation to develop actions for solutions?


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9 Responses to “HIV/AIDS In Punjab and India: The Impact on Women”

  1. Sundari says:

    Phulkari, thanks for posting about this. Interestingly enough, just this week the New England Journal of Medicine published an article describing the "downsized" HIV epidemic in India. Previous numbers suggested that 5.7 million people were living with HIV in India. However more recent reports, based on new data collection methods, suggest the number is closer to 2.5 million. Regardless of the actual number, it's a huge issue and is adversely impacting women in India. (I also think many HIV cases go unreported in the country which could be driving down the numbers).

    I have a lot to say on this, but i will try to be brief. The most difficult thing about this urban epidemic becoming a rural epidemic is the lack of education and prevention messages available to women living in these areas. The implications of HIV spreading to rural areas is huge, and the challenges to overcoming it are distinct from an urban epidemic. The low status of women makes them especially vulnerable to infection. Often times women contract HIV from their husband to only subsequently become widows, and historically in India widows have not been given any legal rights to land and property. This forces many women to have to leave their homes and face severe poverty. Additionally, because of poor health infrastructure and restricted access to health clinics, HIV remains a silent epidemic in rural populations. Much of the time, these women don't even know they are infected (lack of health services) and pass the infection onto their children thus increasing the prevalence.

    I don't know.. is there a role for religion in overcoming the HIV epidemic or is it simply a role for humanity? I think religious groups have been hesitant to take a stand for HIV/AIDS because of their perceptions of how the virus is transmitted. Much of their understanding of transmission (MSM) conflicts with their interpretations of their religious teachings. It's also important to note that India’s highly stratified social structure and traditional taboos on public discussion of sex have contributed to stigmatizing the disease.

    I could seriously go on and on about this, but i'm going to take a breathe and stop here!

  2. Sundari says:

    Phulkari, thanks for posting about this. Interestingly enough, just this week the New England Journal of Medicine published an article describing the “downsized” HIV epidemic in India. Previous numbers suggested that 5.7 million people were living with HIV in India. However more recent reports, based on new data collection methods, suggest the number is closer to 2.5 million. Regardless of the actual number, it’s a huge issue and is adversely impacting women in India. (I also think many HIV cases go unreported in the country which could be driving down the numbers).

    I have a lot to say on this, but i will try to be brief. The most difficult thing about this urban epidemic becoming a rural epidemic is the lack of education and prevention messages available to women living in these areas. The implications of HIV spreading to rural areas is huge, and the challenges to overcoming it are distinct from an urban epidemic. The low status of women makes them especially vulnerable to infection. Often times women contract HIV from their husband to only subsequently become widows, and historically in India widows have not been given any legal rights to land and property. This forces many women to have to leave their homes and face severe poverty. Additionally, because of poor health infrastructure and restricted access to health clinics, HIV remains a silent epidemic in rural populations. Much of the time, these women don’t even know they are infected (lack of health services) and pass the infection onto their children thus increasing the prevalence.

    I don’t know.. is there a role for religion in overcoming the HIV epidemic or is it simply a role for humanity? I think religious groups have been hesitant to take a stand for HIV/AIDS because of their perceptions of how the virus is transmitted. Much of their understanding of transmission (MSM) conflicts with their interpretations of their religious teachings. It’s also important to note that Indias highly stratified social structure and traditional taboos on public discussion of sex have contributed to stigmatizing the disease.

    I could seriously go on and on about this, but i’m going to take a breathe and stop here!

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  5. hivi says:

    thanks for the serious blog post

  6. hivi says:

    thanks for the serious blog post

  7. Simrat Brar says:

    People of Punjab are known for bravery and never say die spirit……………..they should use these forces to against drug addiction and female fieticides.

  8. Simrat Brar says:

    People of Punjab are known for bravery and never say die spirit……………..they should use these forces to against drug addiction and female fieticides.

  9. It is essential for those suffering with pain killer addictions to seekmorphine rehab. This article does a great job of explaining the risk for disease that these problems could carry on.