A Hidden Scourge
India's huge population disguises the growing number of HIV-infected citizens
MUMBAI, INDIA-- Lucky is not a word that would ever seem to apply to the young woman standing by the brothel doorway. At 22, illiterate and unskilled, cut off from her family, Shanu Abdul Sheikh has known little good fortune in her hard life. She is a widow with a 6-year-old daughter she supports by working in a brothel on Falkland Road, the city's most notorious red-light district. Twice a day, sometimes more often, she leads a customer down a narrow corridor to a small interior courtyard, up a flight of warped wooden steps, and into a decrepit room shared with other women. There is barely space for the three sturdy beds, separated by dangling strips of cotton fabric draped from the ceiling to create an illusion of privacy. Her price for sex is as little as 60 rupees, about $1.40, half of which goes to the brothel operator.
Yet, she is lucky, if that word can ever be used about her, in one respect: She so far has tested negative for HIV, the virus that causes AIDS. In Mumbai (formerly Bombay), an estimated 40 percent of the city's 25,000 commercial sex workers have HIV/AIDS, although most are unaware that they are infected. The statistical likelihood, then, is that three of the other six women working in her brothel are HIV-positive, spreading the virus and facing early death.
Even if Sheikh--born in a Bangladeshi village and married off in her early teens--doesn't fully understand HIV, government and private intervention efforts have reached into the brothels. She and other women know about the need for condoms (provided free by the government and private groups) but say they are dependent on the man's willingness to use them, which has been a major obstacle to limiting the virus's spread. On this, she says, there has been a change. "Now, they [the men] are using condoms because they are scared of AIDS."
That news is encouraging but by no means lets India breathe easier. Because of India's huge population, the national HIV/AIDS adult prevalence rate is deceptively low--less than 1 percent--which masks the problem's alarming scale. One in every 8 HIV-infected people worldwide is in India--and the number is growing by 500,000 a year, over 10 times the annual increase in infections in the United States. Officially, the country has at least 5.1 million infected people, second only to South Africa's 5.3 million, 21 percent of its adult population. "The official statistics are wrong," asserts Richard Feachem, head of the internationally backed Global Fund to Fight AIDS, Tuberculosis, and Malaria. "India is in first place."
This is a critical time for India: An optimistic scenario envisions containing the virus, spread here mainly by heterosexual contact, through education and prevention efforts. But there is an alternative scenario, put forward in 2002 by the CIA-affiliated National Intelligence Council, and it is horrible to imagine: as many as 25 million infected Indians by 2010, as the virus extends beyond high-risk groups such as commercial sex workers, long-haul truck drivers, and intravenous drug users--the kind of rapid, devastating spread seen in South Africa in the mid-1990s.
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