Full Document (English) - POLICY Project

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prevalence is less than 10 percent. The clients of female sex workers often refuse
to wear condoms. In a nationwide study (Behaviour Sentinel Surveillance,
2001), it was found that 6.6 percent of the respondents had sex with a nonregular
sex partner in the last year. Less than half (49.3%) had used condoms
during their last sexual encounter with a non-regular sex partner. Unsafe sex with
sex workers, or unprotected casual sex with non-regular sex partners, is the main
reason why the epidemic in India is primarily sexually driven.
High Prevalence of STI in Some Areas
Large-scale population-based studies on the prevalence of STIs are not available.
Available literature suggests that STIs may be more prevalent in some parts of
the country (e.g., Tamil Nadu and Karnataka). The presence of STIs suggests
recent or ongoing sexual behaviour that may result in HIV transmission.
Secondly, many STIs enhance the risk of HIV transmission or acquisition.
High Social Stigma on Issues Related to Sex and Sexuality
Sex and sexuality are taboo topics and not discussed openly. Adolescents most
commonly get information on sex from their peers, pornographic books, and
movies. The information that is available to youth is often misleading, incorrect,
and frequently harmful. Parents do not engage children in healthy discussion on
this topic. Introduction of this topic at the higher secondary school level in the
form of “Life Skills Development” has had limited success. Many of the potential
beneficiaries are out of the school system altogether.
Large Scale Migration
Large numbers of people, mostly male, migrate from rural to urban areas in search
of a livelihood. Migration also takes place from one state to another. Most of the
migrants leave low-prevalence states (e.g., Uttar Pradesh, Bihar, Rajasthan, and
Madhya Pradesh) for high-prevalence states like Maharashtra. The above-mentioned
low-prevalence states have a large population base. Single males living away from the
family for extended periods of time are vulnerable to sex outside marriage. It has
been estimated that approximately 180 million people migrate annually.
Traditional Beliefs and Practices
The “Dasi” system is still prevalent in some states (e.g., Karnataka). Polygamous
marriages in certain parts of tribal Madhya Pradesh exist. Studies among
transport workers have revealed their belief that driving vehicles for long hours
make their bodies “hot.” The body can be cooled only if they have unprotected
sex. Such beliefs and practices enhance the risk of HIV transmission.
Low Levels of Literacy, Gender Disparities, and Poverty
These factors have been globally documented to increase the risk of HIV
acquisition. The person either fails to recognize the risk involved, is unable to
negotiate safe sex, or is unconcerned about the risk involved.
Transmission Dynamics
HIV infection makes its first appearance among what is called a “Core transmitter.”
Female sex workers, injecting drug users, and men who have sex with men (MSM)
Prevention of
HIV/AIDS in Uttar Pradesh