B5gv9

The likelihood
of economic
security, childcare
and insurance
benefits is
closely linked
to community
response to AIDS
experienced hostility, poor treatment
and job loss.
Stigma and discrimination contribute to
the socio-economic vulnerability PLWHA.
Early job loss, lost days due to illness and lack
of insurance or benefits create increasingly
difficult economic circumstances for
individuals and households (Mahal,
2004). For employers, stigma can reduce
labour supply, lead to lower workforce
morale and threaten employee health
and productivity (GBC, 2003). Most
companies largely deny the need to address
HIV and AIDS at the workplace: only 11
percent of Indian private firms maintain a
written policy (Bloom et al, 2004). The ILO
Code of Practice on HIV/AIDS advocates
that at minimum, employers should
implement non-discriminatory workplace
policies. In the absence of clearly defined
corporate policies in India and a lack
of an overarching anti-discrimination
legislation, PLWHA will continue to
face economic vulnerability due
to workplace discrimination. Currently,
the Government of India is drafting nondiscrimination
legislation, a positive step
to decrease stigma (Lawyers Collective,
2003).
The Indian Network of People Living
with HIV (INP+) was constituted to raise
awareness and advocate for the rights
and needs of PLWHA. Increasingly, NACO
and other agencies working in the field
of HIV and AIDS address stigma and
discrimination in prevention, treatment
and care efforts. International research
points to efforts such as awarenessraising
seminars for healthcare providers,
mobilisation of community leaders
and additional research on stigma as a
means to reduce its impact (Busza, 1999).
UNAIDS and WHO have declared that
eradicating stigma and discrimination
is critical to expanding prevention
and care: the World AIDS Campaign
(2002-2003), ‘Live and Let Live’ explores
how individuals can eliminate these
factors and improve the lives of PLWHA.
Research clearly illustrates that stigma
and discrimination hinders prevention,
treatment and care for PLWHA whose
concerns for everyday life are strongly
dictated by the level of discrimination. The
likelihood of having economic security,
childcare and insurance benefits is
closely linked to the community response
to AIDS. Stigma and discrimination
disproportionately affect women and
thus require specially tailored gendered
strategies. Additional research in India is
necessary, particularly at the household
and community level, to understand
the mechanisms and impacts of stigma.
Clearer knowledge of the determinants of
stigma and the pathways of discrimination
will expand the potential to counter the
negative impact and thus improve the
lives of PLWHA.
1.2 HIV and AIDS scenario
in the six high-prevalence
states of India
The impact study has been undertaken
by National Council of Applied Economic
Research (NCAER) in six high-prevalence
states namely Andhra Pradesh, Karnataka,
Maharashtra, Tamil Nadu, Manipur and
Nagaland. When HIV prevalence in any
state is five percent or more among high
risk groups (like commercial sex workers,
MSMs and those attending Sexually
Transmitted Diseases (STD) clinics)
and 1 percent or more among the low
risk population (like women attending
antenatal clinics), then the state is
considered to be in high-prevalence.
All the six states have prevalence rates
much higher than the threshold limits
defined above, particularly with respect
to prevalence rates seen in STD clinic
attendees. The situation is most serious
8
Socio-Economic Impact of HIV and AIDS in India