idea magazine

Fighting HIV in India

January / February 2008

"High caste people get jobs," Anita tells me. "We have to do this."

"This" is prostitution. Anita, 40, has spent most of her life in the sex trade, joining it at the age of 16. The oldest child of poor parents, she felt that she had to work "to help the family".

Anita is a member of the Rajnut community - part of the Untouchable caste - in Rajasthan, north-east India. Rajnut women have been involved in the sex trade for centuries, as they were originally dancers for the local rulers: glamorous, well-paid, and at the heart of celebrity.

She lives in a turquoise-painted house, which still doubles as a brothel, just yards from a six-lane motorway that runs between Delhi and Mumbai. But though her sister Sunita still works in the trade there, Anita's life has changed in the last few years, thanks to a project run by the Christian development agency World Vision.
Now, Anita's left the sex trade and is paid a small amount by World Vision to teach other women about the risks of unprotected sex and HIV/Aids, ultimately to encourage them to leave the profession altogether.

"I had no other option," Anita says of joining the trade in her teens. "At first I felt uneasy, but after five or six months it was habitual. And I earned good money. Then some organisations came to work here and I saw married ladies with their husbands. I wanted that kind of relationship. That made me change my mind about prostitution."
During her life, Anita has also seen how sex workers are treated by the police. "It made me think," she says. "I wanted to do the job I have now for the betterment of society. I can earn something and raise awareness about HIV and Aids."

Help and support

Today, HIV affects as many as 5.7 million Indians, making India second only to South Africa in rates of incidence across the world. In India, prostitution isn't stigmatised, but HIV/Aids is.

So the priority for World Vision has been to help the women to avoid contracting the virus, and to support those who are HIV-positive.

"There is a stigma and discrimination about HIV/Aids," says local project officer Alan Benjamin. "People feel that once a female sex worker has been diagnosed with HIV then she won't get customers and that will affect their income. So that stops people getting tested."

Add to this the fact that the nearest testing centre is 100km away, an impossible distance for many women like Anita, and it is common for women never to know they have HIV until it's too late.

The irony is that anti-retroviral drugs are freely available in India. So on World Aids Day in December, Alan's team launched a mobile health unit that will drive around the villages, testing the local people for sexually transmitted diseases and thereby perhaps avoiding years of illness.

Currently, the organisation works in 14 villages over a 140km stretch of motorway. Every day, 25,000 trucks use this part of the road system, and many stop for sex en-route. So World Vision is also in the business of educating the truckers about HIV.
We pull up by the side of the road in a dusty lay-by where half a dozen trucks have stopped to eat, wash and have sex. The only good news is that the ground is littered with used condom packets.

A small group of men and boys has gathered to listen to a story being told by Naresh, a former trucker who's now a World Vision outreach worker. With the aid of a coloured storybook, he's explaining how sexually transmitted diseases are caught and passed on. You can't, he says, get rid of them by having sex with a virgin, washing, or mating with a donkey. You need to visit a doctor and be prescribed medicine.

"Truckers know that they are at risk," says Alan. "A lot of condoms are available, and the truckers do use them. The sex workers say that if the truckers won't use condoms, they won't take the business."

Back at Anita's house, we see evidence of this. A teenage girl - already a mother - is ready for business. She has two packets of condoms tucked into her bra along with her mobile phone.

Changing her life may be a longer road than the highway on which she lives, but preventing her from contracting HIV/Aids has been a simple matter of education.