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HIV AIDS in News Journalists as Catalysts UNDP PFI |
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HIV/AIDS in News –
Journalists as Catalysts
Population Foundation of India
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POPULATION FOUNDATION OF INDIA
B-28, Qutub Institutional Area, New Delhi - 110 016
email: popfound@sify.com
Phone: 91-11-52899770
Support Team
Usha Rai
Rimjhim Jain
Swapna Majumdar
© United Nations Development Programme 2005.
All rights are reserved. The document may, however, be freely reviewed, quoted, reproduced or trans-
lated, in part or in full, provided the source is acknowledged. The document may not be sold or used
in conjunction with commercial purposes without prior written approval from UNDP. The analysis and
policy recommendations of this report do not necessarily represent the views of the United Nations
Development Programme.
Designed & Printed by
Dharana, Tel.: +91-11-24317735, 24318328
email: studiodharana@gmail.com
Cover photograph by The Servants of the People Society, Chandigarh
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Contents
Foreword
VII
SECTION 1 – The Media Study
HIV/AIDS in News
■ An Overview
3
■ Karnataka
17
■ Punjab
28
■ Uttar Pradesh
36
■ Review of TV News Coverage
46
SECTION 2 – The Many Dimensions of HIV/AIDS
Tracking Changes in the HIV/AIDS Epidemic
53
Removing the HIV Stigma
54
India’s Response to the HIV Epidemic
61
The Cost of the HIV Epidemic
69
Time For Women to be Seen and Heard
77
Finding the Way out of the Needle Maze
86
Children Show the Way
88
Seeking the Right Prescription
95
Standing Up for Their Rights
103
Positive Voices
110
SECTION 3 – Useful Information
Do’s and Don’ts – the Ethics of Reporting on HIV/AIDS
123
Media Guidelines from Consultations
129
Quiz
131
Facts & Myths
133
Frequently Asked Questions
139
Appropriate Terminology
150
List of Contacts/Websites
151
Helpline Assistance
155
Newspaper Clippings
158
Media Workshop Structure
162
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Message
To fight the HIV/AIDS epidemic which has become a major health issue in the country
a larger alliance encompassing all sections of society is needed. No one can afford to
just sit back, everyone has to be proactive. The media is an important partner in cre-
ating awareness about the infection and its management. With the HIV/AIDS epidemic
now spreading into remote corners of the country and affecting all sections of society,
the fourth estate has to be at the forefront of the fight against the infection and has a
special responsibility in informing the public.
I compliment the Population Foundation of India for undertaking a media survey of
HIV/AIDS stories in newspapers and TV channels and analysing its impact on stigma and
discrimination of those affected. It will help the government and our national and interna-
tional partners in working better with the media in the fight against the epidemic.
Despite India’s deeply religious moorings and a culture that believes that sexuality is a
sacred relationship enshrined by wedlock, we now know that it does break the barrier
in certain cases. A large number of those infected are extremely young and in the most
productive years of their lives.
The awareness generated by media goes beyond the normal official publicity on health
issues. Therefore, this endeavour and the manual, is of special value.
Prasanna Hota
Secretary, Health and Family Welfare
Government of India
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Message
The United Nations Development Programme is committed to supporting the national
response to the HIV epidemic. The focus of our approach is on supporting Government in
advocating for policies that are inclusive and address HIV/AIDS as a development issue.
We believe that HIV/AIDS is not just a health issue; it is a development issue as it
affects the economic and social fabric of our society. It is therefore important to build
a multistakeholder partnership to address the issue and UNDP plays a lead role in sup-
porting efforts to mainstream HIV into development work of various stakeholders.
The media is an influential and far reaching stakeholder. Not only is it a powerful medi-
um of communication and awareness generation, but it is also a key behaviour change
medium as it can influence people’s opinions. Journalists can stimulate open and
vibrant public debate about issues that underpin the HIV/AIDS pandemic, such as
unequal gender relations, social inequalities, stigma and cultural norms, and they are
uniquely placed to help break the silence.
To facilitate responsible media reporting with a view to reducing Stigma and
Discrimination within societies UNDP has supported the development of researchbased
manuals with a state level focus. These manuals build upon the analysis of HIV/AIDS
reportage in the print and electronic media in six select states.
The aim is to use these manuals to strengthen media capacity on HIV/AIDS. Two com-
plementary manuals have been developed in partnership with the Population
Foundation of India & FAITH Health care Private Ltd with support from UNDP. The
Resource book includes information on the various dimensions of HIV/AIDS; the ethics
of reporting, appropriate language and guidelines for responsible reporting. The
Training Manual is a hands on guide for training journalists.
I would like to thank everyone who has contributed to the development of the resource
book and the training manual.
I hope that these manuals will be used effectively for media advocacy.
Maxine Olson
Resident Representative UNDP
India
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vii
Foreword
Would the number of HIV positive people in India have increased from just one in
1986 to 5.1 million in 2005 if the media had played a more pro-active role in the early
years of the infection? The media, like others monitoring the epidemic, underestimat-
ed its gravity and seriousness.
Would HIV positive people have been thrown into isolation wards as happened with
Dominic D’Souza in Goa in 1989 and ten years later with Dhiren Sarkar of West Bengal
if the media had presented a more realistic picture of the infection? When Dhiren’s wife
and family discovered he was HIV positive they walked out on him. Some villagers even
bolted the door to his house and tried to set him on fire. The police rescued him and
moved him to a hospital in Katwa where he was left in an abandoned room. He was then
transfered to Burdwan district hospital. Sarkar died a couple of days later in a dark little
corner of the hospital unwanted, deprived of his basic rights as a human being. Afraid of
stigma and discrimination, even today a large number of infected people commit suicide.
In most parts of the country there is still an ominous silence around HIV/AIDS. At the intel-
lectual level there is still a debate on why so much money and importance is given to this
comparatively new infection as against tuberculosis, malaria and a spate of other ailments.
In May 2005 under a UNDP-funded project, the Population Foundation of India appoint-
ed veteran journalist Usha Rai to examine the role of the media in relation to stigma
and discrimination faced by HIV affected people. She was supported by journalists
Rimjhim Jain and Swapna Majumdar. Research was conducted on media coverage of
HIV/AIDS in newspapers in Karnataka, Punjab and Uttar Pradesh and in seven national
television news channels.
The six-month survey shows that there is a big gap in what the media has been writing
on HIV/AIDS and the expectations of HIV positive people on what they perceive should
be the media’s role in reporting on the issue. Though there is considerable coverage of
HIV/AIDS most of it is often superficial – reporting of events or statements by celebrities.
This manual is an attempt to bridge the communication gap between the media, posi-
tive people, NGOs working on the issue and the State AIDS Control Societies.
A R Nanda
Executive Director, Population Foundation of India
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Section I
The Media Study
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An Overview 3
HIV/AIDS in News:
An Overview
The news media is a powerful agent of social and political change and in a country
like India where 50% of the population is illiterate or neo-literate, the printed word is
taken as gospel truth and the images on television can excite viewers. Both leave a
lasting impression. Even an innocuous news story can mould public perceptions and
sensibilities.
This is particularly so while addressing a health concern like HIV/AIDS that is com-
paratively new despite the epidemic being in its 25th year. It is a virus that has
many dimensions and inbuilt prejudices associated with it. Its mode of transmission
makes it susceptible to be associated with deviant behaviors that have negative
perceptions in the public mind. Thus, reporting on HIV/AIDS issues needs to be
extremely responsible. Ill-informed reporting can cause repercussions including stig-
ma and discrimination against people affected by HIV/AIDS. It can lead to people
losing jobs and being thrown out of homes. On the other hand, stories written with
empathy can have them being feted as the champions of a brave new world.
Since this is an epidemic whose dynamics are constantly changing, those covering the
issue need to keep themselves abreast of the latest developments. Changes associat-
ed with HIV/AIDS are happening not only in medical research but also in the spread of
the virus to every section of society.
While the media has
started taking active
note of the issue and the
visibility of HIV/AIDS
stories has gone up,
there was a general feel-
ing that reporting on it
was often insensitive and
caused further stigma
and discrimination
against affected persons
While the media has started taking active note of the issue and the visibility of
HIV/AIDS stories has increased, there is a general feeling that reporting is often
insensitive and causes further stigma and discrimination against affected persons.
To explore this, a print media review was undertaken in Punjab, Karnataka and Uttar
Pradesh with the support of several partner organisations. Seven national television
news channels were also reviewed in Delhi. The purpose was to investigate how the
news media was handling HIV/AIDS. The study is also a comparative analysis of the
differences in qualitative and quantitative coverage between a high HIV/AIDS-preva-
lence state like Karnataka and low-visibility states such as Uttar Pradesh and
Punjab, where the epidemic is in its nascent stage. The study also looked at the dif-
ferences in approach between the language media and the English press in these
states. Basically meant as a resource handbook for journalists, it is hoped that the
information in this Manual will also feed into the State AIDS Control Societies
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4 HIV/AIDS in News – Journalists as Catalysts
strategic planning for information, education and communication (IEC) in the next
phase of the NACO country programme.
What emerged from the study was quite different from the common perception.
There are many more stories appearing on HIV/AIDS today and most reports were
found to be accurate and well informed. But a few bad stories did cause enough
damage.
What emerged from the
study was quite different
from the common per-
ception. Most reports
were found to be fairly
accurate and well
informed. But a few bad
stories did cause enough
damage
The impact of a story can be gauged from the feeling it leaves readers with. For exam-
ple, the stories of a beauty pageant for HIV positive women in Kathmandu, Nepal as
well as one in Botswana for crowning Ms HIV Stigma-free were inspiring. Eight and
twelve women respectively participated in the contests. Newspapers across the coun-
try also carried a heartwarming story on positive people putting out matrimonial adver-
tisements and receiving responses. On the other hand, an irresponsible report from
Uttaranchal stigmatised HIV positive women by negatively terming them vish kanyas
(poison women) and alleging they were sent by the enemy to infect the armed forces.
Some newspaper headlines also branded a whole community - “Safai karamcharis
found HIV positive,” and “HIV infection more among non-literate, pregnant women.”
Looking at the difference in reporting between three states, the coverage in Karnataka
reflected its high prevalence status. Not only did the state have the largest number of
stories, the regional language and English press were better informed. The fact that
there has been a lot of intervention in Karnataka on HIV/AIDS by NACO, the state gov-
ernment and a range of NGOs and activists is probably why there was more responsi-
ble reporting. A cause for concern here was the number of advertisements and stories
about ‘miracle cures.’
In UP where the regional press covered the issue extensively, the reportage was of poor
quality. There were more sensational stories, in Hindi in particular. In Punjab the English
press, especially The Tribune, the state’s leading newspaper, carried some excellent
reports on HIV/AIDS. But the stories were of a national and not regional character. The
language press in Punjabi, Hindi and Urdu carried fewer stories on the issue. The lan-
guage press in both states needs a lot more sensitisation on the issue. In both the
Punjab and UP press few voices of affected people were heard. The only voices reflect-
ed were those of HIV positive persons from other states like Tamil Nadu and Delhi from
where the stories emanated.
While journalists need to highlight the HIV/AIDS situation and methods to tackle it,
the manner in which it is done should not heighten the fear and stigma associated
with the virus.
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An Overview 5
HIV/AIDS IN NEWS: THE STUDY
A detailed media tracking and content analysis was carried out for a greater understand-
ing of the issue. Newspapers in English and the regional languages in each of the three
selected states were monitored intensively for one month in May/June 2005, with two
of the regional language papers in each state being scrutinised for a longer period from
January onwards. This was done to bring out clearly the state of the language press that
is considered more influential and has greater local readership. National television chan-
nels were analysed for coverage on HIV/AIDS for one month in May/June 2005.
The primary objective was to examine whether reportage was enhancing stigma and
discrimination.
Table 1a: Newspapers Analysed
Punjab
English
Punjabi
Urdu
Hindi
The Tribune
Jagbani
Hind Samachar Punjab Kesri*
The Indian Express
Ajit
Dainik Ajit
Hindustan Times
Punjabi Tribune*
Dainik Bhaskar
The Times of India
Desh Sewak
Amar Ujala
Total: 13 Publications
Karnataka
English
Kannada
The Deccan Herald
Kannada Prabha
The Times of India
Prajavani
The Hindu
Vijaya Karnataka*
The New Indian Express Udayavani*
Vijay Times
Samyuktha Karnataka
The Economic Times Suryodaya
Sudha (magazine)
Taranga (magazine)
Total: 14 Publications
Uttar Pradesh
English
Hindi
Urdu
Hindustan Times
Dainik Jagran*
Apna Akhbar
The Pioneer
Rashtriya Sahara
The Times of India
Hindustan*
The Indian Express
Swatantra Bharat
Jansatta Express
Amar Ujala
Aaj
Rashtriya Swarup
Sahara Samay (magazine)
Total: 14 Publications
* These were covered for the period from January to June 2005 while the rest were covered for one month in
May/June 2005
There was a special look
at the language press
that is considered more
influential and has
greater readership
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6 HIV/AIDS in News – Journalists as Catalysts
A total of 443 articles
were found on the sub-
ject in 42 newspapers
and magazines surveyed
in the three states.
Sixteen television news
stories on HIV/AIDS
appeared during one
month
Table 1b: Television News Channels Analysed
Hindi
Aaj Tak
DD News
NDTV India
Sahara Samay
Star News
Zee News
These were covered for one month in May/June 2005
English
NDTV 24x7
A total of 443 articles were found on the subject in 42 newspapers and magazines
surveyed in the three states. Sixteen television news stories on HIV/AIDS appeared
during the period.
Table 2a: Language-wise Breakup of HIV/AIDS Related Articles
Punjab
English
Punjabi*
Urdu
Hindi
Total
79
9
3
20
111
Karnataka
English
Kannada*
85
82
167
Uttar Pradesh
English
Hindi*
Urdu
36
126
3
165
443
* Includes two newspapers covered for the period from January to June 2005 while the rest were covered for
one month in May/June 2005
SUMMARY OF STUDY FINDINGS
Nature of stories and numbers
On the whole the number of stories on HIV/AIDS has gone up in recent years. This was
brought out by a study in Karnataka indicating a 48% increase in HIV/AIDS stories in three
years since 2002 and another by the Centre for Media Studies in Delhi (November 2004
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An Overview 7
to February 2005) which indicates that
within the health sector reporting, half
the stories were on HIV/AIDS.
Table 2b: Total Number of
Television Stories on HIV/AIDS
The survey showed that most coverage on
HIV/AIDS was in the form of news stories
(70%), that is, event-based spot reports.
The rest comprised features (15%), photo-
graphs (5%) and editorials (3%).
Zee News - 2
Star News - 1
Sahara Samay - 3
The findings indicate certain differences
and some similarities in the coverage
between the regional media and the
English press. For instance, the English
press in Punjab had more articles relat-
ed to HIV/AIDS. In UP, however, the
Hindi newspapers carried a significantly
higher number of HIV/AIDS-related sto-
ries. In Karnataka the Kannada and
English papers carried an almost equal
number of stories.
NDTV 24x7 - 6
NDTV India - 2
DD News - 2
Aaj Tak - 0
The Urdu press in Punjab
and UP accorded low pri-
ority to the subject. In
the two states, journal-
ists of the region did not
see it as a “prevailing
disease”
The Urdu press in Punjab and UP accorded low priority to the subject. In the two states,
Urdu newspapers carried just three news items each. The Punjabi press too had just
nine stories during the six-month survey. This in itself may be considered as a case of
discrimination. A discussion with journalists of the region shows they did not see it as
a “prevailing disease.” It was not considered an issue big enough to merit attention at
this stage even though they acknowledged the high degree of risk factors, such as
endemic drug addiction, a huge migrant workforce and a large number of people
involved in the interstate transport sector. There also seemed to be a mental block in
Punjab in talking about a virus that is associated with socially taboo subjects such as
safe sex, differing sexual orientations and extra-marital relations.
Space and positioning
Apart from the number of stories, their length and positioning was also analysed.
Almost 60% of the stories were single or double column. Most stories in the UP and
Karnataka press were single column (40%). In Punjab, however, 60% of stories were
spread over 2-3 columns. More specifically, the state’s English newspapers devoted
more space (over 4 cols). This was a trend noted in the other states too. In UP, almost
30% of the English stories were carried across four columns.
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8 HIV/AIDS in News – Journalists as Catalysts
Several television stories
too associate the virus
with death and ruin.
Stories repeatedly
hammer in that the
‘victims’ are at death’s
door, though the visuals
may show them as
healthy, active individuals
Not only did the English press give more space for HIV/AIDS stories, but in all three
states it also carried a greater number of editorials (5.5% of total HIV/AIDS stories)
as compared to the regional press (1.2%). It also had a marginally larger number of
features (18.5%) in relation to the regional press (12.8%).
Front-page stories were few (5.4%). Most coverage appeared on the inside pages
(88%). A little over five per cent were in supplements. The English press had a margin-
ally larger number of stories on the front page.
The majority of stories - over 90%, were stand-alone, one-time items. They do not form
part of a series or campaign by the press.
Frame of reference
The frame of reference of most articles has been the national and respective state-level
situation of HIV/AIDS. In addition, almost 20% of the stories referred to the global
status of the epidemic. Community and individual responses were insufficient.
Several television stories too associate the virus with death and ruin. For example, a
sensationalised story on a woman in Mumbai who contracted the infection from her
husband/partner who abandoned her was described as ‘roaming free.’ Stories such as
this repeatedly hammer in that the ‘victims’ are at death’s door, though the visuals may
show them as healthy, active individuals. This association of HIV with ‘living death’
heightens the despair of those infected and the fear of those around, causing infected
people to be isolated and rejected.
Issues taken up
The two major concerns of most stories in the survey have been:
Raising awareness to prevent spread of the epidemic.
Stories relating to people affected by HIV/AIDS.
Nearly 40% of the coverage in Karnataka comprised awareness efforts by celebrities
and others to control the epidemic. Across the country, the page three culture of glam-
ourising events has been used for sending out messages on HIV/AIDS. Both the print
and electronic media have extensively carried photos and statements of celebrities.
Even bold pictures of beauty contest winners made a mention about their concern for
HIV/AIDS. At the same time the media needs to be careful not to trivialise the issue.
A lot of space in the three states was taken up by the release of a music album on the
theme of HIV/AIDS within marriage, featuring TV personalities Mandira Bedi and Samir
Soni. While some stories were entirely celebrity-focussed, others used it as an oppor-
tunity to explore how the virus spreads. Other important political personages like Bill
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An Overview 9
Stigma and Discrimination
The primary purpose of this analysis being to look at stigma and discrimination of
those affected, certain parameters were devised to be able to cull this from the
reports. Articles and TV coverage were analysed to see if they projected a single
point of view or had multiple perspectives, if the news item specifically associat-
ed the epidemic to certain behaviour or groups of people, and whether the spread
of the disease to the general population was adequately addressed. Terminology
that could cause panic, accuracy of the information and the confidentiality con-
cerns of infected persons were also examined. The analysis of news stories
through these filters brought out the explicit and implicit stigma and discrimination
components. It revealed that identification of stigma and discrimination in
reportage is often subtle and difficult to pinpoint, yet it does influence the read-
ers/viewers’ perceptions on HIV/AIDS.
While the survey showed that 95% of the print articles did not contain any overt stig-
ma and discrimination against people affected by HIV/AIDS, a closer examination of
the orientation and slant of stories made it evident that at times the wrong message
was being sent out.
For instance, the story titled, “Tamil Nadu school slams doors on HIV positive
orphans, says it’s risky,” is a front-page anchor story in a national daily. An excel-
lent human interest story, the subtitle projects the school’s argument that if the
children fall on or bump against others they will pass on the infection. This dis-
crimination (refusing them admission) is given the stamp of credibility by the non-
committal reporting. It was important to counter the argument of the principal, a
person of public stature, by getting a quote from a medical expert or NGO that
HIV/AIDS is not transmitted by these means. This is not brought out even in the
statement of a medical field worker who says, “An insensitive society and system
can kill them sooner.” In any case this appeared only in the run-over of the article
in an inside page. The news report thus reinforces stigma and discrimination in
the reader’s mind.
Many good stories are marred by terminology commonly used by the media to describe
HIV/AIDS – scourge, dreaded/draconian/deadliest disease/single biggest killer/viral
tsunami/even deadlier than the enemy/pestilence/ugly truth. Infected persons are
called victims/patients/cases. In Punjabi the word kauda, used for those affected by
leprosy, is applied in a derogatory manner for the HIV infected. In Kannada, the word
naraka yatane (deadly disease) is used for describing HIV/AIDS.
Many good stories are
marred by terminology
commonly used by the
media to describe
HIV/AIDS – scourge,
dreaded/draconian/dea-
dliest disease/single
biggest killer/viral
tsunami
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10 HIV/AIDS in News – Journalists as Catalysts
Clinton and Kofi Annan added their clout to the concern on the issue in the media.
In Punjab, 65% of the
articles dealt with people
living with HIV/AIDS.
Despite the large number
of stories, their major
concern of facing stigma
and discrimination has
hardly been addressed
directly
In Punjab, 65% of the articles dealt with people living with HIV/AIDS. However, further
analysis revealed that despite the large number of stories, their major concern of fac-
ing stigma and discrimination has hardly been addressed directly. The stories played
up ‘catchy’ themes or those with an unusual human interest angle. The crime aspect
is invariably hyped. For instance, several newspapers in Punjab wrote about the acid
attack on a woman who left her husband soon after marriage on finding out he was
infected. While the media highlighted the criminal charges that both filed against each
other, it did not take up other vital issues related to living with the virus. These could
have included the woman’s right to know of her husband’s positive status before mar-
riage and her right for protection.
The other HIV/AIDS issues covered were initiatives by the government and various
agencies to tackle the virus, medical research and treatment, and HIV/AIDS impacting
the social fabric.
Absence of multiple perspectives
As many as 70% of the articles did not have multiple perspectives of various parties
involved. This implies that they were one-sided or ‘biased.’ The voices of people living
with HIV/AIDS, caregivers, experts and NGOs were not heard, probably because most
stories comprised straightforward reportage.
Accuracy of information
About six per cent of the overall coverage was factually incorrect. Some stories were
exaggerated and totally false. A story in an Urdu newspaper in Punjab alleged that a
new type of condom with a microchip had been developed to prevent HIV/AIDS! Another
misleading story in the UP papers says, “Tamatar khao, AIDS bhagao” or ‘eat tomatoes
- drive away AIDS.’ Newspapers also need to take a decision whether items promoting
‘cures’ for HIV/AIDS should be carried or not. Articles like the use of cow urine as ther-
apy and healing by a ‘swami’, frequently appearing in the Kannada papers, need to be
verified and crosschecked.
A story that raised dubious concerns was a full-page feature in Hindustan Times on the
theory that the HIV virus does not in fact lead to AIDS. It quoted international scientific
authorities to buttress its claim that “AIDS is a non-contagious lifestyle epidemic caused
by anti-HIV drugs.” Several Indian experts are livid that such a story was carried so
prominently even though the page did have a section on dissenting opinions. They say
that at this juncture of the epidemic such an article could do extensive harm. This
debate has, for instance, set back the response to the epidemic in South Africa.
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An Overview 11
Headlines
Of the stories analysed, 11 .5% (51 articles) had overtly stigmatising or panic-creating head-
lines. Seventeen per cent had headlines that did not match the stories. Titles in the Hindi
and English newspapers in UP such as, “AIDS being spread by wives who have been bought
like goods,” and “247 AIDS patients in the hills and 800 sex workers,” as well as, “From
dance bars to prostitution and HIV” make harmful and stigmatising associations. Even
headlines like, “India sitting on AIDS Time Bomb?” in major national dailies, are alarmist.
A workshop in Lucknow on medical care-givers was headlined in one English newspaper
as, ‘AIDS - paramedics, be careful.’ The story focussed only on “the high danger zone for
those who are in charge of patients... for this dreaded, incurable ailment.” It warned that
even simple accidents caused immediate infections. Nowhere did it mention that HIV
positive patients deserve equal care and treatment or raise the problems they face. The
same workshop was reported with greater responsibility by other newspapers.
Is the copy alarmist?
The news stories were analysed for alarmist or panic creating innuendos. It was felt
that more English news (15.5%) was alarmist/panic creating as compared to the
regional press (7.5%). Overall, 12% of the articles, or 51 items, did contain HIV/AIDS
news in a manner that could invoke fear. For instance, a story in a Karnataka English
newspaper says, “HIV/AIDS spreading at an alarming rate in State.” Another English
article reads, “The pestilence of HIV/AIDS looms large over mankind... the family is
under immediate threat from the scourge.”
A well-meaning aware-
ness campaign by an
artist in Orissa displayed
a sand sculpture of
skulls, reinforcing the
misconception that the
HIV infection spells
death
It may be that the media felt the situation was grave and alarming and adopted this
tone. But keeping in view the need to be sensitive to people living with HIV, who might
face the backlash of such reporting, greater sensitivity and the proper use of terminol-
ogy becomes important.
Photographs/ Illustrations
Almost 30% of all HIV/AIDS stories across the states had an accompanying photograph
or illustration. There were also some photo-only items with captions. Of these 142 pho-
tos and illustrations, seven were found alarmist. For instance, a supposedly well-mean-
ing awareness campaign by an artist in Orissa displayed a sand sculpture of skulls. This
photo was carried by newspapers across the country. There was also a photo caption
saying, “AIDS ka danav” or ‘the demon of AIDS.’ The message sent out was of death
and doom. There was no attempt to contradict this negative portrayal.
Projecting the virus in this manner is likely to lead not so much to preventive measures
against contracting it, but transference of the fear evoked against HIV/AIDS to rejection of
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12 HIV/AIDS in News – Journalists as Catalysts
the persons infected. Instead, a photograph of Sharmila Tagore hugging an HIV positive
woman was the best way of sending the right message that the virus was not infectious.
Tone of story
The overall tone of most stories was neutral (45%) and a few were positive (37%).
Seventeen per cent, however, were negative. Positive stories included tales of courage
and determination as well as those that expanded the scope of coverage to actively
examine the dimensions of the epidemic. For instance, a number of Hindi stories in UP
investigated the changing nature of the spread of the epidemic in different regions as
well as the treatment of infected persons there in medical and social terms.
A photograph of Sharmila
Tagore hugging an HIV
positive woman was the
best way of sending the
right message that the
virus was not infectious
Stories that could be termed negative in tone were those that dealt with the virus in
sensational or judgemental ways. For instance, a story from Ludhiana by a national TV
news channel on a woman and her baby acquiring the infection during her pregnancy
merely reported the incident in a dramatised and bleeding heart tone. It did not take
up obviously important connected issues such as safeguards to blood transfusion and
other legal and medical concerns.
Maintaining confidentiality
Confidentiality is an important right of those affected by HIV/AIDS, particularly in view
of the repercussions invited by its violation. Sixty-three news items have not maintained
it. It is likely this occurred because a greater number of positive people are coming for-
ward and being open about their status in the media. The Tribune carried an entire page
of interviews and photographs of ten HIV positive women from across the country. They
radiated confidence, speaking of their struggles without self-pity or blame. The Sunday
supplement of The Hindu also carried a lead story on the voices of Gomathy and
Meenakshi, two HIV positive women who travel to villages around Chennai, spreading
the message of hope and life beyond the virus. The story was accompanied by a large
photograph of the smiling women. Meenakshi did not want TV channels to mask her
face when she began her new career as a counselor on HIV/AIDS. The Sunday Express
too carried the story and photograph of an HIV/AIDS ‘survivour’, Veena Dhari who has
been running the Karavali Positive Women and Children Network in Karnataka since
2000. However, certain stories, particularly those in television, need to be more care-
ful that the identity of those infected is not given away.
Blaming high-risk and vulnerable groups
Fifty-eight news items, or 13% of the articles, laid blame on certain groups considered
high risk and vulnerable such as women, sex workers, men having sex with men, blood
donors, injecting drug users or truck drivers for spreading the infection. For instance,
damning portrayals of women infected with HIV/AIDS, dubbed ‘vish kanyas’ and
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An Overview 13
accused of deliberately infecting men, seem to be a recurring thread in some language
media. There was also a laudatory curtain raiser in a Hindi newspaper on a movie titled
‘Vish-Kanya’ being shot in UP. The film is reportedly about “a woman deliberately infect-
ing men with the sole purpose of giving them a ghastly death.” Another story from
Dehradun in Uttaranchal accuses an HIV positive woman of engaging in prostitution to
spread the infection and makes a case for her not to be allowed to roam free. A simi-
lar story, based on hardly any facts, was broadcast by a national Hindi news channel
some time earlier. The story claimed to investigate rumours about a woman who would
arrive in a village and indulge in sex with the men there without taking any money. At
the end, she would inform her “victims” - “Welcome to the world of AIDS.” The story
ends with the question, “Who is this woman?”
Association with specific behaviours
Eleven per cent of the stories link behaviour such as extra-marital sex, multiple partners,
different sexual orientations and crime with HIV/AIDS. For instance, a story in a Hindi
newspaper on the death of a dreaded dacoit says he experienced an agonising end
because of HIV/AIDS, a just punishment for his crimes. The news item also mentioned that
the police had found local girls and virility enhancing drugs in his hideout during raids.
Another story carried in an English newspaper in UP traced the life of a bar girl in
Mumbai who was said to be infected because her profession brought her in contact
with multiple partners. When these girls return to their home state, it was claimed, they
passed on the infection to men. Stories like this pass moralistic judgment projecting
a certain section as having contracted the virus in well-deserved punishment for doing
‘wrong.’ The condemnation implicit in these associations with the virus drives the
epidemic underground. It also creates false complacency about its spread among
those who may consider themselves free from such behaviour.
Fifty-eight news items
laid blame on certain
groups considered high
risk and vulnerable such
as women, sex workers,
men having sex with
men, blood donors,
injecting drug users or
truck drivers for spread-
ing the infection
Spread of epidemic into general population
In the English media, 38.5% stories reflected the spread of the epidemic in the gener-
al population, whereas 30% of the regional media reflected it. This implies a larger num-
ber of journalists still have preconceived notions that HIV is spread only among certain
‘high risk groups’. It gives the wrong notion that those who are not part of these groups
are ‘safe.’ These are personal biases more than facts. The reality is that married
women, for instance, with a single partner are equally vulnerable.
Linkages with other issues related to HIV/AIDS
Very few stories - just 17% - dealt with the association of HIV/AIDS with other issues
such as gender, trafficking, migration and poverty. Just 10% of stories discuss gender
concerns, while 6% analysed its impact on poverty and 4.5% linked it to migration. For
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14 HIV/AIDS in News – Journalists as Catalysts
“Newspapers are already
focussing extensively on
emerging national issues
and HIV/AIDS is seen as
important not just from
the point of view of
health but as a social
issue”
instance, a story in Karnataka’s Vijay Times titled, “Strange bedfellows: Drought and
AIDS,” explored the relationship between the two. However, with most news items being
spot stories, such deeper views were evidently lacking. Nevertheless, as HIV has direct
and indirect consequences on society, it is important for these perspectives to be
reflected in the stories to give an overall understanding of a complicated issue.
CONCLUSION
The study found few stories actually stigmatised or victimised affected people or gave
factually incorrect information. This could be because most stories were ‘passive’ spot
news or events or celebrity statements. At the same time, many experts maintain there
is a sea change in media reporting since the first incidence of the virus was reported
in India in 1986.
In the last couple of years in particular, more stories are being written and they are not all
alarmist. As Mr C H Kiron, managing editor of the Telugu daily Eenadu, says: “Newspapers
are already focussing extensively on emerging national issues and HIV/AIDS is seen as
important not just from the point of view of health but as a social issue.”
The fear created by reporting that was not well-informed is being replaced not only by
more extensive coverage, but by more sensitive reporting. The fact that positive people
are speaking up and many of them don’t mind being photographed has added to the
committed journalists’ understanding of HIV/AIDS.
Celina D’Costa, one of the more articulate, public faces of those who are HIV positive,
said that 12 years ago when her infected husband died and doctors in Goa told her she
was positive, the media carried her picture and story. She was still coping with the
death of her husband when her in-laws threw her out. Their excuse ranged from, “Your
brother-in-law will not be able to get married if you are in this house,” to “Mosquito bites
and shared toilets will lead to others in the family contracting the virus.”
Says Celina: “I wish the media had said something about where I could get medical and
legal assistance.” She did not know that she had the right to live in her house or that she
had the right to confidentiality. The right to information on HIV/AIDS, she says, should be
extended not only to infected people, but to the public at large and in particular the media.
In Kerala, where there was a similar protest against those infected with HIV/AIDS being
buried in the church graveyard, the media reported with greater responsibility. The
report prominently quoted Sister Dolores who founded the Cancer and AIDS Shelter
Society to fight for the rights of infected people. The story also carried a statement of
a representative of the Catholic Bishops Conference of India quoting Mother Teresa: “A
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An Overview 15
person infected or affected with HIV is Jesus among us. The Church won’t discriminate
on the basis of this as it would go against our faith.” It also points out that the Bishops
were finalising a policy on HIV/AIDS that would address the issue of stigma and dis-
crimination. The report says Sister Dolores and others broke down the wall that sepa-
rated the condemned graveyard from the rest of the cemetery.
With more people like Celina speaking up, stories such as the one in The Tribune on
HIV positive people teaching school children about the infection, are doing much to
dispel the negative associations with the virus. An accompanying box item in the story
has messages for the children from positive women - “I have absolutely normal chil-
dren, don’t be scared”, “I would encourage safe sex or no premarital sex”, “HIV peo-
ple lead a healthy life, they do not simply die” “I was detected with HIV at the age of
19, that is the time for enjoying youth, please take good care.”
There are comprehensive websites on HIV/AIDS such as www.youandaids.org, www.heroe-
sprojectindia.org and www.indianngo’s.com. The regional as well as national media have
devoted a section of their websites to HIV/AIDS - for instance those of the Women’s
Feature Service and Hindustan Times. In addition there are regular columns in newspapers
give expert advice on HIV/AIDS. Readers can write in to them to clarify their doubts on the
infection. The weekly column in The Hindustan Times devoted to HIV/AIDS is called ‘safe-
sex’ while a column named ‘Jagadgala’ written by A V Balakrishna Holla in the Kannada
paper Udayavani frequently takes up HIV among other issues discussed. A Kannada news-
paper also reported on a phone-in helpline for those affected. The Government of India’s
National AIDS Control programme is also quite informative (www.naconline.com) and active
at the state and district levels. Also, special media programmes and interactions are reg-
ularly held across the country by the government agencies and their partners.
There are regular
columns in newspapers
giving expert advice on
HIV/AIDS. Readers can
write in to them to
clarify their doubts on
the infection
However, there is definitely scope for improvement in coverage by going beyond the
spot stories and seeing more than the immediate news. The media can use its influ-
ence to demystify or break myths associated with HIV/AIDS. For instance, a Hindi
newspaper carried a small story about villagers in Orissa preventing the cremation of
an infected couple. The report said they were worried that smoke from the pyre would
infect the village. The media should have debunked this belief, as in the story of two
infected children in Tamil Nadu denied school admission. Even while reporting about
misconceptions among the people about HIV/AIDS, the opinions of experts can be
taken to give the correct picture. These provide good opportunities to the media to tell
the public how HIV/AIDS actually spreads. Sensitisation of the media on these issues
can facilitate recognition of such reporting opportunities.
Usha Rai
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16 HIV/AIDS in News – Journalists as Catalysts
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Karnataka 17
HIV/AIDS in News:
Karnataka
THE BACKDROP
Karnataka is one of the six HIV/AIDS high prevalence states in India. According to the
Karnataka State AIDS Programme (KSAP), the prevalence of infection has been about
20% in the high risk group. The state is estimated to have a 1.5% adult infection rate,
with over 5 lakh cases of HIV/AIDS in 2004. There have been 627 deaths reported in
relation to HIV/AIDS since 1987. According to the latest estimates, there are 381 HIV
positive children below 14 years and 418 between 15 and 19 years.
Karnataka has 78 VCCTC centres where 4062 people have been screened as of June
2005. Presently 1216 people are undergoing treatment. The infection has moved
into the general population to the extent that 1.5% of women in antenatal clinics are
HIV positive.
THE STUDY
A media analysis of the coverage and content of HIV/AIDS in Karnataka newspapers
was carried out for the period January to June, 2005. It took place in two parts. For six
months from January to June two Kannada newspapers were scanned - Udayavani and
Vijaya Karnataka. In the final month from May 8 to June 7, a comprehensive scan of all
print media in the state was carried out. This covered 12 daily newspapers in both
English and Kannada and two Kannada magazines. All the papers have either originat-
ed in the state or are national level dailies editions from Bangalore.
Bangalore
During the overall study
period of six months,
167 articles and photo-
graphs related to
HIV/AIDS were identified.
Interestingly, the English
newspapers carried a
greater number of stories
on the issue
During the overall study period of six months, 167 articles and photographs related to
HIV/AIDS were identified. Interestingly, the English newspapers carried a far greater
number of stories on the issue. This is evident from the fact that in the one month
when six newspapers in each language were intensively reviewed, there were 85 arti-
cles in English and just 47 in Kannada. Another 35 articles were identified during the
six-month scan of two Kannada papers.
Findings
With over 70% of the stories comprising spot reports like the launch of the Integrated
Disease Surveillance Project in the state or awareness drives, the survey indicates there
is scope for more in-depth and people-oriented reporting on HIV/AIDS. A growing num-
ber of HIV positive people are willing to declare their status publicly. While both the
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18 HIV/AIDS in News – Journalists as Catalysts
The largest number of
stories was on
awareness-raising
efforts, particularly by
celebrities. The other
topic of media interest
was spread of the
epidemic, including
statistics and data on
the number of infections
Table 1: Number of Publications Tracked for the Study
English
Kannada
The Deccan Herald
Kannada Prabha
The Times of India
Prajavani
The Hindu
Vijaya Karnataka
The New Indian Express
Udayavani
Vijay Times
Samyuktha Karnataka
The Economic Times
Suryodaya
Sudha (Magazine)
Taranga (Magazine)
85 news items
82 news items
* These papers were scanned for a longer period from Jan-June 2005
English and Kannada press have projected them in the correct manner, actively hunting
for more stories of this nature will help to erase the stigma and discrimination they face.
Positioning
Most news items on HIV/AIDS were published in the inside pages of the papers and
12 appeared in supplements. There were 13 items on the front page. These included
a report on infections in the BSF and launch of the Integrated Disease Surveillance
Project in Karnataka. The largest number of stories related to HIV/AIDS was on aware-
ness-raising efforts, particularly by celebrities. The other topic of media interest was
spread of the epidemic, including statistics and data on the number of infections. This
was closely followed by human interest stories on people living with HIV/AIDS. They
were inspirational personal accounts and articles on the rights of HIV positive people,
like stamp scam kingpin Abdul Karim Telgi.
Frame of reference
While the frame of reference of 57% of the stories was national, 41% dealt with the
state-level situation of HIV/AIDS, 38% with the global situation, and 16% and 15%
stories respectively carried community and individual responses to the epidemic. It fol-
lows from this that just 12% of the stories included multiple perspectives of various
parties involved, an indicator of subtle discrimination against those actually affected.
In the Kannada press in particular people’s voices were rarely heard. For instance, an
otherwise well-researched feature in Udayavani examined the social, economic and
legal impact of HIV/AIDS but was devoid of comments from people affected by the
virus. The story was generated entirely through data and the author’s own understand-
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Karnataka 19
ing of the issue. This was the case with another story too in the newspaper that made
a case for ‘A healthy society making for a progressive nation’. It cited American efforts
at handling the epidemic and included the controversy about HIV/AIDS figures but
made no effort to get the perspective of infected persons.
Overt bias
Apart from this, the Karnataka press has very little overt stigma or victimisation of
those affected by HIV/AIDS. Obvious elements of bias were seen in 2.4% of the sto-
ries in the survey. Also, almost all the stories were factually correct in their information
on the virus. While the issue of maintaining confidentiality did not come up in 56% of
the stories, 25% of the remaining proportion of stories did take care not to reveal pub-
licly the identity of people affected by HIV/AIDS while 20% were quite lax in the matter.
Headline and story mismatch
In 16% of the cases the headline did not match the rest of the story, as in an article in
The New Indian Express titled, “NCC cadets to work on HIV front,” and another in
Vijay Times headlined, “Kalam for joint venture to develop anti HIV/AIDS vaccine”. In
both cases news relating to the virus was little more than a one-line mention in the arti-
cle while the headline gave it disproportionate attention. In one case, an article in The
Hindu was titled misleadingly, “HIV infection is more among non-literate pregnant
women.” It made a judgemental association that was in fact not borne out by the copy.
A headline in Samyuktha Karnataka titled, “AIDS making India afraid,” was also mislead-
ing. It was an unnecessary inference, as the story only dealt with the figures of HIV
affected people in different states and said that the numbers are increasing because
of lack of awareness among uneducated people in particular. It was one of the eight
headlines in the Kannada press that did not match the story.
The Karnataka press has
very little overt stigma or
victimisation of those
affected by HIV/AIDS. In
16% of the cases the
headline did not match
the rest of the story
Creating an alarm
Ten per cent of the stories created a sense of alarm about the epidemic, with the
English press having more such cases. An equal proportion of stories had alarmist
headlines. These include, “Community efforts keep dreaded virus at bay,” and
‘HIV/AIDS spreading at an alarming rate in state,” as well as, “Is India sitting on AIDS
time bomb?”.
The tone of most stories (64%) was neutral. A significant section of stories - 25% -
could be classified as positive. These include personal accounts of affected women
overcoming prejudice. About eight per cent of the stories did have a negative tone. A
number of stories blamed the spread of the virus on sex workers and truck drivers (3%
each), classified as the most high-risk groups and reservoirs of infection. A small pro-
portion of stories associated the virus with extramarital sex and multiple partners
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20 HIV/AIDS in News – Journalists as Catalysts
(8.4% and 7.8%). Such stories project a lopsided view of the spread of the epidemic
and also cause stigma against affected persons who are perceived to have engaged in
certain forms of behaviour. It was felt that 14.4% of the stories used terminology that
could add to stigma and discrimination.
Namakkal district’s eligi-
ble couples ask for their
potential partner’s HIV
status before marriage.
The article mentions that
nearly 7% of the town’s
population is HIV positive
and indicates that the
virus is an issue of
concern for all
Spread and linkages
Twenty-seven per cent of the stories accurately reflected spread of the epidemic into
the general population. These include a slew of stories on a campaign by television
actress Mandira Bedi to highlight married women’s vulnerability to the epidemic and
another in The New Indian Express on Namakkal district’s eligible couples ask for their
potential partner’s HIV status before marriage. Reflecting generalisation of the epidem-
ic, the article mentions that nearly seven per cent of the town’s population is HIV pos-
itive and indicates that the virus is an issue of concern for all.
Regarding linkages of HIV/AIDS with a wider spectrum of issues, 11% of the stories
linked it to gender, and very few spoke of its connection with poverty, employment and
migration. These included an article in Vijay Times titled, ‘Strange Bedfellows - Drought
and AIDS,’ that brought out the relationship between the two seemingly unrelated
issues and the pressures it imposed on women.
COMPARISON OF REGIONAL LANGUAGE AND ENGLISH MEDIA
The analysis also showed up interesting similarities and variations between the English
language and regional press. In both cases, events made for easy and routine cover-
age. The release of a music video on HIV/AIDS by the organisation ‘Breakthrough’ that
featured Mandira Bedi received extensive attention over several days. Similarly, a can-
dlelight march in memory of infected people who died was reported in a routine man-
ner in all the papers. Nevertheless, some of the news items on the launch of the music
video sought to highlight married women’s vulnerability to the infection.
Statistics were of major media interest, as the extensive coverage of the controversy
related to NACO figures of new infections showed. Some of these stories in the English
media were well-researched and used the opportunity to bring out in unusual ways the
various dimensions of the epidemic. Though the reports were based on data, they car-
ried more than just figures and showed how reporting could go beyond the immediate
event or press conference. For instance, the stories brought out how the epidemic criss-
crossed rural and urban areas and highlighted preventive efforts in a state like Tamil
Nadu that has succeeded in reducing its infection level.
While the Kannada media carried the data released by NACO and also the counter claim
by Robert Feacham of the Global Trust Fund, it made no attempt to analyse the contra-
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Karnataka 21
dictory data or put HIV/AIDS related issues in perspective.
The absence of follow-up effort was reflected by the Kannada media in particular as
it did not take the opportunity to explore the many social or economic dimensions of
HIV/AIDS, leaving wide gaps. For instance, a news item in Vijay Karnataka on the
death of a prisoner “from HIV/AIDS” made no further attempt to find out if he was
given adequate care and attention or if other rights of the prisoner were violated.
Similarly, two news reports in Udayavani on suicides by people infected with
HIV/AIDS received routine coverage that was in fact sensational. There was no effort
to balance the negativity of the tragedy with any form of hope-giving message.
Two small reports in Suryodaya and Vijay Karnataka on the incidence of HIV/AIDS in the
police force and BSF made no attempt again to investigate this issue further. Similarly,
though there were reports on government efforts to initiate laws to address discrimina-
tion at various levels, no attempt was made to explore these initiatives further or find
out at what stage of readiness they are.
The survey highlighted that celebrities associated with HIV/AIDS were big newsmakers
for the English press in particular. Former American president Bill Clinton’s visit to India
on HIV/AIDS work was a major news event. Mandira Bedi and Samir Soni’s association
with an awareness campaign was an attention-grabber. Bill Gates comments in Geneva
on the epidemic also made news. Miss Universe pledging support and money to
HIV/AIDS was covered widely by English newspapers. Another well-known person, the
stamp scam kingpin Abdul Karim Telgi, stayed in the news in the English media because
of his HIV status.
The absence of follow-up
effort was reflected by
the Kannada media in
particular as it did not
take the opportunity to
explore the many social
or economic dimensions
of HIV/AIDS
In the Kannada press however, it was not on the same scale. Bill Clinton’s visit and
Mandira Bedi and Samir Soni’s association with the awareness campaign received com-
paratively less attention. The Miss India contest was not even covered by the regional
papers, but for a single mention in connection with HIV/AIDS. Just a colour photo was
used, without an accompanying report. The Kannada media also did not make much of
Telgi’s HIV positive status. It was mentioned only once in connection with the offer of help
from an NGO. Interestingly, in comparison, statements made by politicians had more of an
impact on the regional language press. The launch of the Integrated Disease Surveillance
Project in Karnataka received extensive coverage (8 items) in Kannada newspapers. There
were also large photographs accompanying the reports. However, in these articles
HIV/AIDS was mentioned only in passing as part of a larger health effort.
Exceptions to the routine coverage included two well-researched feature stories by
The Hindu which were prominently placed in its weekend supplement. Titled, “An
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22 HIV/AIDS in News – Journalists as Catalysts
A full-page feature in The
Economic Times accom-
panied by photographs,
messages and graphics
examined the HIV/AIDS
epidemic as the coun-
try’s next human
resource issue
Inspiration, a hope” and “Live Positive”, the features were accompanied by colour pho-
tographs of HIV positive women who had been interviewed and came out openly about
their experiences. Another notable article was a full-page feature in The Economic Times
accompanied by photographs, messages and graphics. It examined the HIV/AIDS epi-
demic as the country’s next human resource issue. A selection of four different articles
that focussed on this theme and attractive graphics made it compelling reading.
Several newspapers in both languages carried prominently reports on the new trend of
declaring one’s HIV status before marriage.
Reportage on the impact of HIV/AIDS in rural areas was scant in both languages. One
such article in The Deccan Herald, titled ‘Community efforts keep dreaded virus at bay’,
did deal with the spread of the epidemic in villages. Though the headline projects an
alarmist image, the story was a positive account of village elders taking the initiative in
educating the youth on safe sex. Most of the coverage in Kannada appears to have
been generated from handouts, such as two stories on a seminar for HIV positive peo-
ple in Mangalore district.
Gender issues
Women and their concerns in dealing with HIV/AIDS were largely missing from the
news, unless it was a feature on HIV positive women’s accounts. Other than this, the
gender perspective has been excluded from all other coverage by the print media.
Tone
The language used was neutral on the whole. It was not disturbing though a few sto-
ries used terminology with insinuations. For instance, terms like naraka yatane were
used twice in the Kannada papers even when the story was positive. Though none of
the reports were disproportionately alarming, the figures reflected the reality of the
spread of the infection. There were references in both categories of the media to the
AIDS scare/deadly disease/tide of the epidemic/the virus continues to ride/dreaded
disease/patients/scourge. Other panic-causing terms included ‘time bomb’,
‘killer/deadly/fatal disease’ and ‘AIDS is making India shiver.’
Most of the photographs were related to events, such as the one accompanying the
candlelight memorial day to honour infected persons who died and photographs relat-
ing to Miss Universe. A notable variation was the photo-only news item in The Deccan
Herald of an infected Mizoram couple with the caption linking their personal story to the
HIV/AIDS situation in the state. Features on the lives of positive women describing
their experiences were accompanied by prominent photographs of them. The photo-
graph in the New Indian Express of a sand-sculpture of skulls as part of an HIV/AIDS
awareness campaign was disturbing. It created fear and unease that could result in dis-
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Karnataka 23
criminatory behaviour with HIV positive people. Similarly, a photo caption in The Deccan
Herald on the ‘Breakthrough’ campaign was negatively titled, “Targeting a scourge.” A
better alternative, for instance, was the headline to the same story in The Hindu - “Do
you care for your sweetheart?”
Graphics also need to be used with care. The one accompanying an article in Udayavani
depicts skulls, an alarmist imagery giving rise to fear against HIV/AIDS. The Kannada media
however, made little use of photographs. Those carried were of celebrities or politicians.
CONCLUSION
The absence of readers’ feedback in the form of Letters to the Editor or articles relat-
ing to HIV/AIDS – except for one in Vijay Karnataka – indicates a general lack of public
involvement in the media coverage of HIV/AIDS. Four editorials were carried by the
English press, while there were none in the Kannada press.
Several items in the Kannada press featured dubious claims such as cow urine as a
possible cure for HIV/AIDS, without adequate supporting data. News of this nature
needs to be reported with care and caution. There were also several small news releas-
es on camps held regularly in various parts of the state to cure ‘diseases’ such as
HIV/AIDS. Again, these news items have been carried by the newspapers without veri-
fying the veracity of such claims. Stories and advertisements on “cures” for HIV/AIDS
need to be cross-checked by experts before being published. In fact they need to be
debunked so that gullible readers are not misled.
Several items in the
Kannada press featured
dubious claims such as
cow-urine as a possible
cure for HIV/AIDS, with-
out adequate supporting
data. News of this nature
needs to be reported
with care and caution
There was no coverage relating to HIV/AIDS in the two magazines scanned in
May/June. Magazines have an extended shelf life as compared to newspapers and this
opportunity needs to be exploited.
Nevertheless, the language media in Karnataka merits special mention for some of its
initiatives in covering the issue. These include:
A regular column in Udayavani that emphasises the efforts to stem the spread of
HIV/AIDS.
An investigative report in Vijay Times on the negligent and indifferent treatment
meted out to visitors at a Voluntary Counselling and Confidential Treatment Centre
(VCCTC) at a hospital in Bellary.
A feature story in Vijaya Karnataka giving comprehensive information on a helpline
established by the Asha Foundation for those affected by HIV/AIDS. The story was
well written, gave a lot of information on the issue, used the Red Ribbon logo to
highlight the topic and supplied the helpline numbers.
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24 HIV/AIDS in News – Journalists as Catalysts
A small report in
Suryodaya on the
incidence of HIV/AIDS
among BSF soldiers
appeared on the front
page. The infections
are played up in a
manner that indirectly
stigmatises the
entire force
Stigma and Discrimination
Despite such heartening developments, the subtext of media reports reveals stigma
and discrimination in overt and covert forms. The orientation and slant of some sto-
ries gives a mixed message. This could indirectly lead to the marginalisation, exclu-
sion or discrimination of affected groups who could feel a sense of shame, discred-
it and psychological trauma.
Most reports are passive and seemingly neutral, but the language used in some
cases is negative and loaded. For instance, there are some articles that carry head-
lines which blame a particular segment of society. The headline of a prominently
placed, long article in The Hindu, ‘HIV infection is more among non-literate pregnant
women,’ clearly blames this group for being carriers of the virus. Moreover, the head-
line is misleading as the article deals with the fact that the low literacy levels of
many of those affected needs to be addressed by designing different approaches to
HIV/AIDS prevention. The spin-off effect of such a headline is that it could lead to
stigma and discrimination of the “non-literate pregnant woman”.
A report in The New Indian Express states: “Of the 1,300 persons registered with
ARV therapy centres in the state, the majority are men, mostly those who had been
working in other states. Many belong to the middle class and lower middle class.”
This again could convey the impression that the virus is present only among a cer-
tain segment of society and those who are migrants. The reality however is that the
epidemic can be found across all classes of people. In yet another case, the head-
line reads, ‘Men continue to be in high risk group.’ The article on drought and
HIV/AIDS in Vijay Times points to families facing poverty but has an extremely nega-
tive and judgemental statement saying women are resorting “to prostitution as an
easier way of making money rather than working in a legitimate manner.”
In the Kannada press, a small report in Suryodaya on the incidence of HIV/AIDS among
BSF soldiers appeared on the front page. It stated that 98 of the two lakh soldiers are
affected by the virus. The infections are played up in a manner that indirectly stigmatis-
es the entire force. There is no other qualifying statement or balancing opinion. Another
news item in Suryodaya that pointed to a particular segment of people as carriers of the
virus related to the Mumbai police. Carried prominently in the central section of the
newspaper, it was based on the growing number of infections in the Mumbai police and
that the affected men are allowed to avail of medicines from police hospitals.
A small report in Vijaya Karnataka reveals the research findings that Indians and
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Karnataka 25
blacks in South Africa are more prone to HIV/AIDS and that they are not ready to
accept this fact. The report does not explain the reasons why these communities are
more prone or the wider findings of the study.
On the other hand, there are stories that go a long way in reducing prejudice. A report
in The Hindu refers to the, “success of networks formed by HIV-infected people.
These networks helped in lobbying government for better access to medicines and
mobilising popular support for the battle against stigma and discrimination. ....It was
only in 2003 that NACO started seeing the networks formed by HIV-infected people
as partners in the fight against stigma and discrimination and in the task of provid-
ing relevant information to the needy.”
Another positive story in The Hindu on an awareness-raising campaign includes use-
ful information on transmission and modes of prevention. By repeatedly conveying
such facts, the media can break myths about the mode of spread of the virus and
thereby, discriminatory treatment of infected persons.
The coverage on Telgi by The Times of India and Vijay Times brings out the impor-
tant issue of human rights of positive people as well as their constitutional rights.
The reports highlight that as an infected person he was being meted discriminato-
ry treatment and kept in solitary confinement in contravention of the Supreme
Court ruling on the matter.
Interesting reports in The Times of India and The New Indian Express draw attention to the
new custom of asking would-be grooms to produce an all-clear signal on the HIV/AIDS
front. One of the reports even goes on to warn: “There is a flip side - there are cases
where the alliance has been called off after the family of the girl or the boy sought such
a certificate. The stigma attached to AIDS as a sexually transmitted disease still pre-
vails.” Even an editorial was carried on the benefits and impact of such new social norms.
Another report in The New Indian Express headlined, ‘Now in matrimonial columns: HIV
status,’ goes on to say, “Being HIV positive is not as much taboo as it was earlier.”
Noteworthy is the willingness of HIV-positive people to come out about their status.
The Hindu and The Deccan Herald have carried first-hand accounts of HIV positive
people leading lives in a wholesome manner, (“I’m HIV positive...if I can lead a nor-
mal life, so can you”) bringing out the need for better understanding and sensitivity
by society. The features are accompanied by prominent photographs of cheerful
women who do not feel the need to hide their positive status.
There are stories that go
a long way in reducing
prejudice. Networks
formed by HIV-infected
people helped in lobbying
with the government for
better access to
medicines and mobilising
popular support for the
battle against stigma and
discrimination
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26 HIV/AIDS in News – Journalists as Catalysts
Vijaya Karnataka also carried a small announcement of an innovative phone-in pro-
gramme by Akashvani addressing queries on preventing parent to child transmis-
sion of the virus. However, the headline did not indicate the nature of the pro-
gramme, which might have resulted in a lesser number of people tuning in to the
programme.
There was an inspirational story in Vijaya Karnataka about a girl named Asha who
discovered she was HIV positive within months of her marriage and was now work-
ing with an NGO to help other infected people. The story conveyed hope and was
well done.
Human interest stories,
done properly, make
interesting reading and
are able to provide a
face to the numbers
issue. The accounts of
infected people living pro-
ductive lives convey a
hopeful approach in a
scenario that is other-
wise considered bleak
OVERALL COMMENTS & RECOMMENDATIONS
The survey reveals that the coverage of HIV/AIDS issues is not of high priority in the
Karnataka media. The reporting is scanty and sporadic. While one may take comfort in
the growing number of stories on the subject, yet most are passive, spot reports that
are fairly simplistic and of a routine nature. Qualitative/opinion making/advocacy relat-
ed coverage is limited.
Human interest stories, done properly, make interesting reading and are able to pro-
vide a face to the numbers issue. The accounts of infected people living productive
lives convey a hopeful approach in a scenario that is otherwise considered bleak.
The focus of coverage needs to be on ‘what next’ and not on ‘how’ the virus was
contracted.
Most news reports look at HIV/AIDS in isolation, without any supporting assess-
ment of the quality of life of those affected. It could in fact be integrated into the
general coverage by newspapers on health and quality of life. There was only one
such article, in the Kannada daily Udayavani.
News events or stories that have scope for more detailed inquiry into the various
dimensions of the epidemic were seldom exploited. These need to be followed up
and developed.
The publishing of so-called “cures” for HIV/AIDS needs to be critically explored.
Such items need to be verified and cross-checked, not treated as any other product.
There was no sharing of information on HIV/AIDS between sister-publications, such
as The Deccan Herald and Prajavani.
Cartoons or health capsules are a rich source to inform and raise awareness.
However, there was not a single cartoon or health capsule which focussed on
HIV/AIDS during the survey period.
The red ribbon logo associated with HIV/AIDS attracts the eye wherever it has been
used and needs to be encouraged.
While it is necessary to report cases of suicides and murders of people living with
HIV/AIDS, these also provide the opportunity for social-interest messages to be car-
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Karnataka 27
ried along with the story. This could be in the form of mandatory information carry-
ing helpline numbers or the contacts of VCCTCs, or even messages conveying hope.
There was no attempt to do this in any of the stories in Kannada in particular.
An exposure programme for editors, stringers and local journalists needs to be con-
ducted to strengthen media awareness at the grassroots. It is only when a basic
understanding is achieved of a very complex issue, that an understanding of stig-
ma and discrimination can be attempted. For instance, journalists can be oriented
on the use of appropriate non-discriminatory language and terminology related to
HIV/AIDS. However, concerns about use of discriminatory language and about sub-
tle stigmatising messages sent out by stories require a sound base understanding
by the media of HIV/AIDS and its significance.
Shangon Dasgupta
(Director, Communication for Development and Learning, Bangalore)
An exposure programme
for editors, stringers and
local journalists needs to
be conducted to
strengthen media
awareness at the grass-
roots. Journalists can be
oriented on the use of
appropriate non-
discriminatory language
and terminology related
to HIV/AIDS
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28 HIV/AIDS in News – Journalists as Catalysts
Chandigarh
Punjab has large sec-
tions of population that
are constantly on the
move. Away from their
families for long periods,
these groups make the
state at high risk to the
infection
HIV/AIDS in News:
Punjab
THE BACKDROP
Punjab is not a high HIV/AIDS prevalence state but it is an extremely vulnerable one.
According to official data collected till April 2005, there are 2034 people in Punjab who
are HIV positive and another 334 people diagnosed with AIDS. There have been 92
virus-related deaths. HIV testing facilities exist in 17 district hospitals and in the four
medical colleges of the state.
Punjab has large sections of population that are constantly on the move. Away from fam-
ilies for long periods, these groups make the state at high risk to the infection. Not only
does Punjab have a large number of transport sector workers such as truck drivers who
travel all over the country, a sizeable section of its population is in the defence services.
There is a large and mobile business class and also rural youth seeking employment in
other parts of the country as well as abroad. In addition, for some time past Bangladeshis
wanting to go to Pakistan have been passing through Punjab. They are all part of the
state’s shifting population, including its large migrant agricultural workforce.
Another small but growing group is that of terrorists who have either come from
Pakistan or visited it. An increasing area of concern is Punjab’s notoriously unequal sex
ratio that has led to young men looking for and even buying brides from other regions.
The state’s prosperity has also seen a boom in commercial sex work. A very serious
problem in the state is its massive substance abuse which again puts many people at
risk of acquiring the infection.
THE STUDY
To examine how the English and regional language print media in Punjab has been cov-
ering the issue, a survey was carried out. Four newspapers each in English, Hindi and
Punjabi respectively and one in Urdu newspaper were scanned. The study period cov-
ered one month of intensive scanning for all 13 newspapers from May 8-June 10,
2005. In addition, a Punjabi and Hindi newspaper were selected to be scanned for a
longer period for six months from January onwards to gain a fuller understanding of the
influential language press. In all, 111 stories on HIV/AIDS in all publications tracked
were analysed for this study.
From the findings of the six-month survey it was evident that the English press led in
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Punjab 29
Table 1: Newspapers Analysed and Number of Stories
on HIV/AIDS
English
Punjabi
Urdu
(Chandigarh editions)
Hindi
The Tribune
The Indian Express
Hindustan Times
The Times of India
Jagbani
(Jalandhar)
Ajit
(Jalandhar)
Punjabi Tribune*
(Chandigarh)
Desh Sewak
(Chandigarh)
Hind Samachar
(Jalandhar)
Punjab Kesri*
(Jalandhar)
Dainik Ajit
(Jalandhar)
Dainik Bhaskar
(Chandigarh)
Amar Ujala
(Chandigarh)
No. of Stories – 79 No. of Stories – 9 No. of Stories – 3 No. of Stories – 20
* These newspapers were scanned for HIV/AIDS stories from January onwards
the publication of HIV/AIDS related news, features and editorials as it had carried 79
of the total identified news items. This forms a huge 71% of the coverage on the
issue. Hindi papers were next with 20 news items on the subject comprising 18% of
the coverage. This was followed by the Punjabi media that had nine news items form-
ing eight per cent of the overall reportage. The Urdu press had just three items rep-
resenting three per cent of the coverage.
The maximum number of stories (28%) was carried by the English edition of The Tribune
published from Chandigarh, followed by The Times of India (Chandigarh) 19%,
Hindustan Times (Chandigarh) 16% and The Indian Express with 8% of the stories.
Punjab Kesri led in the language newspapers with 7.2% of the stories on HIV/AIDS,
while Dainik Bhaskar and The Tribune in Punjabi had 6.3% respectively.
A majority of the news
items on HIV/AIDS (44%)
were of national complex-
ion, such as release of
all-India figures by NACO
and celebrity endorse-
ment drives like the
release of a music album
by TV actors Mandira
Bedi and Samir Soni
Nearly 40% of the stories were accompanied with photographs or other visuals. They
were largely well displayed, most of them being given two columns or more of space.
However, only four per cent of the stories were on the front page.
A majority of the news items on HIV/AIDS (44%) were of national complexion, such
as release of all-India figures by NACO and celebrity endorsement drives like the
release of a music album by Mandira Bedi and Samir Soni, 35% stories were of state
level such as reports of an incident in Ludhiana in which a pregnant woman received
infected blood from a private nursing home, and 15% were global in nature. Just 15%
and 11% stories included individual perspectives and community concerns.
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30 HIV/AIDS in News – Journalists as Catalysts
The press here has
begun noticing the epi-
demic, but confines it to
the observation of spot
reports of events, semi-
nars, workshops, press
conferences and occa-
sional public statements
of people living with
HIV/AIDS
The subject of these stories related to treatment and care of those affected by the virus
in 61% items, spread of the epidemic in 34% cases and 14% dealt with medical
research. Only six per cent items referred to stigma against those affected by HIV/AIDS,
such as a story from Kerala on the controversy over opposition to infected persons being
buried in a church graveyard, and 15% were alarmist in nature. About 20% stories also
had alarmist headlines. These include a story titled, “AIDS more dangerous for Assam
Rifles than Rebels,” and another titled, “All Punjab cops told to take AIDS test.” An impor-
tant finding is that about 49% stories had a positive impact, such as a report on local
folk theatre in Mandi, Himachal Pradesh being used as an unusual awareness creating
tool and several inspiring reports on the life histories of HIV positive women. Twenty five
per cent stories had a negative complexion such as the report of a dubious so-called
‘AIDS cure’ while 28% were neutral. The latter included a slew of stories on the inaugu-
ration of a Care Centre for infected people by the Administrator of the Union Territory.
Some stories seemed to blame a particular section of society for spreading the virus.
Nineteen per cent stories blamed women and sex workers, such as a story from
Chandigarh titled, “Commercial sex workaron ke jaal mein phansi jawani,” 12% blamed
injecting drug users and 4 per cent attributed the virus to truck drivers. Related to this
are the few stories that associated HIV/AIDS with specific behaviour in a judgemental
manner — nine per cent linked it to extra-marital behaviour through statements warn-
ing truck drivers for instance against such relationships and three per cent to crime,
such as the acid attack story and the one on an attempt to rob HIV positive blood.
Another level of analysis revealed that some stories did look at HIV/AIDS in a holistic
manner in relation to its impact on gender issue (13%), migration (3%) and human
trafficking (3%).
The study makes it clear that the press here has begun noticing the epidemic, but con-
fines it to the observation of spot reports of events, seminars, workshops, press con-
ferences and occasional public statements of people living with HIV/AIDS. At first
glance, it may appear that the press has been quite accommodating in covering the
subject. But it has a long way to go before complex issues of socio-economic and med-
ical nature are handled.
COMPOSITION OF PUNJAB PRESS AND ITS IMPLICATIONS
Of relevance is the particular composition and nature of the Punjab press. The
Punjab media can be divided into three categories. One is the English language
national newspapers headquartered outside Punjab but which have started publish-
ing from this region, like Hindustan Times, The Times of India and The Indian Express.
These papers reflect the policies and attitudes of their parent editions though with
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Punjab 31
some regional variation. They are published mostly from the state capital Chandigarh
and Jalandhar, an old centre to which newspapers displaced from Lahore shifted
after Partition. Quite a few opinion-making sections of Punjab population are fond of
English papers published from outside the state, such as The Hindu, The Telegraph
and The Asian Age.
The second category comprises Hindi newspapers that were established outside Punjab
but bring out editions from the state, like Dainik Bhaskar, Dainik Jagran and Amar Ujala.
The third category is newspapers of regional origin that are published in Punjabi,
Hindi and Urdu. These include The Tribune, Punjab Kesri, Ajit, Desh Sewak, Nawan
Zamana, Jagbani, Hind Samachar and several other smaller papers. These regional
papers are more traditional, conservative and local-oriented. The Tribune, in fact, can
be taken as a category by itself. It has editions in English, Hindi and Punjabi. The
paper tries to maintain its original regional character but takes note of national and
global news trends.
Interestingly, the English and Hindi newspapers form the dominating influence, with
Punjabi papers coming next. Earlier, the Urdu papers had been most influential, but
all of them started Hindi or Punjabi editions after shifting from Lahore. The Tribune,
that originally started publishing in English, came out with its Hindi and Punjabi edi-
tions much later.
The English and Hindi
newspapers form the
dominating influence,
with Punjabi papers com-
ing next. Earlier, the Urdu
papers had been most
influential
Looking at coverage of HIV/AIDS in these distinct groups, it is clear that the English
press is active in publishing news of the issue including some analytical articles and
those on medical research. However, the Hindi and Punjabi papers of regional origin
have yet to take serious notice of the subject. Hardly any space is spared for news or
features related to HIV/AIDS. Some papers bring out weekly or occasional one page
supplements on health but these are devoted to handling heart disease, asthma, eye
problems, digestive disorders, women’s ailments and even cancer among others. There
is rarely anything on HIV/ AIDS.
While the English newspapers do give space to items concerning awareness and pre-
ventive efforts, HIV/AIDS stories that qualify for publication in the regional language
press are mostly those that have an unusual human-interest element. The stories that
the Hindi and Punjabi language press seems to welcome are of a beauty pageant of
HIV positive women even though in distant Kathmandu, the visit of HIV positive women
from South India who openly talked of their personal experiences and stories on mari-
tal disputes arising out of the situation.
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32 HIV/AIDS in News – Journalists as Catalysts
Much of the media indif-
ference in Punjab is
because there is little
awareness of the imme-
diacy of the epidemic. It
is not viewed as prevail-
ing in the state in any
significant manner to
warrant urgent attention
The Urdu press seems interested only if in its opinion there is an angle that is likely to
interest its particular readership. For instance, it completely overlooked several signifi-
cant news stories relating to HIV/AIDS that broke during the survey period, such as
release of national HIV/AIDS figures and the controversy that followed. But it used
advice by actress Mandira Bedi on HIV/AIDS, a visit to Kolkata by Pakistani sex work-
ers who discussed with their counterparts the need for greater awareness about the
virus and carried a wildly exaggerated feature on the development of a condom with a
microchip to prevent the HIV/AIDS infection.
SUMMING UP
Much of this media indifference in Punjab is because there is little awareness of the
immediacy of the epidemic. It is not viewed as prevailing in the state in any significant
manner to warrant urgent attention. The study clearly shows that a story on HIV/AIDS
will be accommodated if it is easily available, otherwise the press is unlikely to search
for stories or even investigate the ones discovered from time to time.
A glaring example is the media coverage of the visit to Chandigarh by a group of HIV
positive women from South India to create greater awareness by recounting their expe-
riences. The women came out with relevant and useful information that provided the
human interest copy. The event received wide coverage, with several newspapers inter-
viewing the women and their views and photographs received ample space. These were
stories of brave women who overcame difficult emotional, physical and economic situ-
ations. Some of them faced social discrimination and stigma.
Though several media persons acknowledged that these stories were both inspir-
ing and readable, none tried to look for similar examples in the state itself. There
are bound to be stories of social discrimination and stigma in Punjab too and the
struggle of people living with HIV/AIDS to overcome this. Most of the time howev-
er, the media is satisfied with reproducing official handouts or reporting ‘spot sto-
ries’ of personal experiences. These include the reports of a woman in
Nawanshahar district who claimed to have been duped into marrying an HIV posi-
tive man or the story from Ludhiana of a pregnant woman being given an infected
blood transfusion.
All these stories have been handled as straightforward crime reportage. A number of
newspapers reported in detail over a period of time developments in the incident of the
couple who filed criminal charges against each other after the woman suffered an acid
attack. She claimed that her estranged husband had retaliated after she left him on
finding out that he had concealed his HIV positive status from her at the time of mar-
riage. There was no attempt to investigate the background to the story or raise issues
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Punjab 33
such as the rights of the partner of an infected person. No one was wiser after read-
ing the spate of stories on the incident.
Again, a story on ‘safai karamcharis’ or cleaning staff in Amritsar being exposed to the
HIV infection due to unsafe handling of medical waste was half-baked, carrying incom-
plete information.
While the language used in reporting is largely innocuous, this could be because most
stories are routine and based on handouts or picked up from wires services. Another
observation of the survey is that a large number of stories in the English media origi-
nate outside Punjab. Not only are few stories from the state written with flair and
panache, local journalists also need to look for more stories from the region.
The reason for the regional language media in particular turning a blind eye to the epi-
demic may lie in the conservative nature of this section of the press and its hesitation
to discuss this delicate issue. For instance, while there have been several detailed and
well displayed reports about people coping with the infection contracted from suspect-
ed blood transfusion as in the case of the pregnant woman in Ludhiana, stories relat-
ing to issues such as alternate sexuality, extra marital relationships and drug addiction
are completely avoided. While it is known that the reality of drug addiction is a massive
problem, the various aspects of the epidemic spreading among injecting drug users are
almost never addressed. Again, a very large number of truck drivers originating from
Punjab ply all over the country. Instead of taking up issues relating to them the press
seems rather to turn a blind eye to such matters.
The reason for the
regional language media
in particular turning a
blind eye to the epidemic
may lie in the conserva-
tive nature of this sec-
tion of the press and its
hesitation to discuss this
delicate issue
While generally the worst that can be said about the Punjab media’s coverage is its lack
of interest in the issue, stories that fuel stigma and discrimination against people
affected by the virus are few unlike in other states. However, these need to be pointed
out. For example the story in Amar Ujala blames ‘loose’ women such as commercial
sex workers for spreading the virus among middle class youngsters even while absolv-
ing the men who are their willing clients.
The article has a bullet point saying, “Prostitution has spread even in the city’s prosper-
ous localities.” In the worst display of class consciousness, it reports on Chandigarh’s
well-off ‘Sectors’ too being in the grip of a vice that makes them vulnerable to the
HIV/AIDS infection. Such reporting links the virus with the poor and those segments that
are of ‘bad character’. The article associates HIV/AIDS as an infection of the ‘others’,
implying that the rich are morally pure and therefore generally immune to it.
Another story that ostracises an entire community is the one headlined, “Safai sewaks
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34 HIV/AIDS in News – Journalists as Catalysts
found HIV positive.’ Two others say that AIDS has felled more men in the Assam Rifles
than the enemy and all Punjab cops being made to test for HIV/AIDS. Not only are
these stories misleading as they do not highlight the fact that only a few people in each
of these groups have been found infected, but opportunities to raise several pertinent
issues associated with the virus are not taken up. These stories could have looked at
the individual’s right of granting consent before being tested for the virus and if the
infected persons’ rights to confidentiality and fair treatment by employers was being
met or not.
What needs to be
addressed is the media’s
lack of urgency about the
state’s HIV/AIDS situa-
tion and its many impli-
cations
It is also common for almost all stories to use terms like “AIDS patients’ to describe
HIV positive persons whether they are sick or not, use the ostracising Punjabi word
‘kauda’ or leper to describe an infected person and say ‘AIDS ka danav’ or AIDS ka
demon’ and ‘viral tsunami’ to point out the threat of the virus. Such terminology adds
to the fear and horror against HIV/AIDS, a feeling that can be imperceptibly transferred
by some readers to those affected by the virus and influence interactions with them.
However, this can be dealt with by proper motivation and orientation of media-persons.
This is evident in the recent performance of the English edition of The Tribune. The
quantity and quality of its coverage on HIV/AIDS has greatly improved in the past few
months with a shift in news focus, direction from top personnel and extra effort at the
reporting level. Unfortunately, the Hindi and Punjabi editions of the paper do not reflect
the same concern.
RECOMMENDATIONS
Routine stories based on speeches, statements and press conferences are not cre-
ating an impact. To be noticed, more features and human interest stories must be
attempted. What needs to be addressed is the media’s lack of urgency about the
state’s HIV/AIDS situation and its many implications.
The press can add weight to its stories on HIV/AIDS by taking the comments of
public figures such as social activists, spiritual leaders, filmstars and even politi-
cians.
As far as possible, editorial matter needs to be related to familiar local situations.
Even stories emanating from distant places can be reoriented to inject a familiar
flavour.
There is scope for information-based educative news on HIV/AIDS but it needs to
be presented in a more interesting manner. This calls for more research-effort and
gathering of background material not only by journalists but also by NGO’s and offi-
cial agencies involved.
Media persons must be motivated enough to chase more stories on HIV/AIDS and
consider the issue of significant importance. Media organisations could even con-
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Punjab 35
sider assigning the work to its specialised staff.
Instead of mere reporting, a pro-active approach is necessary. More investigative
and interpretative stories need to be attempted. A special effort needs to be made
to explore elements of stigma and discrimination in stories concerning persons liv-
ing with HIV/AIDS.
The media must be vigilant that its reporting does not give rise overtly or covertly
to stigma and discrimination against those affected.
There is scope for more editorials to be written on the subject.
The eye-catching symbol of the Red Ribbon that symbolises HIV/AIDS should be
used more often with the stories.
A training programme for the media should include building of awareness, take into
account motivation levels for covering such stories, help in identifying sources of
information and look at the manner of treatment of HIV/AIDS stories.
Prem Kumar
Former resident editor, The Indian Express, Chandigarh
There is scope for more
editorials to be written
on the subject. The eye-
catching symbol of the
Red Ribbon that symbol-
ises HIV/AIDS should be
used more often with the
stories
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36 HIV/AIDS in News – Journalists as Catalysts
Lucknow
Uttar Pradesh’s large
migrant population and
low levels of healthcare
make it particularly prone
to the epidemic.
However, the epidemic is
low in visibility
HIV/AIDS in News:
Uttar Pradesh
THE BACKDROP
Uttar Pradesh, the country’s most populous state, is a highly vulnerable region with
regard to spread of the HIV/AIDS virus. Its large migrant population and low levels
of healthcare make it particularly prone to the epidemic. However, the epidemic is
low in visibility here, recording 1.4% of the total number of HIV/AIDS cases report-
ed from across the country. In 2004, UP had 10,896 people infected with HIV/AIDS.
The prevalence rate is 0.8% in groups considered high-risk and 0.23% in the rest.
Districts with high levels of infection include Varanasi, Allahabad, Lucknow, Agra and
Gorakhpur.
THE STUDY
A content analysis of the coverage of HIV/AIDS by newspapers published from UP was
carried out from January 1–June 8, 2005, in two parts. For the first five months of the
survey from January to May, two Hindi dailies, Dainik Jagran and Hindustan, were con-
sidered. For a month from May 8–June 10, 2005, an intensive scan was carried out of
all major print media in the state. This included 13 newspapers and a weekly. All of
them have either originated from the state or are national papers with editions from
Lucknow. The study revealed that a total of 165 articles related to HIV/AIDS were pub-
lished in the print media during this period.
Table 1: List of UP Newspapers Tracked
Hindi
Aaj
Rashtriya Swaroop
Sahara Samay
(Weekly newspaper)
Swatantra Bharat
Amar Ujala
Hindustan
Dainik Jagran
Jansatta Express
Rashtriya Sahara
126 news items
English
The Pioneer
The Times of India
Hindustan Times
Urdu
Apna Akhbar
The Indian Express
36 news items
3 news items
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Uttar Pradesh 37
Findings
The analysis of HIV/AIDS reportage shows that the issue has high visibility with a
large number of stories published. Except for a single day, stories on the subject
appeared on all the other days of the month-long intensive analysis. The coverage
peaked to as many as 14 articles on one particular day. An average of 3-4 articles
appeared daily.
Of the 165 articles, 119, or 72 per cent, were news stories, 28, or 17 per cent, were
features and four were editorials. Fifty-three stories had accompanying photographs
while 11 items were only photographs. Most stories (85%) were placed on the inside
pages, with seven stories appearing on the front page. Eleven stories were published
in newspaper supplements.
The maximum number of stories appeared on May 27 and 28, (13 and 14 articles
respectively) on the following issues:
Bill Clinton’s visit – 6 articles.
Union Government’s report of reduction in HIV infection rate – 4 articles.
An HIV/AIDS clinical workshop organised by CII in Lucknow – 14 articles.
The frame of reference of the majority of stories was equally divided between national
(60 stories) and state-level (58 stories), indicating that local journalists were quite
active in reporting on the situation. Thirty stories were about the global HIV/AIDS situ-
ation, 25 dealt with the community-level situation and seven looked at individuals
affected. Only 24 stories carried multiple perspectives of all affected parties and 19
stories were particular about maintaining the confidentiality of those living with
HIV/AIDS.
A considerable number of
stories (48) expanded
the scope of their cover-
age to examine HIV/AIDS
linkages with migration,
human trafficking,
employment, poverty and
gender issues
On the brighter side, a considerable number of stories (48) expanded the scope of
their coverage to examine HIV/AIDS linkages with migration, human trafficking,
employment, poverty and gender issues. Another positive finding was that 56 stories
correctly reflected the spread of the epidemic from high-risk segments to the general
population. Nevertheless, some stories (30) still levelled blame for spreading the
virus on particular segments of the population, like women and sex workers, men who
have sex with men, injecting drug users, blood donors and truck drivers. These stories
also carried covert elements of stigma and discrimination. Many of these articles per-
petuate the notion that HIV/AIDS is an epidemic of the poor and uneducated. A Dainik
Jagran article says: “The poor and illiterate people from Purvanchal region who go to
other states return with the infection, which is then spread here by them.” This falsely
distances the virus from other segments, whereas the epidemic does not discriminate
between rich and poor.
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38 HIV/AIDS in News – Journalists as Catalysts
The article conveys a
warped message that
HIV/AIDS is just punish-
ment for criminal action,
an association that
reflects negatively on oth-
ers who are infected
Another 16 stories, or 10% of the coverage, served to perpetuate false notions of the
epidemic by associating HIV/AIDS with behaviours such as crime, extramarital sex and
multiple partners as well as sexually perverted practices. For instance, a story in Dainik
Jagran headlined, “Dreaded terrorist in Doda dies of AIDS,” opens thus: “There is a say-
ing that those who are cruel, end cruelly,” implying that the criminal deserved to die
from the virus. The article conveys a warped message that HIV/AIDS is just punishment
for criminal action, an association that reflects negatively on others who are infected.
The article also points out that “blue films, local girls and virility boosting potions were
found in the terrorist’s hideout during police raids,” indicating that sexually depraved
behaviour resulted in the infection. This judgmental attitude intensifies stigma faced by
people with HIV/AIDS.
Some stories (25) gave factually incorrect information. For instance, a story in Jansatta
Express on a scientific breakthrough in treatment raises false hopes without providing
any substantial facts to back it. It also has a sub-heading that is misleading and trivialis-
es the infection, “Tamatar khao-AIDS bhagao” (“Eat tomatoes and scare away AIDS.”)
Creating panic and scare
Some alarmist news items were part of an ongoing series by their newspaper and served
to evoke a feeling of doom around HIV/AIDS. The story on tomatoes and AIDS, for exam-
ple, says: “Everyone is afraid of death, and to top that if one’s life is taken inch by inch
and one has to put up with discrimination at the same time then it becomes dangerous.”
A photograph of a sand sculpture depicting skulls created by an artist, ironically to pro-
mote awareness, instead reinforced the fear that life ended with HIV/AIDS. This nega-
tive imagery was carried without comment by a number of newspapers.
Headlines in the media (11 stories), like “Hepatitis B not as dangerous as AIDS” and
“Four members of a single family have AIDS” or “Entire family in grip of HIV,” and “Youth
dies of AIDS”, not only selectively highlight individual infections that would be likely to
lead to their ostracism, but are based only on the fact that someone has contracted
the virus. They do not carry any information on prevention and control of the infection
or go into other dimensions that would give a full picture.
Words commonly used in the context of HIV/AIDS to describe its serious nature are
‘bomb, genocide, dangerous disadvantage, bhayanak trasadi or fearsome tragedy’. A
popular description to convey the horror of the infection is- til til kar marna or dying in
slow agony. The terminology expresses the view that HIV/AIDS means agonizing death
and the infection is as destructive as a bomb. The fear thus evoked against the virus
leads to revulsion against those who have it.
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Uttar Pradesh 39
Comparison of regional language and English press
The study shows that there were more articles on HIV/AIDS in the Hindi press in Uttar
Pradesh as compared to the English press. While this was partly because more Hindi
newspapers are published in the state and were therefore included in the study, the
Hindi press did in fact have a greater proportion of stories.
A detailed look at the coverage by the Hindi language media reveals that the two major
issues it took up were HIV/AIDS awareness campaigns including those by celebrities
and, the spread of the epidemic. Fifty of the 126 articles had a neutral tone since most
of the stories were based on press conferences or government releases or were event-
oriented reports of workshops, training events or camps. Twenty-one stories had a neg-
ative tone. For instance, an article on an infected woman described her as a sex work-
er and a threat to military personnel in Dehradun; another article attributed an increase
in STI and HIV/AIDS infections in Bundelkhand to the growing practice of buying brides
from other regions who were blamed for spreading the virus.
The rest were positive reports like the stories in Jansatta Express titled, “AIDS spread-
ing from cities to rural areas,” and in Hindustan titled, “If Pepsi and Coke can reach vil-
lages then why not condoms,” “Health administration lax on HIV epidemic,” deals with
a host of issues around the epidemic in UP and the government apathy.
Twenty-one stories had a
negative tone. For
instance, an article on an
infected woman who was
described as a sex worker
and a threat to military
personnel in Dehradun
In comparison, the English press in UP carried a significantly smaller proportion of
news on HIV/AIDS but it had a larger number of individual and community-based sto-
ries. Six of the 36 stories were related to spot events. The proportion of stories with
a neutral tone was also smaller compared to the Hindi press. However, a majority of
the articles were informative and analytical, providing a perspective. They were also
better displayed.
For further analysis of both categories of the state’s print media, their differing manner
of reportage of the same news event was studied. Almost all the newspapers had
reported on the Union Health Minister announcing a reduction in the transmission rates
of HIV/AIDS infections in the country. The reports were carried on May 26 and 27. The
Hindi dailies reported it as follows:
The Swatantra Bharat carried a long article on the government’s HIV/AIDS figures,
the controversy generated by Global Fund’s contradiction and a reaction by the
Vishwa Hindu Parishad to the Global Fund’s claim of differing rates of spread of the
virus among Hindu and Muslim populations.
Amar Ujala had a slightly smaller story mentioning the government data and its vari-
ance from figures given by the Global Fund.
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40 HIV/AIDS in News – Journalists as Catalysts
Nineteen articles in UP
discussed care as being
a fundamental right of
HIV positive people,
many of them debunked
wrong notions leading to
stigma and discrimina-
tion faced by positive
people
The Jansatta Express only reported the event from the point of view of the VHP press
conference that contradicted the Global Fund report. It also had a colour photograph
of VHP supremo Ashok Singhal.
Aaj carried three articles on the same day, one on the government mentioning that
infection rates have come down and two others that discussed the VHP’s
contentions.
The English dailies covered the same news in the following manner:
The Pioneer had a total of three news items on the topic. A long news story on May
26 was followed with an editorial on May 27 and also a separate photograph. The
editorial welcomed the news of reduced infections but suggested caution.
The Indian Express had a four-column story on the government announcement on
the front page which carried over to an equally long concluding section on page two.
The Hindustan Times provided an editorial on the HIV/AIDS numbers.
While adequate space was provided to the news in both cases, the English newspapers
carried additional editorial comments that gave a balanced view. Significantly, the
English press did not make any reference to the claims by the VHP which raised a reli-
gion-based controversy on the rate of spread of the virus. This was quite unlike the
Hindi papers, where all but one gave prominent coverage to the issue.
Regarding the Urdu press, there were three articles on HIV/AIDS in the one month of
intensive media survey. The stories dealt with the state health ministers’ statements
and a workshop on the growing number of people in India and UP who are affected,
including preventive measures. The articles were largely balanced and neutral
in tone.
Media treatment of people living with HIV/AIDS and
stigma and discrimination
If the issue of stigma has been raised directly in any of the stories, it has been done
so with concern in most cases. For instance, 19 articles discussed care as being a
fundamental right of HIV positive people, many of them debunked wrong notions lead-
ing to stigma and discrimination faced by positive people and provided inspiring life
histories. Some of these stories are briefly described:
English
English
English
Story on how infected people are getting married after putting out matri-
monial advertisements and declaring their status.
Very short item on how survival rates after contracting the virus have
increased globally.
Article describing the isolation and discrimination faced by a young infected
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Uttar Pradesh 41
English
Hindi
Hindi
Hindi
Hindi
Hindi
Hindi
Hindi
Hindi
Hindi &
English
girl in Madhya Pradesh
Story from Karnataka of a positive woman’s efforts to help other infected
persons by starting an NGO. Full page story with colour photograph,
appearing in a supplement.
Three separate stories, two on a beauty pageant in Nepal for positive
women and another on a similar pageant in Botswana and the role of diet
in ensuring healthy lifespan for positive people.
Picture of Miss Universe contestants pledging assistance against the epi-
demic.
Story from Africa of the marriage of an infected couple breaking all social
barriers.
Three separate media report on an NGO asking for treatment of impris-
oned Telgi who is HIV Positive.
Two articles on a cultural programme organised in Lucknow to raise funds
for those taking ARVs and to spread awareness.
Article describing spread of the virus in relation to the vulnerability of the
migrant population in eastern UP and preventive efforts by Banaras Hindu
University.
Discusses the vulnerability of women to the epidemic and the steps being
taken by networks of positive women in different states.
Launch of a Toolkit by Oxfam relating to prevention and care of positive
people.
Several media reports related to a CII workshop in Lucknow of clinical
care of HIV/AIDS affected people.
Three stories, however,
raised the risk to health-
care personnel and their
safety concerns in a
manner that would add
to their fear of treating
HIV/AIDS affected
persons
The workshop on clinical care organised by the CII in Lucknow, with assistance from
Australian experts, generated extensive coverage. This could be because most regional-
level workshops had only conveyed the threat-perception of the epidemic without giving
it the human face that this particular workshop on clinical care did. The different ways
in which various newspapers covered this event provides an interesting study.
Five of the news reports, in English and Hindi, took a neutral stance by carrying event-
based reports that focussed on who spoke at the inauguration and reported the minis-
ter’s speech. They did not address the issues that were raised. Four positive reports
focussed on what had been said, using the workshop as an event to explore the vari-
ous dimensions of the virus and its spread. Three stories, however, raised the risk to
health-care personnel and their safety concerns in a manner that would add to their
fear of treating HIV/AIDS affected persons. In its story titled, “AIDS: Paramedics be
careful,” The Times of India said there is a ‘high danger zone for those who are in charge
of the patients. Even simple accidents cause immediate infection.” It highlighted the
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42 HIV/AIDS in News – Journalists as Catalysts
A speculative report on
ARVs quotes the
instance of a man losing
his mental balance after
taking the drugs and
attempting to murder his
wife. Again, the news is
one sided, as it does not
carry any supportive
statements by doctors
statement that in a place like UP in which the condition of health care centres such as
that of the one in Mohanlalganj in the capital was pathetic, paramedics were exposed
to a higher degree of threat from this “dreaded incurable ailment.” Such a report has
the effect of prejudicing caregivers against HIV positive persons.
Similarly, a report in the Dainik Jagran headlined, “Medical workers being targeted by
AIDS,” warns rural health workers that they are in the direct line of fire from AIDS.
Instead of reporting in a responsible manner on precautions to be taken, the item
advises that hospital workers who are pregnant, “should not even come near such
patients.” Such sensational and factually wrong information can dash hopes for non-
discriminatory treatment of infected persons.
A report in The Indian Express is an interesting juxtaposition of two articles derived from
the same workshop. One focussed entirely on specific incidents of stigmatising and
discriminatory treatment meted out by health workers to infected persons. It does not
balance this coverage by including comments about why such ostracism is wrong. The
other article is a speculative report that quotes the instance of a man losing his men-
tal balance after taking the drugs and attempting to murder his wife. Again, the news
is one sided, as it does not carry any supportive statements by doctors. Such a seri-
ous charge could inhibit people from taking ARVs.
Reporting on HIV and gender issues
The media has exhibited two extreme ways of reporting on HIV positive individuals,
women in particular. A feature in The Indian Express on Veena Dhari, a positive woman
from Karnataka who spoke of overcoming stigma and discrimination and became an
inspiration for others was a sensitive story that helps reduce discriminatory reactions
by ill-informed public.
Four stories deal with the launch of a media campaign by Mandira Bedi and others on
wives being vulnerable to the infection and the need for even married couples to use con-
doms. An article in Sahara Samay titled, “Earning and bringing home AIDS” focusses on
the reasons for spread of the epidemic in eastern UP. It brings out the risks faced by
women of the region by discussing the high rate of migration for work. The feature clear-
ly establishes the epidemic’s link to poverty and unemployment, analyses the availability
of medical help for infected persons and their treatment by family and society.
A similar positive role is played by an article in Hindustan titled: “28 persons have died
of AIDS in Kushinagar district in the past two and a half years.” Despite the sensation-
al headline, the story is a meaningful investigation into eastern UP’s infection levels
with special mention of the vulnerability of women. One news item deals with the health
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Uttar Pradesh 43
impact of the National Commission for Women’s contention that sex workers can never
be officially recognised, while another informs that female condoms will soon be avail-
able. An extremely encouraging photograph carried in Dainik Jagran was that of celebri-
ty Sharmila Tagore hugging an HIV positive woman.
However, these are exceptions. Only 12 of the 165 news items discussed concerns of
women in relation to the virus. Overall, their concern and greater vulnerability to the
virus or how they are coping, has not been reflected in the media. In fact, the study
found 21 negative stories that could have a devastating impact on infected women.
A section of the Hindi newspapers repeatedly referred in a derogatory manner to
women with the virus as ‘vish kanyas’ or ‘poison women’. The media adds to the stig-
matisation by alleging these women were infecting ‘innocent victims’. A report in the
Swatantra Bharat titled “The film Vish Kanya to raise public awareness on AIDS”, is
datelined Gorakhpur and praises the movie for alerting people by its story of “a woman
afflicted with AIDS who establishes relationships with people and gives them torturous
death in return for just a few moments of pleasure.” A three-column story in Dainik
Jagran titled, “Vish kanyas are stinging the jawans,” claims that infected women are
being sent by terrorists to deliberately infect Indian armed forces. The article insists
this is not just hearsay but true reportage and that even the union health ministry was
involved in countering this threat.
A series of prominently placed three-column articles in Hindustan ‘exposes’ for the
sake of public safety, the designs of an infected woman who has been ‘found’ in
Dehradun and was allegedly spreading the epidemic by engaging in prostitution. The
article claims that this woman was left loose or ‘khulla choda hua’ with the state
administration supposedly being in a flap for letting her go. The newspaper raises
questions about the effectiveness of the AIDS control programme pointing out that
the infected woman, who was brought to the city for treatment by an NGO, was roam-
ing freely. The article dehumanises the woman into a beast who must be kept
chained for public safety.
A section of the Hindi
newspapers repeatedly
referred in a derogatory
manner to women with
the virus as ‘vish kanyas’
or ‘poison women’. The
media adds to the stig-
matisation by alleging
these women were infect-
ing ‘innocent victims’
Articles of this nature always conclude that a HIV/AIDS infected woman must be a pros-
titute. The same article in Hindustan has a box item titled, “247 AIDS patients in the
mountains and 800 sex workers.” It is such ill informed news reporting that leads to
public hatred and fear of infected women and even their being stoned to death. The
men involved are projected sympathetically, often as victims.
Another article that similarly reflects this mindset is a story in Hindustan that alleges
the virus is spread in the Bundelkhand area by brides ‘bought’ from other parts. It
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44 HIV/AIDS in News – Journalists as Catalysts
HIV/AIDS is no longer a
theoretical threat for the
state. It is a reality
among the hundreds and
thousands of men and
women who are depend-
ent on earning a liveli-
hood away from home
concludes that these women were infected as they had previously been engaged in
prostitution and sympathises with those who married them. The story says that the
men were paying the price for sins committed by their wives. Moreover, the article is
written in a light-hearted tone, further trivialising the issue.
Hindustan Times also carried a story titled, “From dance bars to prostitution and HIV,”
that links the three subjects. It traces the life of an infected woman and here again,
the blame rests on ‘bad’ women like her who have contracted the infection by their sex-
ual activities and are passing it on to the hapless men. Another story in The Pioneer
headlined, “CTS Colony fighting against AIDS and no civic amenities,” stigmatises a
particular ‘basti’ in Kanpur by making the unsupported charge that over 25% of the
female population here was infected. It says the women of the basti “have a fascina-
tion towards the flesh trade.”
SUMMARY & CONCLUSION
While there is considerable visibility of HIV/AIDS related issues in the newspapers from
Uttar Pradesh, the reporting needs to be focussed on the nature of the epidemic.
Improved reporting and coverage of HIV/AIDS issues is imperative. Some specific find-
ings and recommendations that emerge from the study are:
1. HIV/AIDS is no longer a theoretical threat for the state. It is a reality among the hun-
dreds and thousands of men and women who are dependent on earning a livelihood
away from home. Vulnerability factors include poverty, lack of economic opportunity
and migration to cities like Mumbai and Surat by thousands of young men particular-
ly from eastern UP. These men need to be forewarned about the epidemic and
equipped with better ways to protect themselves from unsafe sex. Creating a fear psy-
chosis about HIV/AIDS is not the best way to do this. The media should inform the
youth about the different ways to avoid unprotected sexual intercourse and carry pos-
itive stories of men who have dealt with this situation. It need not restrict itself to
mere reportage of events and the reportage needs to avoid broad generalisations.
2. HIV/AIDS is often seen as being a virulent infection. This is not the case. The mere
presence of the virus in the body does not lead to either disability or death. There
are long gaps between the time the infection is contracted to when the immune sys-
tem is significantly suppressed leading to disease manifestation. Thus, there is life
after and beyond infection. Individuals who are HIV positive need gestures of hope
and communities need information to help them support such individuals. A respon-
sible media can play a positive role in helping individuals and communities support
each other by publishing stories of hope and profiles of courage.
3. At present the health system response to HIV/AIDS is inadequate. Despite the
funding by the National AIDS Control Organisation and its state units, the HIV/AIDS
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Uttar Pradesh 45
programme in UP is limited. Also, key areas like blood safety have not been
addressed. Instead of simply publishing reports of events where officials make big
promises, it is necessary to monitor the implementation of the government pro-
gramme. The fact that many districts exist without safe blood banks needs to be
highlighted, as also that the state programme is still obsessed with targetted inter-
ventions among sex workers or truckers while the whole population is at risk
because of overwhelming poverty and lack of economic opportunity.
4. The vulnerability of women is an issue of grave concern. However, the trivialisation
of the risk to women as shown by the ‘vish kanya’ report shows the lack of serious-
ness. As sexual partners or as trafficked sex-workers, women are vulnerable to HIV
as they have no say in the matter.
5. It is necessary for senior journalists and editors to put in place a clear editorial
policy and guidelines for reporting on HIV/AIDS. This policy/guideline can be devel-
oped in collaboration with those who are working on the issue as well as with
groups of HIV positive persons. Reporters and even stringers should be provided
with training.
The media plays a critical role in creating public opinion and in spearheading social
change. In the case of HIV/AIDS, a clear understanding of the nuances of the subject,
a concern for human rights, capacity building among journalists to understand and
report on a such a sensitive issue and clear editorial policy will enable the media to
play a key role in facilitating a holistic and effective response to the HIV/AIDS epidem-
ic in Uttar Pradesh.
The vulnerability of
women is an issue of
grave concern. However,
the trivialisation of the
risk to women as shown
by the ‘vish kanya’ report
shows the lack of seri-
ousness
Dr Abhijit Das
(Advisor, Sahayog, Lucknow)
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46 HIV/AIDS in News – Journalists as Catalysts
Review of TV News Coverage of
HIV/AIDS
The electronic media has
devoted considerable
time and space to
HIV/AIDS-related stories.
Stories often comprise
as much as a third of the
total news bulletin
Television brings out the human face of HIV/AIDS more graphically than the print
media. It also has a greater responsibility to report with sensitivity so that identities
of those infected are not revealed and stories, while being factually correct, are not
alarmist. A study of the seven national channels, however, reveals that while much
time and prominence is being given to HIV-related reports, barring one or two chan-
nels, there is too much hype. Many of the stories are sensationalised and a dooms-
day scenario projected. To study how the electronic media handles this relatively new
infection, CMS Media Labs monitored prime time news for a month from May 8 to June
10, 2005. Only NDTV 24x7 is in English while DD News has some English bulletins.
The rest comprise Hindi broadcasts.
A total of 16 items were examined in this month-long scan of seven channels, moni-
tored between 7 pm and 11 pm, with another passing mention in one of the channels.
Overall, there had been a general lull in political news, particularly after Parliament
adjourned on May 13.
Table 1: Total Number of Television Stories on HIV/AIDS
Channel
HIV/AIDS
Stories
Aaj Tak DD
News
0
2
NDTV NDTV Sahara Star Zee Total
India 24x7 Samay News News
2
6
3
12
16
SALIENT FINDINGS AND ANALYSIS
The electronic media has devoted considerable time and space to HIV/AIDS-related
stories. The issue seems to be high in terms of news-priority. Stories often comprise
as much as a third of the total news bulletin. Fourteen stories were 1-3 minutes long
each. On two occasions NDTV 24x7 devoted 7-10 minutes. Of the seven channels
reviewed, it had the most coverage on the topic.
The stories appeared mostly in the middle or latter part of bulletins. Only one - the con-
troversy over the official HIV/AIDS figures in India and South Africa- appeared in the first
half of the bulletin. The majority comprised event-based reportage. Interestingly, the
media’s initiative was seen mainly in covering ‘sensational’ individual cases.
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Review of TV News Coverage 47
A number of stories were personality and celebrity-driven. While the visit of Bill Clinton
to India for HIV/AIDS work represented the positive impact of celebrity involvement,
there were stories where the personality was of greater significance than the issue. The
Zee News story on the release of a music video by Mandira Bedi and Samir Soni, car-
ried no actual information on the virus or the extent of its spread.
The majority of items (8) had a national frame of reference, such as awareness campaigns
and the release of new HIV/AIDS figures by the government. Two stories from Kolkata on
a campaign by sex-workers were interesting in that though the reporting was state level,
the American Anti-prostitution Bill they were protesting against had global ramifications.
The stories represented the global connections of the epidemic. The media also portrayed
three individual cases describing the spread of HIV/AIDS among the population.
Aaj Tak had no coverage on HIV/AIDS during prime time in the monitoring period. There
was only a brief mention during Bill Clinton’s visit.
The ‘questioning’ role
The electronic media played a crucial role in questioning authority. When the govern-
ment released new data on HIV/AIDS, the credibility of the figures was the focus of an
entire bulletin on NDTV 24x7, called ‘The X Factor.’ A debate was held between experts.
The 10- minute coverage took up one-third of the bulletin. This was also the only news
item in the survey where graphics were used to explain the HIV/AIDS situation.
However, the graphics and scroll information used alarmist terminology such as, ‘Has
India lost the AIDS Battle?” and ‘The AIDS Time Bomb’.
The electronic media
played a crucial role in
questioning authority.
When the government
released new data on
HIV/AIDS, the credibility
of the figures was the
focus of an entire
bulletin
Some stories brought out hard facts on HIV/AIDS in a direct and forceful manner that
was not panic creating. For instance, a short story on NDTV 24x7 about the visit of
Manchester United’s football stars to Malawi, though a celebrity story, sent out a strong
message that “Ten people die of AIDS every hour in Malawi, a country clearly in the epi-
centre of the epidemic in Africa.” While images of death and disease are not to be
evoked lightly, this single line had tremendous impact.
Three spot stories brought out the many dimensions of the epidemic. A Star News story
about schoolteachers in Kolkata being trained on sexual health and HIV/AIDS highlight-
ed the need to demystify the infection. The subject of youth and HIV/AIDS is also dealt
with in an NDTV story on a cross-country awareness-raising marathon. The story was
followed by a live discussion with two of the boys. This story got a fourth of the time
allotted to the bulletin. The youngsters also discussed the importance of removing stig-
ma and discrimination. Sahara Samay reported on the unusual use of the Kuchipudi
dance form to create awareness on HIV/AIDS.
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48 HIV/AIDS in News – Journalists as Catalysts
The straightforward asso-
ciation of HIV/AIDS with
death continues through
the entire script. It even
ends saying “The very
knowledge of having this
life-taking virus in one’s
body is enough to break
down anyone’s courage”
An NDTV 24x7 story on popular serials trying to integrate HIV/AIDS in normal life began
with a live discussion. The story carried clips of the TV shows and had a producer say-
ing, “We wanted to do something different, which is to depict a character with HIV who
is living well, as a productive member of society.” By holding live discussions on
HIV/AIDS related stories even during prime time the channel serves to emphasise the
importance of the issue among the top stories.
The “instigating” role
While the electronic media took some initiative in highlighting the spread of the infec-
tion among all sections, on many occasions the manner of reporting led to fear which
could further stigmatise and discriminate against those living with HIV/AIDS. Instead
of sensationalising incidences of the virus, it could have played a more positive role in
taking up issues that were relevant, such as blood safety or the rebuilding of lives.
A DD News story on a family in Ludhiana dealing with infection of the wife and child
through blood transfusion, was developed as a crime story. It seemed anxious to paint
the doctor involved as the villain, rather than addressing the issue of blood screening
or mother to child transmission of the virus. Nor does the story indicate an understand-
ing of the fact that there is life after HIV infection.
Several such stories were reported in a manner likely to scare those affected by the
virus. This is particularly evident in the human interest stories where individual cases
have been highlighted.
In the Ludhiana story the theme of life versus death is constantly reinforced. The
anchor’s introduction says: “The negligence of a doctor who should have been life-giv-
ing, led to a woman and her baby getting caught in the coils of this deadly disease.”
The opening voiceover again counterpoints the joy of living with the terror of death by
HIV/AIDS. “With this blood transfusion the woman received in her veins not just life
but also material which brought her death.” This was said when the woman and her
child are alive.
The straightforward association of HIV/AIDS with death continues through the entire
script. It even ends saying: “The very knowledge of having this life-taking virus in one’s
body is enough to break down anyone’s courage...what of that innocent baby who does
not even understand its misfortune.”
A similar engagement with death and personal ruin is reflected in a Zee News story
from Mumbai about a woman getting infected from a man who then abandons her.
“Her eyes once saw dreams of spending a beautiful life with her lover, the
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Review of TV News Coverage 49
woman....was instead left in the lurch when he gifted her AIDS.” The woman is shown
mourning her dead baby.
In the attempt to heighten the dramatic appeal, life and death are constantly juxtaposed.
No mention is made of the infected persons fighting back against injustice or how they
are coping with life and probably trying to make it productive. In these reports one who
has contracted HIV/AIDS may be considered dead. The visuals reinforce this theme. The
affected woman is seen shedding tears, holding up her dead infant’s clothes.
The infected persons are always referred to as ‘victims’ or ‘patients’ and pity is con-
stantly evoked. In the Zee News Mumbai-based story, the man who infected his part-
ner is described as the one who got away and is ‘roaming free.’ Rather than imparting
the message of awareness in a positive manner, this leaves viewers with the fear that
there is someone uncontrolled out there spreading the infection.
A moralistic tone is also evident, particularly in the Mumbai story. The infected woman
is described as having ‘given up everything’ to be with her lover and was in return
rewarded with AIDS. It is only towards the end that viewers discover he is actually her
‘husband.’ There is even a shot of their wedding photo.
Similarly, a story on medical research advancement is marred by the bleeding heart
approach. The Sahara Samay report on a medical innovation that would benefit the HIV
infected begins with the anchor evoking pity for ‘victims’ by quoting from a mournful
Hindi song. This approach once again clubs all those who are HIV positive as helpless
people at death’s door.
If done well, recounting
of individual cases pro-
vide TV viewers a face to
the virus and brings the
issue closer to their
lives. The stories bring
out the spread of the epi-
demic to the general pop-
ulation
IMPLICATIONS: CARRYING THE STORY FORWARD
Yet these stories are important. If done well, recounting of individual cases provide TV
viewers a face to the virus and brings the issue closer to their lives. The stories bring
out the spread of the epidemic to the general population, revealing that HIV/AIDS is no
longer restricted to certain traditional high-risk groups but is spreading fast among
housewives and infants. This is information worth absorbing, even though the vulnera-
bility of women and children is brought out in a negative manner.
The legal rights of those who are affected could have been pursued in the Mumbai story
about the HIV positive woman. There is a sound byte from a lawyer but the information
is scanty. The availability of safe blood is taken up in the Ludhiana story but in an inad-
equate manner, and the obviously wrong treatment of a pregnant woman being given
blood transfusion due to ‘khoon ki kami’ (her anaemic status) is neither questioned nor
investigated. The story has other gaps too.
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50 HIV/AIDS in News – Journalists as Catalysts
A story on NDTV India about Telgi preparing his will could have taken up the issue of
the man being kept in solitary confinement. Is it due to his HIV positive status? This
investigation could have led to a discussion on the rights of positive people and the
stigma and discrimination they face. Nevertheless, the story maintains a neutral tone
with no attempt to associate criminal offences with HIV/AIDS. Media reporting on this
issue has overall been refreshing as Telgi has not covered up or denied the infection,
and neither has the media misrepresented or dramatised the situation.
In most stories the confi-
dentiality of infected per-
sons has been main-
tained by superimposing
a mosaic on the faces.
However, identification is
possible through the hus-
band/father whose visu-
als and soundbyte have
been freely used
In most stories the confidentiality of infected persons has been maintained by super-
imposing a mosaic on the faces. However, in the DD News story from Ludhiana, even
though the infected woman and child have been masked their identification is possible
through the husband/father whose visuals and soundbyte have been freely used.
Similarly, the Mumbai story about the woman contracting the infection from her partner,
names the woman even though her face is masked. The story does not mention of a
pseudonym. Moreover, the ‘husband’ who infected her is named and shown through
photographs, the implication being that one need not have any qualms about violating
his privacy rights.
To sum up, the tracking of TV news brings out the fact that though HIV/AIDS has high
visibility, the discussion of the issue and visuals related to it must be more enlightened
and sensitive. While the media can pat itself for bringing HIV issues into the limelight,
it needs to be more supportive of those living with it.
CMS Media Labs
Centre for Media Studies, Delhi
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Section II
The Many Dimensions
of HIV/AIDS
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Tracking Changes 53
Tracking Changes in the
HIV/AIDS Epidemic
While statistics are important as they reflect the gravity of the epidemic, the rapidly
changing dimensions of HIV/AIDS also needs to be recognised by the media as they
have the power to influence and change public opinion. But to do so, the media must
be informed of the various aspects of the epidemic.
The second section of the manual comprises articles by eminent journalists and
experts on the changing government policy, the different linkages between HIV/AIDS
and issues like productivity, gender, stigma and discrimination.
While highlighting the changing dimensions of the epidemic, articles in this section
underline the crucial role the media can play in allaying fears and debunking myths.
Although Manipur has not been included in the overall study, since it was one of the
first states where HIV/AIDS was detected, it mirrors the changing face of the infection
seen in the rest of the country. The first wave of the epidemic in India in the early
nineties was among drug users. In Manipur, addiction to injectible drugs facilitated by
the easy availability of heroin, made hundreds of young people highly vulnerable as they
often shared needles and thus exposed themselves to the infection.
While highlighting the
changing dimensions of
the epidemic, all the arti-
cles in this section
underline the crucial role
the media can play in
allaying fears and
debunking myths
The infection then changed track when it was transmitted to unsuspecting spouses
through the sexual route after desperate parents turned to marriage in an effort to
wean them off drugs. When pregnant women unknowingly passed it on to their children,
the gender dimension of the epidemic was seen.
Ignorance about the modes of transmission has added to the stigma and discrimina-
tion against persons infected and affected by HIV/AIDS. Denial of treatment by doctors,
familial and societal ostracism has obfuscated the truth that HIV/AIDS is a manage-
able infection. Disseminating information that a regulated medical regimen supported
by love, care and acceptance can build esteem and confidence, helping them to lead
healthy lives.
A majority of HIV positive people depend on their jobs for survival. By drawing attention
to little known facts about legal rights of persons infected, which include the right to
work, the media can reduce stigma and discrimination.
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54 HIV/AIDS in News – Journalists as Catalysts
Removing the
HIV Stigma
It was only through the
doctor’s register, with the
word ‘AIDS’ emblazoned
on it, that he first came
to know he was infected
with the human immuno-
deficiency virus (HIV)
This story dates back to Goa in 1989, of how ignorance compounded by wrong laws
stigmatised an HIV positive person and put him through the most terrible humiliation
and indignity. Dominic D’Souza fought back and became one of the strongest advo-
cates for the rights of people living with HIV/AIDS.
On the morning of February 14, the police knocked on the doors of Dominic’s house
and asked him to come to the police station. Thinking one of his friends was in trou-
ble, Dominic rushed to the police station only to find himself being taken off to a hos-
pital under police escort. No reason was given for this or the physical and medical tests
that he was put through under the watchful eyes of burly policemen. It was only through
the doctor’s register, with the word ‘AIDS’ emblazoned on it, that he first came to know
he was infected with the human immunodeficiency virus (HIV).
There was no explanation, no counselling, not a word of sympathy or support to
assuage his mounting fear and humiliation. But worse was in store. He was taken to a
former TB sanatorium and detained for 64 days. Confined to a small, dirty room, he was
not allowed to contact his family or friends....not even to let them know where he was.
In his own account of those first 24 hours, Dominic said he survived only because he
had no knife or gun to take his life.
Over the next couple of days Dominic learnt the blood that he had donated some
months ago had tested positive. Instead of informing him, the hospital tipped off the
police. The police detained him under the Public Health Act which was then in force in
Goa. Under the Act, detention of all HIV positive persons was indefinite, regardless of
whether there was any actual risk of HIV transmission to other members of the public.
After a legal battle he was allowed to return home.
Dominic’s story does not end here. When he tried to return to work, he found that his
job had been given to someone else and his employer asked him to resign because
other employees would not want to work with a HIV positive person.
Though the mandatory detention of all HIV positive persons was stopped, detention
was left to the discretion of health authorities. Dominic died in May 1992 but he laid
the foundations for the rights of positive people in Goa. The stigma, humiliation and
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Removing the HIV Stigma 55
discrimination he suffered were documented in the print and electronic media and
became the subject of international conferences on HIV/AIDS.
Stigma is in fact a powerful tool of social control. It can be used to marginalise,
Bollywood and HIV/AIDS
Several films have been made on HIV/AIDS, the stigma attached to the infection
and on the rights of HIV positive people. The film Philadelphia, starring Tom Hanks,
was the first mainstream Hollywood film on homosexuality. It highlighted that
unsafe sex between men can make them vulnerable to HIV/AIDS. It brought out
the tremendous discrimination that existed against those infected in the United
States in the nineties. Though a top executive in an American firm, Tom Hanks is
isolated and thrown out of his job when the company gets to know he is HIV pos-
itive. After a lot of running around, Hanks is able to find a black lawyer who fights
his case of discrimination because of the infection. He wins the case and gets a
whopping compensation from the company but dies. Tom Hanks was awarded an
Oscar for his performance.
Two films have been
made by Bollywood in
2004 and 2005 on HIV
and the stigma and
discrimination attached
to it
In India, which has the second largest number of HIV positive people after South
Africa, two films have been made by Bollywood in 2004 and 2005 on HIV and the
stigma and discrimination attached to it. While Phir Milenge, was made by actress
turned producer Revathy and has Shilpa Shetty, Abhishek Bachchan and Salman
Khan in lead roles, My Brother Nikhil was produced by Sanjay Suri and was written
and directed by Onir. Both are excellent feature films which however did not do well
at the box office. My Brother Nikhil is a takeoff on the case of activist Dominic
D’Souza of Goa, who died in 1992. With a star cast of Juhi Chawla, Sanjay Suri,
Victor Banerjee, Lillete Dubey and Purab Kohli, the film tells you the story of a man
who suddenly falls from grace and is socially ostracised. His parents, friends and
colleagues turn their backs on him. Suddenly his whole world collapses. Then he
rallies around.
Even though the Indian films did not have box office coffers jingling, they portrayed
in a sensitive manner the trauma of a very real, social issue confronting the nation.
In that sense they are landmark films.
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56 HIV/AIDS in News – Journalists as Catalysts
When a newspaper
reports that a couple
who had died of
HIV/AIDS in Orissa was
not allowed to be
cremated for fear that
the smoke from the pyre
would pollute the entire
village, it does an incom-
plete job. It allows a
myth to go unchallenged
exclude and exercise power over individuals who show certain characteristics. It is
a mark of shame or discredit on a person or group. In fact stigma precedes discrim-
ination. Discrimination manifests in denial of rights and in difference in the treatment
of affected people.
For centuries there was stigma and discrimination around leprosy. Those infected were
not allowed to walk the same streets as others. They had to live in isolation, in clus-
ters, called ‘lepers colonies.’ In fact the word ‘leper’ was used to describe someone
who was shunned/despised. Then came tuberculosis, another highly contagious dis-
ease, and the stigma and discrimination persisted but not to the extent as in leprosy.
Now with HIV/AIDS, stigma and discrimination are back.
In HIV there is stigma around a range of issues - all related to sex and sexual prefer-
ences. In India, there is also some misunderstanding that it is only the poor, the une-
ducated who are infected. It is only recently that Subroto Roy of the Sahara group of
industries came out in the media to deny he was HIV positive. Abdul Karim Telgi of the
stamp paper scam, however, announced his positive status and sought special treat-
ment and medical assistance in prison. He is probably the first high profile person in
India to have gone public about his infection.
The media in particular, both print and electronic, have an important role to play in
reporting on HIV/AIDS stories with sensitivity and understanding. Because of stigma
and discrimination of those infected with the virus, they have to maintain their confi-
dentiality and mask their identity. They have to dispel the gloom that surrounds the
infection. With the new therapy available, HIV positive people can lead long and
active lives. Using words like vish kanyas or poison women to describe infected
women who supposedly engage in prostitution not only stigmatises them as well as
sex workers but provokes negative feelings for this class of people. There are news-
papers that have used the word ‘kaudi’ (leper) to describe an HIV positive person.
Some Hindi newspapers in UP warned pregnant doctors and medical personnel
against working with HIV positive patients. They reportedly gathered their information
from a training workshop for health personnel on treatment and care of HIV/AIDS
infected persons.
Lack of accurate information is an important reason for the stigma and discrimina-
tion of those infected. The media has not only to be well informed but has to give
correct information. There is still a smoke screen around the mode of transmission
of the infection. When a newspaper reports that a couple who had died of HIV/AIDS
in Orissa was not allowed to be cremated for fear that the smoke from the pyre
would pollute the entire village, it does an incomplete job. It allows a myth to
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Removing the HIV Stigma 57
go unchallenged. It has to counter the fears by giving correct information that the
virus can only be transmitted through sexual contact, blood transfusion or using an
infected needle.
It is equally important to point out that the children of HIV positive people may not be
infected and the mother to child transmission rate is 30%.
Stigma can disintegrate families. In Dharwad, Karnataka, auto driver Prakash Salodagi
was declared HIV positive when he went with his wife to a local hospital for his recur-
ring bouts of tiredness and weakness. What is worse, the diagnosis was blatantly
wrong. His wife and two children promptly left him. Distraught, Prakash attempted to
kill himself twice. Later, some friends took him for a retest to the Karnataka Institute
of Medical Sciences, Hubli. After three tests, the hospital confirmed he was free of the
infection. Armed with this report he went back to the Dharward hospital and showed it
to the doctors. The hospital again tested him and found he was not infected. A third
test at the district hospital too confirmed he was free of the infection. But all this was
little consolation to Prakash. He had lost everything-wife, children and his peace of
mind. “Can the hospital compensate for the trauma that I was put through because of
wrong diagnosis,” he asks.
Dominic had felt so angry and hurt when he was dumped by the police in a dirty TB
sanatorium. There are umpteen others like Dominic who, unable to take the shock of
the HIV positive diagnosis, have jumped off hospital buildings or laid down their lives
on the railway tracks. Over three successive days there were three suicides in
Mumbai in April 2005. Two suicides were from the fifth floor of the government run J
J Hospital and the third of an unemployed sweeper in Mulund, a suburb of Mumbai.
One of the men who jumped off J J Hospital was 28 years old and had tested HIV
positive two days earlier.
We are assuming these
suicides are due to
stigma but there may be
a host of reasons.
Sometimes people lack
understanding. They are
really on the edge and
often find there is no one
they can turn to
Dr Shalini Bharat of the Tata Institute of Social Sciences, in an interview to a reporter
covering the Mumbai suicides said: “We are assuming these suicides are due to stig-
ma but there may be a host of reasons. Sometimes people lack understanding. They
are really on the edge and often find there is no one they can turn to. They despair of
their socio-economic conditions or job losses, or when the diagnosis is handed to them
in a stigmatising way.”
The main issue, she feels, is psycho-social support and hope of treatment. Well-trained
counsellors can play a very central role but, she says, there are not enough counsel-
lors for HIV positive people. “We have to give them hope that they can live and perhaps
that’s where there is a great need for value neutral advice,” she adds.
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58 HIV/AIDS in News – Journalists as Catalysts
Conquering Stigma With Love
Dr Suniti Solomon of the YR Gaitonde Centre for AIDS Research and Education,
Chennai, identified the first case of HIV in India 18 years ago. Since then, the num-
ber of persons affected by HIV has risen dramatically. However, this only strength-
ened Dr Solomon’s resolve not to let numbers overwhelm her efforts to beat the
disease by providing better care and support.
But to do this she has often had to think out of the box. Her novel idea of arrang-
ing marriages between infected people has been one such inspiration that has
given hope and improved the quality of their lives.
But the most touching moment in her 20 years of working with persons infected
and affected by HIV/AIDS, came a couple of months ago when one young woman
she was treating came to see her with her boy friend.
“The woman introduced her friend as her former class mate. Both were highly edu-
cated. She had brought her friend to my clinic because he was unable to under-
stand why she had turned down his proposal of marriage even though she con-
fessed her love for him. I could see both were deeply troubled,” said Dr Solomon.
The girl didn’t want to keep him in the dark about her status. However, she knew
that her friend would never believe her if she told him she was HIV positive. So
she brought him to Dr Solomon’s clinic and asked the doctor to disclose her infec-
tion to ensure that he understood the situation,
“When I told him about her being HIV positive, the young man became silent and then
walked out of the room. Seeing that the young woman was devastated, I took her out
for a cup of coffee so that she could regain her composure,” said Dr Solomon.
After some time when they returned to her room in the clinic, they found the man
sitting there with a huge bouquet of roses. Said Dr Solomon: “He said that his love
and respect for his girlfriend had gone up because she had not hidden the infec-
tion from him. He didn’t want to know how she acquired the infection but only how
he could take care of her. Both the girl and I started crying and that was one day
that I didn’t bother to hide the tears rolling down my face. I really wish there would
be more such men.”
Swapna Majumdar
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Removing the HIV Stigma 59
Stigma and discrimination seem to multiply alarmingly when the infected person is a
woman. Nearly half of all adults living with HIV today are women, up from a third in
1985. A variety of factors render them more vulnerable. They include social norms
which deny women sexual health knowledge and practices that prevent them from con-
trolling their bodies and deciding the terms on which they have sex.
HIV positive women have to suffer the traditional taboos of widowhood as well
as cope with the indignity heaped on them because of the infection. Most
infected women in rural India have had a single partner-their husband —yet they are
thrown out of their marital homes after the death of their husbands. The stigma
of the HIV positive daughter-in-law and the greed to grab her husband’s hard
earned savings propels in-laws to drive them out. With the help of NGOs and the
Lawyers Collective, many of these women have managed to get back their property
and jewellery.
Dulhari (name changed) from Mainpuri in UP was 13 years old when she was married
by her family to Ram Singh (not his real name), an interstate taxi driver. When she
was 18 years she had her first daughter. Dulhari had never stepped out of her home
and village. Then her husband kept falling ill frequently. He was treated for tubercu-
losis initially. She took him to Agra where he was diagnosed as HIV positive. So she
brought him back to Mainpuri and looked after him. Her husband died. Dulhari is HIV
positive and so is one of her two daughters. Dulhari is on ARVs and has been able
to rebuild her life as a care giver in a home for HIV positive people in north Delhi.
Today she has amazing confidence and is often on All India Radio giving ‘talks’ on
HIV/AIDS and related issues.
The fear of social boy-
cott or discrimination
had compelled the family
to pass it off as cancer.
Now the mother’s ail-
ment would also be dis-
closed as cancer or
some other more
‘acceptable’ illness
In Madhya Pradesh, a young married woman decided not to reveal that her mother has
been diagnosed as HIV positive. Her infected father had died earlier. The fear of social
boycott or discrimination had compelled the family to pass it off as cancer. Now the
mother’s ailment would also be disclosed as cancer or some other more ‘acceptable’
illness. “If I tell the truth, there could be a setback to my marriage as well as the career
of my younger brother,” she said.
What happened to Dominic, Prakash or the others is reality for many people with
HIV, whether in India, America or Africa. Ignorance about the way the virus is
transmitted, unjustified fear of infection and prejudice against groups of people per-
ceived to be at risk have transcended national boundaries and differences of race
and culture. As Julie Hamblin, who specialises in legal and ethical aspects of
health policies, puts it: “HIV threatens human rights as profoundly as it threatens
public health.”
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60 HIV/AIDS in News – Journalists as Catalysts
The myth that conflict is inevitable between individual rights and public health has to
be dispelled, says Hamblin*. “Policies and laws that reduce the stigma attached to the
HIV infection and build self esteem of people with HIV or at risk of infection can create
the environment of mutual trust, support and collaboration that is critical to bringing
about and sustaining behaviour change.”
Usha Rai
* UNDP report – People Living With HIV: The Law, Ethics and Discrimination
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India’s Response to the HIV Epidemic 61
India’s Response to
the HIV Epidemic
Chenamma is middle aged. After her husband died of tuberculosis, she remarried.
When she became pregnant she visited the government antenatal clinic where, after
undergoing prescribed tests, she discovered she was HIV positive. While the immedi-
ate cause of her first husband’s death was TB, it had become morbid due to his HIV
status. The virus had been transmitted to his wife. She had transmitted it to her sec-
ond husband. Meanwhile, medical efforts were being taken to protect their unborn child
from the virus.
Chenamma’s story represents the cycle of HIV infection that is entering people’s lives.
Like her first husband dying of TB without anyone associating it with the HIV virus, no one
dies of AIDS (Acquired Immuno Deficiency Syndrome). Because of this disconnect
between AIDS and fatalities, there is a controversy over the number of persons who have
died of the infection since the first HIV positive person was identified in Chennai in 1986.
Interestingly, the Union Government has set up a committee to determine the total num-
ber of persons who have died from HIV/AIDS related causes, as there is a wide variation
between the official estimate of 7000 deaths and 160,000 deaths estimated by interna-
tional agencies. This is not the only controversy that dogs the country’s official HIV/AIDS
control programme. There are disagreements over its approach and effectiveness.
The low numbers and the
geographic distribution of
HIV/AIDS cases show
that these numbers do
not reflect the true situa-
tion in the country and
there is under-reporting
The official estimate of the total number of HIV positive persons in 2004 is 5.13 mil-
lion. This indicates a significant fall in the annual increase in the number of infections.
However, this data has been questioned widely. It is felt that the Government is under-
playing the spread of the epidemic. Interestingly, the official report for 1999-2000 had
a candid disclaimer: “The low numbers and the geographic distribution of HIV/AIDS
cases show that these numbers do not reflect the true situation in the country and
there is under-reporting.” Admitting the difficulties in making exact estimates in the
Indian context, the report mentions approximate estimates and trends for arriving at
the total HIV/AIDS numbers. Ignoring this caveat, the present managers of the HIV pre-
vention programme swear by the figure of 5.13 million HIV positive people.
LAUNCH OF NATIONAL AIDS CONTROL PROGRAMME
Soon after the first HIV positive person was identified in 1986, the government
appointed a committee to deal with the epidemic and the National AIDS Control
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62 HIV/AIDS in News – Journalists as Catalysts
Programme (NACP) was launched in 1987. In the early years it tried to generate pub-
lic awareness about the virus, introduced blood screening for safe transfusion and
conducted surveillance activities in what were regarded then as epicentres of the epi-
demic, that is, areas of high commercial sex work. In 1992 the National AIDS Control
Organisation (NACO) was set up to develop a national public health programme for
prevention and control of HIV/AIDS. The NACP I was launched from 1992-99. The
second phase will end in 2006 and preparations are on for drafting the third phase
of the programme.
A goal of NACP II was to achieve zero rate of new infections by 2007. In 1999, when
this goal was set, the judgment day seemed far away. It was also not realised that
the ground work done during NACP I may not be sufficient for the programme to
meet such an ambitious goal. At a NACO meeting in 2005, it emerged that this goal
was not expected to be achieved. It was also suggested that the goal of zero rate
of infection should be interpreted to mean that it should not exceed the then pre-
vailing rate of infection and in any case not allowed to cross 0.9% infection among
the total population.
With a budget of over Rs 2,000 crore for five years, the NACP is one of the largest dis-
ease control programmes in the country. In addition, the Global Fund to fight AIDS, TB
and Malaria has pledged $240 million; the Bill and Melinda Gates Foundation another
$200 million, and the Clinton Foundation’s HIV/AIDS Initiative has partnered with the
Confederation of Indian Industries. Seeking to make strategic interventions, these foun-
dations have taken up specific programme areas. On paper the proposed outlay of Rs
1,425 crore seems huge but in actual practice the government allowed NACO to spend
only a little more than half of this amount during the five-year period ending in 2002.
NACO claims that it fully utilises the allocations.
Unions in Sonagachi Negotiate Safe Sex
In the land of comrades if you put two of them together, they form a union. This has
happened in Sonagachi, one of the largest red light areas of Kolkata, West Bengal.
While fighting for their professional rights, the commercial sex workers union here
has transformed itself into a unique, self-driven community project. It addresses the
problems of sex workers’ health through peer education and carries out HIV/AIDS
awareness campaigns among its members. They have been taught to negotiate the
use of condoms with the clients. The use of the rubber sheath is now 80% and the
exposure to HIV infection under control. The Sonagachi project covers 60,000 mem-
bers and has attracted international funding.
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India’s Response to the HIV Epidemic 63
The NACP is centrally sponsored and implemented through 38 state societies with the
mandate of designing programmes according to the needs of each state.
NACP’S TRACK RECORD
During the first phase, the estimated HIV infection rate among adults (15-49 years) was
0.7 per cent. With World Bank support of $84 million, an attempt was made during this
period to develop infrastructure for HIV/AIDS control based upon the contemporary
understanding of the epidemic. These efforts resulted in strengthening of the HIV sur-
veillance system by installing 180 sentinel sites. A beginning was made in setting up
voluntary counselling and confidentiial testing centres in medical college hospitals. The
HIV/AIDS control programme was linked to control of sexually transmitted diseases and
blood banks were modernised. In addition, campaigns for building public awareness
about HIV/AIDS were scaled up and condom use promoted.
In reviewing this phase, official documents clearly admit that while the Central
Government’s commitment was reasonably high, similar state level commitment was
lacking. However, Maharashtra, Tamil Nadu and Manipur, where HIV was spreading rap-
idly, took full advantage of the programme. This was essentially a learning phase in an
environment where large sections of people questioned the priority given to HIV preven-
tion. Some even saw a foreign conspiracy in pushing the programme.
Even the sentinel survey could not be conducted across all states, nor was there any
emphasis on providing care and support services to HIV positive people. The important
lesson learnt was that a centrally driven programme lacked ownership at the state
level. It was found that civil society’s participation as a stakeholder had not been fac-
tored in adequately and this translated into lack of ownership by the communities. Such
weaknesses called for drastic changes in the programme design and implementation.
The important lesson
learnt was that a central-
ly driven programme
lacked ownership at the
state level. Civil society’s
participation as a stake-
holder had not been fac-
tored in
Nevertheless, even the limited campaigns did improve awareness among urban people.
When the Behavioral Surveillance Survey (BSS) was carried out across the country in
2000-01, awareness among adults was 76%, reaching 89% in urban areas. Despite the
large gaps in the programme, a beginning was made in the modernisation of blood banks
and a policy framework drawn up for modern transfusion services. This brought down HIV
infections due to transfusion from eight per cent to four per cent.
NACP II
Building on the lessons learnt, NACP II (1999-2006) set out to reduce the growth rate
of HIV infections and strengthen the national capacity for responding to the HIV chal-
lenge. Specifically, it defined the maintaining of HIV sero-positive levels below five per
cent among adults in the six high prevalence states of Andhra Pradesh, Karnataka,
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64 HIV/AIDS in News – Journalists as Catalysts
Maharashtra, Manipur, Nagaland and Tamil Nadu; below three per cent in the moderate
prevalence states of Gujarat, Goa and Pondicherry; and below one per cent in the rest
that were categorised as low prevalence.
NACP II was designed to be vastly different from its predecessor. Both international and
national experience showed that action needed to be initiated simultaneously on sev-
eral fronts, from awareness building among the general population, condom promotion,
propagation of safe practices among intravenous drug users and commercial sex work-
ers to research and development for a vaccine against HIV.
Cocktail Therapy
It was a rare coincidence that the country with the largest number of HIV positive people
– South Africa – became the venue, in 2000, for announcing that HIV/AIDS was a treat-
able disease. This raised the hopes of millions of infected people across continents.
Three powerful drugs - Stavudine, Lamivudine and Nevirapine - administered under
expert supervision enable HIV infected people who require medical treatment, to
lead normal lives. Nevirapine is used for preventing HIV transmission from pregnant
mothers to children. The three drugs are known as antiretrovirals (ARVs). They
entered the market as branded drugs and the annual expenditure on the drug per
person was about $10,000. This placed the treatment beyond the reach of most
people. When generic formulations of these branded versions were introduced, vio-
lating patent laws initially, the drug prices dropped dramatically.
Brazil was one of the first developing countries to make available free ARVs. The Indian
pharmaceutical major, CIPLA, offered ARVs at $370 for a year’s treatment to organisa-
tions and countries supplying free drugs to infected persons. Ranbaxy then came out
with an offer of $275 for a year’s treatment. CIPLA came up with another first when it
combined the three drugs into one and greatly simplified the drug regimen.
A major development in India’s care and support programme for HIV positive persons
was the government’s announcement in 2003 making ARV therapy available free at
government hospitals. The free treatment was available from April 2004 in the six
high prevalence states. However, providing treatment has been an uphill task as an
adequate supply of drugs and a large number of specially trained doctors are need-
ed to administer ARVs. While NACO is training hundreds of doctors, the Clinton
Foundation has also offered to train thousands of doctors. Close supervision is also
required of those on ARVs so that they adhere to the treatment. Any failure in follow-
ing the strict regimen of ARVs could expose them to drug resistant HIV.
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India’s Response to the HIV Epidemic 65
This approach translated into cost effective interventions. Since 86% of the infections
are through sexual transmission, followed by the blood route, emphasis was given to
condom use and its multiple benefits. Reduction in sexual partners was also stressed.
As a third of all HIV positive people have TB, a link was forged with the government’s
TB control programme.
Targetted interventions were intensified for sections like sex workers, termed high-risk
groups. For the general population, awareness building on risky behaviour was priori-
tised and Voluntary Counselling and Confidential HIV Testing Centres (VCCTC) set up.
The programme strategy was rejigged to decentralise and empower State AIDS Control
Societies and involve the NGO sector in a big way. Government departments like the
railways, defence and other organised areas of work were encourage to accept owner-
ship of HIV/AIDS programmes.
THE CHALLENGES
During NACP I the prevalence rate was 0.7 per cent and NACP II was dealing with a
prevalence of close to one per cent of the general population. Experts reckon that if
HIV infections cross this critical figure, controlling the epidemic would become hard-
er as technically, the country would then face a generalised epidemic compared to
one among specific areas. The major concern was that because of India’s large adult
population of 720 million, of which 280 million were in the most vulnerable age-group
of 15-24 years, a mere 0.1 per cent increase in the prevalence rate would catapult
the number of HIV positive people by more than half a million. Moreover, the epidem-
ic was moving into the general population and rural areas and becoming concentrat-
ed among marginalised sections. One out of four persons reported to be HIV posi-
tive was a woman.
Since 86% of the infec-
tions are through sexual
transmission, followed by
the blood route, empha-
sis was given to condom
use and its multiple
benefits
The magnitude and diversity of the spread of the HIV virus makes it extremely difficult
to control. Experts say in India there is not one single HIV epidemic but a number of
distinct epidemics often co-existing within a state, with different vulnerabilities, stages
of maturity and impact. For example, though a state may be classified as a low preva-
lence one, it could have pockets of high HIV prevalence, which makes those living
around these areas more vulnerable.
A focus of the programme for the past five years has been raising awareness about
STDs and their treatment, as sexual tract infections make a person eight to ten times
more vulnerable to HIV. However, only 20% of those infected avail of the free government
medical services because of the suspicion that the confidentiality of tests and diagno-
sis may be breached. Sexually transmitted diseases carry the burden of stigma. The next
phase of the programme should plan to cover most of the groups termed high risk.
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66 HIV/AIDS in News – Journalists as Catalysts
Impact of HIV
About 15 years ago the average life expectancy in India was just over 50 years.
Compared to this, a country like Botswana had a life expectancy of over 60 years.
That situation has now been reversed.
The average life expectancy in India is presently over 60 years and in Botswana it
has declined to 30 years. Botswana has experienced a widespread epidemic of
HIV/AIDS, particularly among its younger population. HIV reduces the Disease
Altered Life Years (DALY) by about 15 years.
There is a huge chal-
lenge facing the national
programme that plans to
work down to the district
and lower levels. The
efforts made so far in
convincing the states’
leadership to take up HIV
prevention on a priority
basis seem ad hoc and
inadequate
To cope with this sudden loss of trained manpower due to the infection, banks and
business houses in Botswana and other severely affected countries, introduced
strong work-place HIV/AIDS education campaigns for their personnel.
HIV treatment can begin only after tests at the VCCTC confirm infection. The key words
are ‘voluntary’ and ‘confidentiality’ of tests. VCCTCs are being set up right down to the
village level. However, the challenge is to make them user-friendly. NACO is planning to
give VCCTCs a separate identity. But with the fear and stigma attached to HIV, this may
not be a good move.
The national AIDS control programme has created an extensive infrastructure for
dealing with the epidemic. Political commitment for HIV/AIDS prevention is reflected
in the manifestos of national political parties. Decentralisation of the national pro-
gramme by delegating more responsibilities to related central ministries and the
state societies is another major step in improving implementation. However, the chal-
lenge of reaching out to more than half a million villages and to marginalised sec-
tions is a daunting one. Perhaps a programme like NACP has not been implemented
anywhere on a scale and diversity as in India, and that too in a democratic and fed-
eral setting. This shows up as gaps between the vision and concern of NACO and
that of the states. Many states, in fact, do not have the requisite capacity for imple-
menting the programme.
In several states considered ‘vulnerable’ by NACO, the basic health infrastructure is
weak and HIV prevention is not a priority. There are seemingly more pressing issues of
poverty and health crying for attention. This is a huge challenge facing the national pro-
gramme that plans to work down to the district and lower levels. The efforts made so
far in convincing the states’ leadership to take up HIV prevention on a priority basis
seem ad hoc and inadequate. This is evident in a matter as simple as heads of state
AIDS prevention programmes being appointed without a fixed tenure.
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India’s Response to the HIV Epidemic 67
A, B, C, D Choices
India’s approach to HIV/AIDS prevention has been evolving continuously. Within the govern-
ment there has been no clarity on which approach to follow. The government has wavered
on several occasions. One of the earliest strategies was to emphasise that HIV/AIDS could
be prevented by practicing one or all four of the choices known as Abstinence, Be faithful
(to your sexual partner), consistent Condom use, and Delaying sexual debut.
The government has had mixed views on the way the ABCD approach should be
implemented. Most people feel that the method of HIV/AIDS prevention should be
left to individuals instead of being decided by AIDS control organisations.
As far as A or Abstinence is concerned, they feel it is not a practical preventive meas-
ure even for adolescents engaging in sexual behaviour at an early age who need to know
about HIV, STD infections, unwanted pregnancies and the benefits of condom use.
B (be faithful) has been presented by some sections as the most desirable option
for adults but others argue that this would lead to moralistic values being associat-
ed with the virus. There is no agreement either on the benefits of promoting C (con-
dom use) through the mass media. Those who believe that condom promotion actu-
ally encourages casual sex argue that A and B should be aggressively promoted.
Conservative religious groups support this view.
Communication capaigns addressed to adolescents and young people also advocate
D or Delaying of sexual dedut. There is an opinion that this message is too idealis-
tic and enhances the vulnerability of the very young.
In the United States there is a section of people which feels that excessive condom
advocacy and the sexually liberated behaviour of the fifties worked against ‘family
values’, that is, fidelity in marriage. On the other hand, the promotion of condoms
among sex workers and their clients imparted to it a negative image, as a protective
device to be used in casual sex, particularly its commercial transactions.
In India, the condom has been promoted as a family planning device and only recent-
ly has it been promoted as protection against STD and HIV. When the National
Democratic Alliance government of Atal Bihari Vajpayee was in power, the condom
campaign was put on the back burner. The government wanted a balanced projection
of A, B, and C strategies, while favouring A and B. The Congress-led government
favours promotion of C and the balance has once again shifted.
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68 HIV/AIDS in News – Journalists as Catalysts
International AIDS prevention observers are keenly watching India’s response. While
there may be no overt dissent, an undercurrent of difference exists between them and
the Government in perception about the HIV/AIDS challenge and the action taken.
Experts believe that at this stage, India can change the course of the epidemic. Given
her size and economic importance, the outcome here can critically alter the internation-
al HIV/AIDS scenario.
S Narendra
Former Principal Information Officer to Government of India
and presently working with NACO on NACP III
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The Cost of the HIV Epidemic 69
The Cost of the
HIV Epidemic
Considered as a disease of the young, most persons affected by HIV/AIDS are in their
prime years and productive period of their lives. In India, almost 90% of people are in
the working population, in the 15-49 year age group. It is estimated that about one per
cent of this section is infected. The fallout of so many productive persons getting affect-
ed is immense on households, businesses, service sectors and the national economy
as a whole.
We have seen the devastating impact of HIV on the economies of poor countries in
Africa. The GDP of some of these countries have been eroded a great deal. Several
studies have estimated that the rate of economic growth has dropped by two to four
per cent in sub-Saharan Africa due to the HIV burden. South Africa’s GDP is expected
to suffer a 17% set back by the beginning of the next decade. These projections are
based on HIV’s impact on household incomes, burden on state-run health infrastruc-
ture, loss of productive workforce, impact on education etc.
There are over 7.5 million infections in Asia and half a million deaths occur each year
due to HIV/AIDS related illnesses. The Asian Development Bank estimated that in
2001 alone, economic losses due to HIV/AIDS in Asia were about $7 billion. It could
rise to $17 billion by 2010 if present trends continue.
The Asian Development
Bank estimated that in
2001 alone, economic
losses due to HIV/AIDS
in Asia were about
$7 billion. It could rise
to $17 billion by 2010 if
present trends continue
However, in India, there have been few studies to quantify the costs of the HIV epidem-
ic on the national economy. Studies done so far are based on various assumptions and
projected scenarios. Given the fact that the major route of HIV transmission in India is
sexual, it is clear that it affects people in their most productive ages, and that there
could be multiple infections within families. Women - who contribute so much to the
economic well being of a rural household - are also getting affected in a big way. Almost
50% of those infected are women.
A 1999 study by the Centre for Community Medicine at the All India Institute of
Medical Sciences, New Delhi, has put the economic loss due to HIV to one per cent
of GDP in India. The study looked at the ten-year period from 1986 to 1995. The
cost of HIV infections included the loss of productivity due to sickness and death;
productivity loss due to caregivers of those infected; and cost of management of
those ill.
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70 HIV/AIDS in News – Journalists as Catalysts
Based on an assumption
of 4.5 million cases, the
AIIMS study concluded
that the estimated
annual cost of HIV/AIDS
appears to be about one
per cent of India’s GDP.
This comes to about
Rs 28,000 crore
The study did not include use of antiretroviral drugs, cost of retraining of new workforce,
strengthening of health care system, research and development, communication activ-
ities, prevention of vertical transmission, and the intangible cost of pain and suffering
to those ill and their families. Based on an assumption of 4.5 million cases, the AIIMS
study concluded that the estimated annual cost of HIV/AIDS appears to be about one
per cent of India’s GDP. This comes to about Rs 28,000 crore.
However, a Harvard School of Public Health study on the economic impact of HIV in India
has concluded that it is unlikely that effects on output due to the epidemic at the all
India or even at the state level, will be large in the next 15-20 years. There may be sec-
tor level effects, particularly in the health sector in the form of growing use of health
services and increased public spending on health. HIV/AIDS will substantially lower the
well being of affected households and their members. Female members and households
belonging to the poor and less educated groups appear to be especially at high risk.
IMPACT ON WORKING POPULATION
An estimated 400 million people are categorised as working population in India and as
many as 93% of them work in the informal, unorganised sectors. The prevalence of HIV
is growing, but these workers do not have access to information, testing or treatment.
They are not covered under any security net. For them, there is hardly any dividing line
between workplace and living place and both male and female members work. A large
number of migrants work at construction sites in cities like Delhi and Mumbai as well
as in projects such as dams and power stations in remote areas. Their sexual behav-
iour is often risky. But these workers are not covered under any awareness or interven-
tion programmes nor do they have any treatment facilities.
In terms of agriculture, one of the scenarios predicted is that producers may be faced
by shortage of labour and switch from cash crops to lower value-added food crops. This
would reduce incomes and result in lower foreign exchange and lower tax yields for the
government. In all cases where there is an effective fall in labour supply, attempts such
as this will be made to economise on labour.
Truckers and transport workers are perhaps the only section of the unorganised sec-
tor that is being targeted for awareness and intervention programmes. This could be
because they serve large, organised sector companies in oil, cement and other prod-
ucts. Similar efforts need to be made in areas like construction, shipping, urban
transport and railways where a large number of casual and contract labour is
employed. Here trade unions and sector specific workers’ organisations, such as
three-wheeler drivers’ association or trade unions of railway porters, can play an
important role.
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The Cost of the HIV Epidemic 71
Most HIV positive people depend on their jobs for survival. It keeps their households
going and helps them buy medicines. A study by the International Labour Organisa-
tion (ILO) found that household incomes of HIV positive persons in India are deplet-
ed by one third, while the average monthly expenditure on food and treatment
increases substantially. As a result, these households have to compromise on their
children’s education. Nearly 38% of the respondents reported being forced to with-
draw children from school.
In view of the gravity of the situation, ILO has begun working with governments, busi-
nesses and trade unions to sensitise them on the rights of HIV positive workers.
Three key issues identified are non-discrimination, treatment and social security. In
collaboration with the National Labour Institute, ILO has developed a training manu-
al for trade unions and has conducted training programmes. It is also working with
the Central Board for Workers Education to conduct training courses and integrate
HIV/AIDS within the workers’ education programme. The National AIDS Control
Organisation has also endorsed ILO’s Code of Practice for use in workplace interven-
tions throughout India.
DISCRIMINATION AT THE WORKPLACE
In the initial phase, a number of cases of discrimination were reported. Workers were
dismissed from their jobs once it was discovered they were HIV positive. This was a
The Case of Badan Singh
Badan Singh, a head constable in the Border Security Force since 1990, was termi-
nated from service in 1999 after he was found HIV positive during a medical exam-
ination. But Singh contended in the Delhi High Court that he was not suffering from
any medical problem at the time of his termination.
He appealed that he should either be reinstated or given all retirement benefits as
are due to employees with medical disability attributable to service. He also point-
ed out he would have been due for pension in some years time. But the BSF lawyer
argued that if the HIV infection is considered a disability and Singh is given all the
benefits, it would “bestow a premium for his sexual deviation or recklessness.” The
court dismissed this argument, saying “assuming that the petitioner acquired AIDS
through extra marital sexual intercourse, it could hardly be presumed that he
intended to contract this fatal and stigmatic health disorder, leading immediately
to ostracism, so as to become eligible for premature pension.” In its final judg-
ment, the court ordered that Singh be given invalid pension with interest from the
date of his dismissal.
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72 HIV/AIDS in News – Journalists as Catalysts
reflection of the stigma attached to the disease in society. Fearing job loss, many infect-
ed persons do not disclose their HIV status to employers. Even big companies did not
know how to deal with employees who were infected. They did not have any separate
policy nor was the health service equipped to handle HIV positive people. Many com-
panies did not care to take any specific steps, thinking that the problem was not big
enough to merit special attention.
Surprisingly, some of the worst cases of discrimination against HIV positive employees
have been reported from the government sector, particularly the armed forces.
The worst cases of dis-
crimination have been
reported from the govern-
ment sector, particularly
the armed forces. Some
HIV positive workers
challenged their dis-
missal in the courts.
When their numbers
started growing, busi-
ness organisations
realised the need for
intervention programmes
With growing awareness and cases like that of Badan Singh (See Box), the situation
has started changing. Workers, employers, trade unions and governments started
becoming aware of the issues involved in HIV at the workplace. Sustained efforts by
organisations of HIV positive people, activist lawyers and other civil society groups
brought the need for having workplace guidelines and policies into focus. Cases of dis-
crimination at the workplace have been highlighted by the media. Some HIV positive
workers challenged their dismissal in the courts. When their numbers started growing,
business organisations too sat up and realised the need for intervention programmes.
Still, most efforts are limited to the large, organised corporate sector. The situation in
the unorganised sector is quite different.
EFFORTS IN ORGANISED SECTOR
The economic impact of HIV/AIDS on the organised industry can be severe. Besides
productive losses, companies have to bear additional expenses of increased medical
bills, insurance, ex-gratia in case of death and delays in recruiting skilled employees.
There are examples of companies in African countries spending huge sums on such
additional expenditures. A major transport company with 11,500 workers in Zimbabwe
found that 3,400 of them were HIV positive in 1996. The HIV related costs for the com-
pany amounted to over USD 1 million or 20% of its profits.
Replacing skilled, trained professionals is a major problem faced by companies with
higher HIV incidences in some African nations. To overcome this problem, a multination-
al firm in South Africa is said to be hiring three workers for each skilled position to
make sure that a replacement is readily available in case an employee dies. It has even
been suggested that a pool of unemployed or underemployed workers be kept ready.
The situation in India is not that bad, but widespread appreciation of the problem is
still missing. Only large companies are taking note of the epidemic and have begun
prevention programmes. Surveys have revealed that their mindsets are still antiquat-
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The Cost of the HIV Epidemic 73
ed. Most businesses do not feel the need to act because the prevalence rate is still
low. They also don’t feel the need to have written HIV/AIDS policies or run awareness
and prevention programmes. It is also a myth that HIV/AIDS is a problem of labour-
intensive industries only. Nearly half of India’s GDP comes from the service sector
that employs millions of young people in vulnerable age groups. These people are
mobile and have large disposable incomes. They form a new segment at risk of con-
tracting HIV.
In three large-scale private enterprises in India, absenteeism is projected to double over
five years due to HIV/AIDS. The medical expenses of Brihanmumbai Electric Supply and
Transport (BEST) Ltd are on the rise because of the cost of providing ARVs to about 130
employees. Similarly, the Railways supports some 500 infected employees.
The Confederation of Indian Industry is encouraging its member companies to adopt
non-discriminatory workplace policies and take up advocacy programmes with work-
ers. The guidelines clearly state that it is the responsibility of the management to
provide employees with a supportive work environment and ensure non - discrimina-
tion; provide a basic code of conduct for all employees towards those infected; and
ensure confidentiality. There should be no pre-employment testing for HIV nor should
an HIV test be part of the annual medical check-up. Even if found to be HIV positive,
the person is to be allowed to continue to in the job unless medical conditions inter-
fere with the work. No employee can refuse to work with an HIV positive colleague.
Companies are not to discriminate against any staff member infected by HIV in pro-
motion, training or other privileges.
The medical expenses of
Brihanmumbai Electric
Supply and Transport
(BEST) Ltd are on the
rise because of the cost
of providing ARVs to
about 130 employees.
Similarly, the Railways
supports some 500
infected employees
“Investing in AIDS prevention and care programmes makes excellent business sense,”
says Tarun Das, chief mentor of CII and managing trustee of the Indian Business Trust
for HIV/AIDS. “Such programmes save huge recurring expenses like constant recruit-
ment and training of new staff, increased medical bills, greater insurance premiums
and increased management time spent on AIDS-related issues. In the long run they
also establish the company as a caring and humane employer,” says Das.
Codification of workplace policies is an important step in addressing the problem. For
instance, Tata Tea Limited that employs 59,000 workers throughout the country, adopt-
ed an HIV policy in 1999. Its highlights are:
Non discrimination:
(1) Employees will not be dismissed on the ground of their HIV status;
(2) Employees will not be screened for HIV before employment and
(3) Hiring decisions will not depend on HIV status.
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74 HIV/AIDS in News – Journalists as Catalysts
Newspapers and televi-
sion are a primary
source of information
among workers and man-
agement. By highlighting
issues, the media can
create a favourable
atmosphere for positive
action by companies and
trade unions
Confidentially and disclosure:
(1) An employee is not required to disclose status;
(2) If status is disclosed, it cannot be disclosed to others without written consent.
Benefits:
(1) Benefits are provided for employees, management, and dependants;
(2) Benefit packages do not discriminate by HIV status;
(3) All tea estate workers and dependants have free access to the company health pro-
grammes including VCTC (voluntary counseling and testing centres).
Termination:
(1) The medical officer of the estate evaluates when an employee is deemed medically
incapacitated;
(2) The employee has the right to appeal against the decision.
The number of companies adopting such policies and taking up awareness and
intervention programmes is increasing. Some of these benefits also spill over to
other people who interact with the company, such as truckers hired by cement com-
panies, farmers supplying sugarcane to the mills, direct marketing persons working
for companies and casual labour hired for specific jobs. Though not on company
rolls, such groups often benefit from awareness, counselling and condom pro-
grammes run by it.
ROLE OF THE MEDIA
Newspapers and television are a primary source of information among workers and
management in both organised and unorganised sectors. By highlighting issues, the
media can create a favourable atmosphere for positive action by companies, trade
unions, labour departments and workers.
Any discrimination based on workers HIV status is a violation of their basic human
rights. Practices like retrenchment, forced testing at the time of appointment and denial
of promotions to HIV positive employees need to be covered by the media. They must
emphasise that right to health is a basic human right that cannot be denied to work-
ers. Employees have a right to medical care and financial support to the family in case
of loss of employment or death related to HIV.
Care should also be taken to protect the confidentiality and identity of workers’ involved
so as to prevent stigmatisation by co-workers or society. Reporters need to look care-
fully at HIV workplace policies. They may just be focussing on awareness campaigns,
counselling and non-discrimination, while leaving out medical care.
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The Cost of the HIV Epidemic 75
While some companies don’t dismiss workers if they are found HIV positive, they have
a policy not to employ those found infected at the time of entry. Companies don’t take
any specific stand on the continuing financial security of a worker if the person is taken
seriously ill or dies in harness. Only some workplace policies specifically mention this
point. Modicare’s policy says:
(1) HIV/AIDS and related opportunistic infections will be considered like any other dis-
ease and the infected person will be entitled to reimbursement for his or her med-
ical bill as per his or her entitlement
(2) Modicare will consider to sponsor fully or partially the AZT treatment of the employ-
ee if s/he is not able to afford the cost of treatment;
(3) Sponsorship will be done on a case by case basis, with the aim to continue support
as long as medically appropriate.
The serious threat of HIV at the workplace can be challenged effectively only when it is consid-
ered a matter of right to health of workers. All aspects of HIV/AIDS should be taken care of.
IMPACT
On households: loss of income due to inability to work, premature death, increased
medical expenditure on tests and drugs, impact on children’s education, economic
loss due to stigma and discrimination.
On industry: higher absenteeism rates, increased medical expenditure, cost of hir-
ing and training new personnel in case of death due to HIV, higher burden of insur-
ance and retirement benefits.
On national economy: additional stress on health infrastructure, higher allocations
for HIV, impact on allocations for other diseases, loss of productivity and incomes,
drop in savings, depletion of human resources.
AGENDA FOR HIV AT WORKPLACE
Non-discriminatory workplace policies for existing employees as well as new recruits
needed. No termination or denial of promotions on the basis of HIV status.
Confidentiality and disclosure norms to prevent discrimination and stigma among
co-workers and others.
Provision of voluntary testing and counselling services at workplace, as a follow
up of awareness and condom promotion campaigns.
Provision of antiretroviral therapy for workers with HIV.
Assurance of benefits to affected employees, no cut-back in benefits, medical cov-
erage and retirement/death benefits.
Dinesh C Sharma
Science, Health and Development Journalist
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76 HIV/AIDS in News – Journalists as Catalysts
RESOURCES:
Indian Business Trust for HIV/AIDS
Asian Business Coalition on AIDS
International Labour Organization (ILO)
World Economic Forum Global Health Initiative
The Global Business Coalition on HIV/AIDS
Tata Tea’s HIV project
www.indianbusinesstrust.org
www.abconaids.org
www.ilo.org/aids
www.weforum.org/globalhealth
www.businessfightsaids.org
www.ishima.info
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Time for Women to be
Seen and Heard
Time for Women to be Seen and Heard 77
A doctor and a boy were fishing together. The boy was the doctor’s son but the doctor was
not the boy’s father. Who was the doctor?
Many people are unable to solve the above riddle because it defies the stereotype. The
answer is that the doctor was the boy’s mother!
Media reporting from a gender perspective on HIV/AIDS too is more an exception than
the rule. There is too much stereotyping in viewing women either as ‘victims’ or ‘trans-
mitters,’ as, for example, in their role as sex workers.
This needs to change. Both because gender plays a critical role in prevention, care
Gender Inequality is Critical to the HIV/AIDS Epidemic
The word ‘gender’ cannot be used interchangeably with the word ‘women’ or ‘sex.’
Biological and physiological attributes, such as genitalia and hormones of men and
women define their sex. Gender characteristics encompass the whole gamut of
socially constructed roles, behaviours, attitudes, beliefs and activities of men and
women in a given society.
Gender characteristics greatly influence men and women’s access to education, par-
ticipation in the labour market, division of work within homes and control over pro-
ductive resources such as property and capital. Sex-defined characteristics are sim-
ilar across societies but gender-based attributes vary. Equitable or inequitable gen-
der relations can enhance or hamper women’s access to prevention, care and treat-
ment of HIV/AIDS.
“Gender inequality is at the heart of the epidemic…we must address power imbal-
ances in every single policy, strategy and programme relating to prevention, treat-
ment and care if we seriously want to tackle this global challenge. It is not simply a
matter of justice and fairness. In this case, gender inequality is fatal,” says Dr
Noeleen Heyzer, Executive Director, UNIFEM.
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78 HIV/AIDS in News – Journalists as Catalysts
Data from a number of
studies suggest that
male-to-female
transmission during sex
is twice as likely to occur
as female-to-male
transmission
and treatment of HIV/AIDS in men and women and because positive women are sur-
vivours, not ‘victims’ and have needs, concerns and desires very similar to sero-neg-
ative women.
Leela Banta, President, Manipur People Living with HIV (MNP+), said in 2001, “It is not
how long we live that is important but how well we live.” Positive women can live a
healthy, fulfilling life. They can work, travel, get married, have children and do almost
everything that ‘normal’ women do. If society allows them to be ‘normal.’ This is what
the media needs to portray both to reflect the real picture on the ground and to help
reduce stigma and discrimination towards positive women.
The media also needs to be aware that women are more vulnerable to HIV both biolog-
ically and because of gender inequalities. Data from a number of studies suggest that
male-to-female transmission during sex is twice as likely to occur as female-to-male
transmission (UNAIDS Report 2004). And what makes women even more vulnerable is
their lack of social, economic and political power within their homes and communities.
Men and women need appropriate care, prevention and treatment mechanisms. Yet, it
is usual for men’s voices and perspectives to dominate in the media; and for stereo-
types to be reiterated.
Gender relations affect women more because:
Most women cannot negotiate safe sex even with their own partners
Blood transfusions are undertaken often without informed consent
Most women lack exposure to the media and access to even basic information
Most women lack the resources to take care of their own needs, and access to even
basic health needs
The greater the gender discrimination in societies and lower the position of women, the
worse are they affected by HIV. More equitable gender relations and better empower-
ment of women mitigate the spread of HIV and enable women to cope better.
Women face higher stigma and discrimination
The downside of all this is that positive women, already a discriminated lot at many lev-
els, face an even higher degree of stigma, shame and marginalisation when their pos-
itive status is known.
“My husband, who was also positive, kept me house bound for five years!” says
Shobha* from Chhatisgarh. “He said he was punishing me because it was only after
marrying me that he became HIV positive. He said he had gone to other women for
years and nothing had happened - till I brought ill-luck upon him.” But Shobha decid-
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Time for Women to be Seen and Heard 79
Women are Now the Most Affected…
The number of positive women has steadily risen. Initially, positive men vastly out-
numbered the women and then their proportion fell. The latest figures are avail-
able for December 2003 by when girls and women accounted for half of all peo-
ple living with HIV; in sub-Saharan Africa, the proportion was 57 %; in India, posi-
tive men still outnumber women with a 3:1 ratio but these are official figures. Fear
of stigma and discrimination keeps many women from disclosing their status.
According to UNAIDS, young women in developing countries are twice as likely to be
infected as men.
But they are also acting as change agents…
Many are coming forward to disclose their status, to mobilise others like them so
that they have a stronger, collective voice and the wisdom to influence decisions
regarding their economic and social well-being. Women like Kousalya Periaswamy
who was told by her husband about his positive status just a few weeks after mar-
riage, have turned their anguish and angst into positive energies. Widowed now,
Kousalya braved social disapproval to speak out and encourage other positive
women also to come out. The Positive Women’s group of South India is her contri-
bution to the cause. It provides space for women to talk about their trauma and
live with it through counselling and various other social services.
“It has to be recognised that women are not just infected/affected by HIV; they are
agents of change. Their voices must be heard and their leadership invested in,” said
Kathleen Cravero, Deputy Director of UNAIDS in 2004.
“My husband, who was
also positive, kept me
house bound for five
years! He said he was
punishing me because it
was only after marrying
me that he became HIV
positive. He said he had
gone to other women for
years and nothing had
happened”
ed to fight. She managed to run away from her uncaring husband and now works as
a daily wager - sweeping the floors in a private office in Bhopal. “I am happy because
I am free,” she says. “I live with another infected woman and we support each other.
At times I’m scared that if she becomes ill and dies, I will have no one. Yet, this is
so even for women who lose their husbands. Maybe I too will die quickly. Or maybe I
will live and continue to give support to another positive woman.”
Anita*, thrown out by her in-laws after the death of her husband, lives with her elderly
parents in Maharashtra. “My in-laws gave me nothing - no money, no share in the land
for my four-year-old son and no jewellery for my two-year-old daughter,” she says. “I see
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80 HIV/AIDS in News – Journalists as Catalysts
Reports about positive
women being ostracised,
being subjected to physi-
cal and mental violence,
turned out from homes,
being disinherited and
even beaten to death
abound. What are miss-
ing are media stories
about how infected and
affected women are cop-
ing with this epidemic
myself as lucky because both my children are HIV negative. I look after my parents now
as both my brothers broke all ties with us on learning of my status. My parents will look
after my children if I die earlier,” she says matter-of-factly. Anita has told her children
about her positive status and finds that they are empathetic. “They will be more sensi-
tive human beings than their uncles (her brothers),” she says. “That will be my contri-
bution to society.”
Reports about positive women being ostracised, subjected to physical and mental vio-
lence, turned out from homes, disinherited and even beaten to death abound. In one
instance, people burnt down the homes of sex workers in their neighbourhood, fearing
their presence would spread HIV infection in their area! Yet, what are missing are media
stories about how infected and affected women are coping with this epidemic, and
bringing about behavioural, social or economic change.
‘Low-risk’ women put to high risk
Shobha and Anita’s experience point to another chilling fact. ‘Low-risk’ women are at
threat because their only fault is that they get married! Women are in no position to
ascertain whether their potential partners’ are positive or not.
Changing the Focus of ‘Lifestyle’ Stories
There are umpteen ‘lifestyle’ stories about wealthy professionals and industrial-
ists buying the services of ‘high class’ call girls; and stories of ‘bored’ housewives
taking to this ‘work’ for ‘recreation.’ What does not get written about is that unsafe
sex makes this a highly risky behaviour; that education and money are no longer
a bar from getting infected; that children often become unintended victims of this
unsafe sex.
Current public debate focusses on the morals of extra-marital sexual relationships.
The media can inject gender issues into this debate: whether educated and wealthy
women are informed about safe sex and able to negotiate it; whether educated and
wealthy men are responsible enough to have safe sex with their wives and/or with
‘other’ women; and whether a society that sees an upward trend in this kind of
‘promiscuous’ behaviour can uphold values such as dignity, respect, responsibility
and hope if it does not also deal with unsafe sex. Such debates on sexual behav-
iour in society can help decrease the stigma and discrimination against positive
women.
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Time for Women to be Seen and Heard 81
Missing the HIV Link
Crime reporters never talk of the HIV risk when they report on rape. Reports only
touch aspects such as mental/physical trauma and economic depravity.
Deteriorating law and order situations raise the threat of HIV infection in a city and
the health agencies should wake up to this fact.
War/conflict correspondents too ignore stories on HIV. Journalists often receive spe-
cialised training in war reporting but this does not include exposure to the risks
faced by innocent women. Since the training is often undertaken by the Army, this is
perhaps quite understandable!
“Two months before my marriage, a relative told my father that I would face problems
if I married Ajay,” says Vinita*. “My father dismissed the remark. He was sure his
decision was right as Ajay’s family was well off and Ajay seemed to be successful
marketing executive in a shoe firm. We learnt about his positive status three months
after marriage and my father has refused to take me back. I do all the housework
and look after our year-old child. My husband is too busy travelling and comes to me
only when he wants sex. He started wearing a condom after I got pregnant but has
never taken me for any test and I’m too scared to undertake it myself. This unknown
status is better than knowing that I am positive and being rejected by my larger fam-
ily! Even if it’s only a matter of time, I’d rather wait than know the truth.”
Vinita’s story points to the new threat that extended families in India face today. How good
are our traditional care and support structures? How much do they need to change with
the times? Women’s voices are needed to identify gaps, articulate the needs and show
the direction of change. The media would do well to pick these up as new ‘stories.’
Married women, cutting
across class, are today
one of the highest risk
groups in India and
South Asia even as
NACO still sees the con-
ventional high-risk groups
as sex workers, homo-
sexuals, drug addicts,
truck drivers and
migrants
Married women, cutting across class, are today one of the highest risk groups in India
and South Asia even as the National AIDS Control Organisation (NACO), still sees the
conventional high-risk groups as sex workers, homosexuals, drug addicts, truck drivers
and migrants. Yet, its own 2003 statistics show that more than one per cent of women
accessing antenatal services in public health institutions are testing sero-postive. The
YR Gaitonde Centre for AIDS Research and Education in Chennai, for instance, has
been treating wealthy businessmen’s children who are HIV positive.
Concealment of information regarding one’s HIV status at the time of marriage is a form
of violence against women. Another form of violence overlooked by the media is that
forced sex is often used as a weapon within homes and communities times of peace
and especially during conflict situations. No specific studies have been carried out on
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82 HIV/AIDS in News – Journalists as Catalysts
Concealment of informa-
tion regarding one’s HIV
status at the time of
marriage is a form of
violence against women.
Another form of violence
overlooked by the media
is that forced sex is
often used as a weapon
within homes and
communities
this cause of the spread of the epidemic. It is reported that the widespread rape of
women by soldiers in Uganda in 1986 was a major factor in the spread of HIV in the
northern part of the country. The soldiers reportedly had a one in three rate of infec-
tion at the time. Forced sex – incest, rape and even marital rape are topics that need
to come out of the closet to mitigate the epidemic and remove the stigma and discrim-
ination encountered by women who have faced this violence.
Monika*, raped by her father’s brother from the time she was six-years-old, learnt
about her HIV positive status at 16. Fighting back, she got in touch with a counselling
centre and has initiated a small network of positive women. “We spread awareness
about violence against women and HIV by word of mouth,” she says. “It is still very
difficult to come out in the open and talk about this.”
Vulnerability to HIV/AIDS – A health issue for women
“A gender perspective is essential in our evaluation of conditions to HIV vulnerability,”
says Mariamma, an activist working with positive women in Andhra Pradesh.
Reproductive tract infections (RTIs) - often the result of poor living conditions, malnutrition
and the resultant anaemia - and sexually transmitted diseases (STDs) make women more
vulnerable to getting HIV infection. Positive women tend to develop frequent gynaecologi-
cal problems, cervical cancer and more pregnancy-related complications.
An overwhelming number of women in backward, rural areas and in poor urban slums often
suffer from STDs unknowingly because they may not have any outward symptom or they
consider some of the symptoms ‘normal.’ Several micro-level surveys have found that
white discharges because of STDs, pelvic inflammatory diseases and cervicitis is so com-
mon that up to 80% of the women think of as quite normal and not requiring treatment!
Many women also do not want to talk about their problem for fear of stigma and dis-
crimination - that their husbands will blame them for the diseases and beat them up;
or take another woman or even go to a sex worker.
Lack of disaggregated data on women’s reproductive health makes it difficult to esti-
mate the potential of HIV infection. Or, when government doctors do not take the
responsibility of sharing information and explaining the virus to women in particular,
it leads to the spread of infection.
The media can effectively break the gender barrier to raise an informed debate on the
needs, concerns and desires of women - along with those of men. The focus of sto-
ries can be on women having reproductive and sexual rights.By placing low priority on
women’s health, policy makers are fuelling the HIV epidemic. This lacuna is being
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Time for Women to be Seen and Heard 83
addressed by the recent Reproductive and Child Health round II and III programme pol-
icy frameworks that talk about strengthening RTI/STD services to improve access for
vulnerable groups like women and young girls; as also linking it up with the Revised
National Tuberculosis Control Programme. These are fertile grounds for media stories
to see who is really being reached, where and how much difference these policy frame-
works are making in the lives of infected and affected women and girls. As also, how
much of the focus is just on treatment and how much also on care and support which
are integral to proper treatment.
It is not only in the health sector that women’s voices need to be heard and responded
to. There is a need to talk to women in other HIV/AIDS-related arenas too – how many
women, as compared to men, know that condom prevents infection? How many women -
married, unmarried, housewives, working women or sex workers are aware of their bod-
ies? The questions are endless but the bottomline is the same. Girls and women need
to come to the fore and be the focus of policy makers, civil society organisations and rel-
evant professionals like doctors, psychiatrists, teachers and academics, so that society
can hear what women have to say, what they experience and what they need.
Gender and HIV/AIDS – A Development Issue
Modification of risky behaviour can, theoretically, check the spread of the the HIV
virus. This change, however, is influenced by socio-economic and political factors
that are beyond an individual’s control where gender relations are concerned.
Undernourished, ill and unemployed women are at greater risk of getting infected.
Lack of enough women doctors and women teachers hamper women’s access to
health care and education. Women are also scared of telling their spouses about
STDs or RTIs and so cannot avail timely and correct treatment for these.
Women - especially an
overwhelming number of
them in backward, rural
areas and in poor urban
slums - often suffer from
STDs unknowingly
because they may not
have any outward symp-
toms or they consider
such symptoms ‘normal’
Media stories can link HIV prevention or spread to women’s development. Stories
that reflect politics, economics, business, lifestyle, entertainment and development
have the potential for integrating the HIV factor.
For example, what are the effects of HIV infection on women workers, especially in
the informal sector? How can women care givers be valued for their contribution to
the national economy? Which age group of women are being infected more and what
does that say for their work life and the national income? Or that Self Help Groups
in Karnataka, Orissa and Manipur are taking up projects tha would provide income,
care and support to positive women and to widows of positive men. The media can
act as the catalyst by flagging such issues.
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84 HIV/AIDS in News – Journalists as Catalysts
Care givers: the double burden
Besides being the majority of those infected, women and girls are bearing
the brunt of the epidemic in other ways too now: as mothers, wives, sisters, grand-
mothers, daughters and even friends, they increasingly carry the
physical and emotional responsibility of tending to loved ones who are infected.
These women are coming forward regardless of the resources they may have and
giving care under extremely adverse circumstances because there is no alternative.
The questions are end-
less but the bottomline
is the same. Girls and
women need to come to
the fore, need to be the
focus of policy makers,
civil society organisations
as well as of relevant
professionals
What is worse, though they may not be sero-positive, even as care givers they face stig-
ma and discrimination. When Vinita, a school teacher in Ahmedabad, shared her hus-
band’s positive status with her extended family, her husband’s two brothers, living sep-
arately, stopped all interactions with her. “I had not contracted the infection. Thank God
we came to know about it before I returned from the US where I had gone for a study
course. I shared this ‘secret’because I thought the family was really close and I need
support,” she says. “They still talk to my husband though only when there is a real
need. I’m completely ignored - as if it is all my fault and had I not gone for the course
my husband would not have ‘strayed’ and been infected!”
Vinita has decided to stay with her husband because she still cares for him. After all, he
did share with her his ‘secret’. She is grateful for that. If the media could do stories on
other such women it would help to spread awareness on one of the most sensitive and
complex issues in HIV/AIDS - the need for confidentiality and for notifying the partner of
one’s status. Discussions on AIDS-India e-group, for instance, have focussed on this
issue. In Mumbai, Jaikishan’s* mother now sleeps on the Mumbai pavement because
she has had to leave her village to look after her infected son. Maya -ma, as she is called
in her village, knows she will never return to her own home. Close to 60 years, she says
the village will not accept her after she has ‘touched’ her infected son. She is clad in her
only saree - so faded that it is difficult to identify its original colours. “My life has also
faded away,” she responds. “In more ways than one. I cannot even die where I was
born....”
Maya-ma’s role of a care giver needs to be recognised and supported by government
services. These are ‘stories’ that give the media an opportunity to put care givers on
the radar of policy makers - these women need special food rations, medical aid, coun-
selling and economic support among other things.
The care provided by these women, including the rising number of nursing profession-
als, should be recognised and supported. In Orissa, for instance, traditional birth atten-
dants (TBAs) or dais, have been trained by an NGO, in collaboration with the district
authority, to identify STDs and RTIs, counsel women and take them for treatment.
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Time for Women to be Seen and Heard 85
Information on HIV, testing and counselling are the next step. Care and support servic-
es, including individual and family counselling, are just as important as medical treat-
ment and the media can raise a public and policy-level debate on this critical issue.
Care givers, for instance, can bring their experience to decision-making, to shape the
kinds of care and support services needed at the village, block, district or state level.
Is science really neutral?
A major question in HIV prevention is how gender responsive is scientific research and
treatment? For instance, it took the medical fraternity some time and a great deal of evi-
dence to accept the idea that HIV was a threat to women (UNAIDS Report 2004)! The pro-
portion of infected women has steadily grown worldwide and this is a dangerous trend
requiring scientific solutions as much as socio-economic and political changes.
“We oppose trials on pregnant women with HIV/AIDS if treatment is withdrawn imme-
diately after they have given birth,” Patricia Monica Perez of the International
Community of Women Living with HIV/AIDS (ICW) had once said. The discrimination
continues in other ways. For instance, there is hardly any research on traditional and
other affordable and accessible alternatives to breastfeeding. The focus is on promot-
ing commercial formulae. Similarly, new scientific developments like the female con-
dom and vaginal microbicidal products, which are women controlled barriers to HIV
infection, have taken a long time to come and are still not widely accessible.
How do the medicines and vaccines impact women’s bodies? What are their adverse effects
on menstruation and fertility and how can these be mitigated? What about the effects of the
virus on women’s mental health and well-being? The media’s eye on these ‘hidden’ impera-
tives would goad the scientific community to focus more on women’s needs.
Aditi Kapoor
Regional Media Coordinator, South Asia Office, Oxfam (India)
* Name changed to protect identity
Resources
www.genderandaids.org
www.genderandaids.org/modules.php?name=News&new_topic=21 (for media toolkit)
www.itrainonline.org/itrainonline/mmtk/mmtk_hivaids_additional_resources.doc
www.eldis.org
www.unaids.org
www.unifem.undp.org
http://www.gnpplus.net/gipa_in_action.html
http://health.groups.yahoo.com/group/AIDS-INDIA/
Vinita has decided to
stay with her husband
because she still cares
for him. After all, he did
share with her his
‘secret’ on his own. If
the media could do
stories on more such
‘Vinitas’, it could spread
awareness on one of the
most sensitive issues in
HIV/AIDS – the need for
confidentiality
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86 HIV/AIDS in News – Journalists as Catalysts
Finding the Way Out of
the Needle Maze
The easy availability of heroin in the tiny North Eastern state of Manipur in the early eight-
ies led to hundreds of young people getting addicted to injectible drugs. As they punc-
tured their veins to get a ‘high,’ several of them sharing the same needle, they exposed
themselves to the HIV infection which was still at a nascent stage in the country.
In Manipur the first wave
of the epidemic was
among drug users. In the
second phase it was
transmitted to unsuspect-
ing spouses. From 1995
the spread of the epidem-
ic was more through the
sexual route. From 1997
the mother to child trans-
mission of the virus began
Desperate to get them off drugs, parents pleaded with the jail authorities to take them
in and detoxify them. In the social turmoil that the state went through, jails filled with
injectible drug users, desperate parents and social workers tied up drug users to elec-
tric pole and thrashed them to discourage them from drugs, faith healers in rehabilita-
tion centres also chained them as they chanted their voodoo and the white powder was
seized at the border and burnt publicly. But the social sanctions and the hardline ‘spoil
the rod and spare the child’ methods of treatment did not have the desired effect.
It was in 1989 that the first samples of blood of drug users were collected and sent to
Pune for testing. In February 1990, the government officially announced 960 cases of
HIV/AIDS in Manipur. Close to 50% of the high risk groups had tested positive.
The first wave of the epidemic in the early nineties was among drug users. In the sec-
ond phase it was transmitted to unsuspecting spouses. From 1995 the spread of the
epidemic was more through the sexual route. From 1997 the mother to child transmis-
sion of the virus had begun, says Mr Abhiram Mongjam, state coordinator for Population
Foundation of India’s Global Fund Project on HIV/AIDS.
Mr Mongjam, who was earlier with the Manipur AIDS Control Society, says “desperate
to get their sons off drugs, parents turned to marriage as a panacea. But in the process
they infected the simple village brides. Many sold off their wife’s saris and gold trinkets
so that they could continue to buy drugs. Abused and infected many of the girls
returned to their parents. The rejection by their spouses enhanced the drug users
dependence on drugs.
It was only in October 1996 that Manipur adopted an AIDS policy and the post of dis-
trict AIDS officer was created. In 1998 the first targetted intervention of injectible drug
users and commercial sex workers was initiated by the Manipur State AIDS Control
Society.
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Finding the Way Out of the Needle Maze 87
In June 2005 of the 126036 blood samples tested for HIV, 20297 were positive. Of
this number 3917 were women and 3466 were AIDS cases. In fact despite all the inter-
ventions the infection rate is a staggering 16% in the high risk groups, which means of
every 100 in Manipur, 16 are infected. Among pregnant women, the rate of infection is
1.6%. The reporting of deaths is poor in the State because terminally ill people prefer
to come. So the 492 deaths reported are largely from hospital records.
Though in some rehabilitation centres, drug users are still kept in chains for better con-
trol and treatment, very clearly HIV infections among drug users in Manipur is coming
down. In 1997, close to 77% of the injectible drug users were HIV positive. In 2004
just 21% of the injectible drug users were HIV positive.
Even though the use of drugs continues, sharing of needles has reduced drastically.
Because of the intervention of NACO and other groups, health awareness has
increased among them. Today if there is an abcess, the drug user does not hesitate to
visit a doctor. Since heroin is no longer that easily available and is very expensive,
tablets like spasmo proxivon which are non-injectible are being powdered, diluted in
water and injected. Peddling of drugs is still lucrative business and in 2003 a former
finance minister of the state was caught red handed in a Guwahati hotel.
HIV widows groups have been formed and through the support of UNICEF, women and
children are getting treated. The official free supply of ARVs is just 500. Some 1800
people are on the waiting list for ARVs. But several doctors are providing ARVs for those
who can afford to pay for it.
Even though the use of
drugs continues, sharing
of needles has reduced.
Because of the interven-
tion of NACO and other
groups, health awareness
has increased. Today if
there is an abcess, the
drug user does not hesi-
tate to visit a doctor
Usha Rai
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88 HIV/AIDS in News – Journalists as Catalysts
Children Show
the Way
There are umpteen chil-
dren like him in Punjab
who are HIV positive. Yet
people in rural areas in
particular are not willing
to accept the reality of
HIV/AIDS and refuse to
take even their children
to the doctor for tests
Surinder Singh of a village in Fatehgarh Sahib, Punjab, had not imagined that his one-
and-a-half-year old child would be born with a virus called HIV with which he would
have to live for the rest of his life. The tragedy struck the family when Surinder took
his pregnant wife to a doctor in Ludhiana who told him that she urgently required
blood transfusion. Surinder quickly arranged four donors and the blood was given to
her without any checks. The result - she contracted the HIV virus.
Surinder’s baby is a happy child, oblivious of his parents’ sorrow. He is HIV positive
- the result of a mother-to-child transmission (MTCT) of the virus. MTCT has an esti-
mated 30% chance of infecting a new-born. No one in the village knows that the two
are infected. Surinder’s grandfather has been to Kerala in search of an ayurvedic
drug and he now plans to go to Nanded in Maharashtra in pursuit of another “mira-
cle cure.’’
There are umpteen children like him in Punjab who are HIV positive. Yet people in
rural areas in particular are not willing to accept the reality of HIV/AIDS and refuse
to take even their children to the doctor for tests.
After losing both parents to the virus, Sonu, (name changed) a student of standard
three in a village in Ropar district, is being brought up by his uncle, Jassi Motta. But
the family is poor and it is not clear how long Sonu will get this support. “Orphaned
children whose parents had HIV/AIDS should get assistance from the government till
they are 18 years,” suggests Manmohan Sharma of the Voluntary Health Association
of Punjab.
In Ropar and Rajpura districts, ignorance about HIV/AIDS has resulted in children
continuing in school after the death of their parents. The children are not ostracised
here. “The old value system of joint families is sustaining those who are HIV posi-
tive, including children. But we do not know how long this will continue,’’ says
Sharma.
In Iruakalkada village in Koppal district of Karnataka, a group of children are busy
enacting plays on the treatment meted out to HIV positive people by family members,
the community, schools and the medical fraternity. These children, some of whom are
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HIV positive, have been brought together for a consultation on HIV/AIDS by the non-
government organisation Samuha-Samraksha with the help of Plan International.
Their knowledge levels are high, as Samuha has a school education programme that
has succeeded in creating awareness about HIV/AIDS.
The children are vocal in discussing the role of the media in perpetuating stigma and
discrimination. Ningamma who was involved in a filmmaking project last year called,
Awareness for Life, sounds like an adult when she says, “The media is only after sen-
sational stories. They are not interested in highlighting positive stories of care and
support.”
When Samuha started work in Koppal district of Karnataka in the nineties, there was
little awareness on HIV/AIDS. A rural HIV/AIDS clinic was set up in Kushtagi village with
the support of Karnataka State AIDS Prevention Society and work started on a model
offering a continuum of care and support. “Our effort was to build the entire communi-
ty as a resource. We were always fighting off the media in the early days,” recalls
Sanghamitra Iyengar, project director, Samuha-Samraksha.
Awareness for Life
Awareness for Life is the story of a group of young children who came together to
make a film on HIV/AIDS. Among them were two infected children and many HIV-
affected children. The youngsters learnt how to do script writing, camera work and
research. As they eat, sleep and work together, they realise it is this spirit of cama-
raderie which has taken them beyond stigma and discrimination. The film captures
this transition beautifully.
Ningamma says, “The film is a powerful way of narrating the reality of HIV/AIDS. The
project also proved to be a novel method of learning and self-discovery as we had
not realised that children with HIV/AIDS were being treated differently. One girl from
my village who had HIV/AIDS had been taken out of the school where she studied.
I screened the film we had made in the community and the result is she has been
taken back by the school.’’
The film, which is part of a children’s video project called: ‘Children have Something
to Say’, changed the life of Jagdish, another boy who was involved in making it.
“When we worked on the documentary, we came to know a lot about stigma and
discrimination,’’ he says. Says Shyamala, another girl sensitised to the issue, “We
do not know whom we will marry or where we will get married. All this knowledge is
very useful.’’
Children Show the Way 89
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90 HIV/AIDS in News – Journalists as Catalysts
The Kushtagi clinic
caters to 157 HIV posi-
tive children. Samuha’s
awareness programmes,
including candlelight
memorials, have helped
to remove the stigma of
HIV/AIDS as a killer
disease
The Kushtagi clinic caters to 157 HIV positive children. Samuha’s awareness pro-
grammes, including candlelight memorials, have helped to remove the stigma of
HIV/AIDS as a killer disease. Many people now know that it is a chronic, manageable
illness. The stories about people living with HIV/AIDS are no longer sensational, says
Iyengar. “Yes, the media still loves horror stories of stigma and discrimination but it
has also played a supportive role. One reason for the change is that HIV/AIDS is no
longer viewed as a foreign invasion. Everyone knows someone who has been
affected by it.”
Her organisation brings out a newsletter featuring stories of care and support to
encourage better media reportage on HIV/AIDS issues. It reported on youth groups
in a village getting together to reinstate a HIV positive person who was thrown out
of job and on people’s movements for procuring ARVs and making it available to
those who cannot afford it. Iyengar believes that such stories of hope encourage
more people to offer care and support to those with the infection. She also feels
the media could identify and examine factors like easy access to blue films in rural
areas in particular and its impact in encouraging young people to experiment with
sex in risky ways. Samuha, for instance, has awarerness programmes in the high
prevalence Koppal district where it conducts slide shows and interactive sessions
in local theatres.
The media impact on people is clear at another children’s group in Maharajganj, a dis-
trict in Uttar Pradesh bordering Nepal from where trafficking is very high. Here, a group
of children enthusiastically analyse the positive impact of the Hindi film Phir Milenge
that captures the reality of HIV/AIDS in daily life and society’s attitude towards it. “I like
the scene in which the heroine, Shilpa Shetty, accepts the reality of HIV/AIDS in her
life,” says Jawahar Kumar, a member of Babu Bahini Manch, a children’s forum for
expression, advocacy and action.
Through the Manch, the children take up a range of social issues, including HIV/AIDS.
They want to organise special screenings of Phir Milenge in their community. “The press
only reports incidents and events. It does not report positive stories,’’ says Ameena, a
member of the Manch. Cases of stigma and discrimination are etched in their memo-
ry. They recall instances of family members ill-treating infected people. There was a boy
in Bijmanganj village whose mother was infected. Her family drove her away from home
and a voluntary organisation helped her obtain domestic work. The boy was taken away
by his relatives after his mother died.
The children discuss how the positive projection by the media can help dispel myths
and reduce the burden of stigma and discrimination. They refer to the positive influence
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Children Show the Way 91
of the TV series ‘Vijay Jasoos,’ where the central character is HIV positive and helps oth-
ers cope with the infection.
Worldwide there are 2 million to 2.6 million children below 15 years who are infected
and struggling for survival without the support of parents or guardians. Not only do
these children lose the security and safety of their immediate families, but they fre-
quently end up taking on adult responsibilities. They provide care for dying patients, sib-
lings and earn money for basic necessities. Often, they are forced to give up school,
have less access to health care, and become vulnerable to malnutrition.
In India, there has been no real study on the impact of HIV/AIDS on children. As per
NACO’s December 2004 data 1,20,000 children below 15 years are infected by the HIV
virus. There is no data on children affected by AIDS. But Karnataka, Punjab and Uttar
Pradesh, where the media scan was done, report an increase in the number of
HIV/AIDS orphans. Moreover, because of the increasing number of HIV/AIDS patients
in the three states, the number of children getting infected is very high. The mother-to-
child transmission is as high as 30 % but the government does not have a youth-friend-
ly awareness and prevention programme in place.
While children infected and affected by HIV/AIDS are being taken care of by the com-
munity in Punjab, this is more because of the ignorance about the infection
than an empathetic response. Simultaneously, there are several myths about
HIV/AIDS, especially about it being a “killer disease.” This results in people hiding
the infection.
In India, there has been
no real study on the
impact of HIV/AIDS on
children. As per NACO’s
December 2004 data,
1,20,000 children below
15 years are infected by
the HIV virus
Even in Karnataka where awareness is very high, cases of stigma and discrimination
come out as sensational media reports. Availability of medicines is another concern.
In Karnataka, Samuha has established free seva clinics where people are counselled,
diagnosed and given free treatment. To encourage people to come to the clinics with-
out fear of stigma and discrimination, free general check-up is offered.
Samuha runs a chain of women’s clinics which deal with all health complaints, includ-
ing HIV/AIDS and reproductive tract infections. The programme, called Namma
Arogya, has heightened awareness and increased access, including bringing in infected
children.
In Punjab, the only super-speciality hospital for HIV/AIDS is the Post-Graduate Institute
for Medical Research, Chandigarh, which also has a children’s wing. However, the pres-
sure on the Institute is high and people have to wait for weeks to get attention. Though
medicines are free, they are not easily accessible.
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92 HIV/AIDS in News – Journalists as Catalysts
Memory Books Link Children Orphaned by AIDS to Their Past
“My favourite memories of you go back to the day when you were born, February 20,
1990. This day has become my most precious memory of you. When you came into
this world, you were such a nice and lovable baby, admired by all,” says Christine
Akuga to her daughter Evelyn Akoth.
Although Christine died of HIV/AIDS related causes, her daughter Evelyn has
received more than a few special memories from her mom. Written in English, the
Memory Book is a powerful insight into the family life of this 10-year-old girl who,
luckily, has not contracted the HIV virus from her parents. The pages, curled and
crisp due to thick and heavy pressure writing, tell stories about Evelyn’s mother,
father and grandparents.
A great deal of space is dedicated to the mother’s health once she tested positive and
to the uneasy relationship she had with her husband’s second wife-her daughter’s step-
mother. “This Memory Book was quite revealing for Christine’s parents as well. As they
read through it, they learnt many things they were not aware of,” explains Beatrice
Muwa, Health Coordinator for Plan in the Ugandan district of Tororo.
The idea of writing a Memory Book comes from terminally ill patients in the United
Kingdom. In Uganda, the National Community of Women Living with HIV/AIDS (NAC-
WOLA) began to promote this approach in 1998, and has since encouraged hun-
dreds of women to pass on their family history this way to their children.
NACWOLA came into existence as a result of HIV infected mothers finding it difficult
to communicate to their children about their ill health:
“Secrecy wears you down fast,” explains Beatrice Were, Programme Coordinator for
NACWOLA as she recalls the moment she disclosed her HIV status to her children.
“I was relieved to be able to share my condition with them. In my experience what
hurts a child the most is to find out later that you have kept crucial information away
from them. But after the sero status is disclosed to children, it is important to
involve them in all decisions that will affect them.”
The development of child-friendly IEC material will help communicate issues con-
cerning HIV/AIDS to vulnerable children and adolescents. It can also be used by
NGOs to generate awareness about HIV/AIDS while working with people who can-
not read or write.
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Children Show the Way 93
Impact of HIV/AIDS on children
1. Uncertainity about the future
2. Gender difference impacts girl child
3. Vulnerability to infections
4. Economic problems
5. Less access to education
6. Property grabbing
7. Foster care or child headed households
8. Inadequate nutrition/food security
9. Risk of sexual exploitation/abuse
10.Households headed by the elderly
11.Psychological trauma for the infected and affected children
However, under the Indian law consent of parents or guardians is a pre-requisite for pro-
viding any kind of care and support for children below 18 years. This is an impediment
for preventive programmes on HIV/AIDS. Elders do not even approve of safe sex educa-
tion. The law needs to be amended so that children above 12 years and especially those
who live on the streets or are married very young have confidential access to sexual
health information, contraceptives including condoms, STI and HIV/AIDS testing and
treatment services.
The HIV/AIDS comics
book is being distributed
to NGOs, HIV/AIDS pro-
fessionals all over the
country and to school
children in the Hindi
speaking areas
The reponse to HIV/AIDS differs from country to country but Uganda’s Memory Books
are a wonderful way for those infected to communicate with their young ones about
their family history.
Comics on HIV/AIDS
In January 2005, children of 8 to 17 years were involved in preparing comics on
HIV/AIDS with the support of World Comics and NGOs working on the issue. Sixty street
children, orphans, school going and non-school going children from slums, a large num-
ber of them infected or affected by HIV participated in the project. After orientation
through interactive sessions by a counsellor and infected persons and street plays, the
children developed stories on issues such as transmission, prevention, stigma and dis-
crimination and positive living.
With inputs from cartoonists and technical experts on HIV, the children developed comics
based on stories they had written. Some 60-70 comics developed by the children were
even exhibited. The HIV/AIDS Comics Book, is being distributed to NGOs , HIV/AIDS pro-
fessionals all over the country and to school children in the Hindi speaking areas.
A helper in a teashop at Chandni Chowk, one of the busiest commercial areas in Delhi,
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94 HIV/AIDS in News – Journalists as Catalysts
Amit’s melancholy stems
from the fact that no one
told him not to have mul-
tiple partners. “I would
not have ventured into
such sexual practices if I
was warned about the
HIV infection”
Amit (name changed) ran away from his home in Bihar and came to Delhi eight years
ago. Now 18 and infected with HIV, he is among the many children who have got the
infection from the street. “As long as I can remember, I have been involved with girls. I
also used to frequent the red light areas of Delhi. My life has been determined by my
friends and those who abused me sexually during my early days in Delhi,” he recalls.
Amit’s melancholy stems from the fact that no one told him not to have multiple part-
ners. “I would not have ventured into such sexual practices if I was warned about the
HIV infection,” he says. There may be many Amits in the country’s metros. The new
comic book could be their ‘life saver.’
Krishnaswamy Kannan & E.K. Vinayakan
Plan International (India)
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Seeking the Right Prescription 95
Seeking the
Right Prescription
Anti-retroviral drugs, vaccines, microbicides and patent issues
“Make drugs available and you will notice the stigma that surrounds HIV/AIDS reced-
ing”, said an NGO representative, to stress that a lot of the silence around HIV/AIDS
and peoples’ inability to declare their positive status has also been because they know
it will not mean any improvement in their physical situation. In the early days of the epi-
demic in India, with hardly any AIDS drugs or anti-retrovirals (ARVs) available there
seemed little point in declaring one’s HIV status.
In its annual report of 2002-04, the National AIDS Control Organisation (NACO) made
a point: People were not showing up at Voluntary Counselling and Confidential Testing
Centres (VCCTCs) because if they were declared HIV-positive, the only tangible follow-
up would be for the government to write out a referral. The growing availability of
ARVs and their improvement in India and across the world has helped address the
stigma associated with HIV/AIDS in the simple sense of treatment options being
available. They may not always be suited to individual patients, they are extraordinar-
ily expensive to date, and they may create toxicity, but their availability is helping peo-
ple living with HIV/AIDS deal with the burden of stigma and discrimination associat-
ed with the infection.
The growing availability of
ARVs and their improve-
ment in India and across
the world has helped
address the stigma asso-
ciated with HIV/AIDS in
the simple sense of
treatment options being
available
Today, we live in a changed India. A little over a year ago, the Central Government
launched a free roll-out of ARVs at select centres in the six high HIV prevalence states.
It was back in 2001 that the UN General Assembly Special Session on HIV/AIDS
pushed for worldwide agreement on the need for ARVs and the Indian government,
through NACO, decided on a radical policy change. The National AIDS Control
Programme was to give free ARVs to 100,000 people. This initiative was finally
launched from April 2004. According to NACO, nearly 7,000 people are receiving free
ARVs - a target that is expected to grow to cover one lakh people by 2007. Meanwhile,
the government hopes to expand the programme to 100 centres by the end of 2005.
The new Patents Bill of 2005 is also a factor for the change. (See Box No 1: India’s
New Rules with Patents)
However the reality on the ground is not as promising. (See Box No 2: From The Indian
Express). People in need of ARVs are queuing up and doctors at government-designat-
ed centres are being forced to take some tough decisions on who can be given free
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96 HIV/AIDS in News – Journalists as Catalysts
The “3 by 5” initiative
launched by the World
Health Organisation and
UNAIDS in 2003, catal-
ysed treatment in India
and other developing
countries
ARVs. There are concerns about what line of treatment is being offered in terms of drug
choice within the free ARVs programme and about the support infrastructure keeping
pace with the roll-out. These are important issues that pose hard challenges. But it is
clear that there is global pressure now for science and medicine to deliver. What are
the most important scientific breakthroughs? Do they translate into actual improve-
ment in treatment and other options for people living with HIV/AIDS? Is state-of-the-art
treatment reaching the needy? But a beginning has been made in widening access to
treatment and that is an achievement.
The “3 by 5” initiative (to reach treatment to three million people by the end of
2005), launched by the World Health Organisation (WHO) and UNAIDS in 2003,
catalysed treatment in India and other developing countries. Although the pro-
gramme is unlikely to reach its target by the end of 2005 as per UN data, the last
few years have seen overwhelming changes in the approach to ARVs and HIV/AIDS.
These were fuelled by the need to expand treatment options in developing countries
in particular.
Expanding the reach of treatment options is important. At the Rio conference in July
2005 on HIV pathogenesis and treatment, the focus was on finding innovative means
of doing so. HIV/AIDS is an evolving epidemic and the careful monitoring of viral sub-
types will be essential to stem its growth. There is urgency now for the world to learn
how to lessen the gap between scientific discovery and practice. This is closely linked
to finding faster and better ways to treat HIV/AIDS. World leaders repeatedly get
India’s New Rules with Patents
India got a new patents regime in 2005, one that is expected to push forward origi-
nal research and ensured that processes and products patents are protected. Here’s
the concern: For several years India has been playing a significant role in the world-
wide access to drugs - especially in the developing world - making generic formula-
tions available at affordable prices. It has also been a leader in the global debate at
the World Trade Organisation on TRIPS and its impact on public health.
In 2000 Indian pharma companies began manufacturing generic antiretroviral drugs,
which impacted positively on the cost of ARVs and allowed wider access to the drugs.
According to Medecins Sans Frontieres (MSF), of the 700,000 people who receive
ARVs in the developing world, almost half receive Indian generics. In February 2005,
MSF said it treated 25,000 people in 27 countries with ARVs and 70 per cent of the
patients were on medicines that originated from India. MSF has been a strong advo-
cate for flexibility in the patent regime that will allow wide and free access to ARVs.
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Seeking the Right Prescription 97
together to endorse the need for fresh investment and resources to meet the goal of
universal access to treatment by 2010.
According to WHO and UNAIDS, 67,000 people are undergoing treatment for
HIV/AIDS in India. This means coverage of 4-9% of those infected. The unmet need
is 7,35,000. From the Global Fund to Fight AIDS, TB and Malaria, some 4,500
women, their partners and children are to get ARVs. The Round 4 proposal aims to
provide 180,000 people with ARVs in the public sector and 200,000 people in the
private sector by the fifth year.
In India, the private sector is the most active provider of treatment and the case with
HIV/AIDS is no different. The Employees State Insurance Scheme in the Central
Government Health Scheme also provide ARVs to employees.
In the overall scenario of providing ARVs to as many people as possible, there is an
issue that must be considered. It is established that from among all those who are HIV-
positive, only 10-15% really need ARVs. It is very common practice to find that there
are several people who are being put onto ARVs but do not really need it - these are
people with relatively high CD4 counts (measure of the health of the immune system
in an HIV infected person) and no Opportunistic Infections (OIs).
Ideally, ARVs should be prescribed only once immune suppression has really reached
an advanced stage and the basic rule for availing free ARVs is that the patient’s CD4
counts should be lower than 200. Many health professionals believe that real success
will lie in early tracking of infection and looking after newly-positive people so well that
their need for ARVs can be pushed as far ahead as possible. Early detection, compe-
tent and sensitive counselling, nutrition, social care and support through non-discrimi-
natory employment are vital. Equally important is strict regulation and guidelines in the
medical practice of prescribing ARVs, insurance coverage, and addressing the line of
regimen available in free ARV centres.
It is established that
from among all those
who are HIV positive,
only 10-15% really need
ARVs. It is very common
practice to find that there
are several people who
are being put onto ARVs
but do not really need it
It was in the late eighties that the first ARVs were developed, to interrupt and suppress
viral replication and try and restore immune function (See Box No 3: Drugs to Combat
HIV/AIDS). From single drugs to coupled combinations to multi-drug combinations now
- the upsurge has been rapid, fuelled by quick development of resistance to drugs by
HIV within a few years of the first ARVs being used. For less than a dollar ( Rs 48) a
day, ARVs are available in India, from generic manufacturers. But shelling out so much
per day just for one family member’s drug intake is too much for many families. Yet, it
is important to value ARV provision because it means not just reduced viral loads but
reducing the spread of infection.
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98 HIV/AIDS in News – Journalists as Catalysts
From The Indian Express
Indian Express, May 11, 2005, Anuradha Mascarenhas: Free Anti-Retroviral Therapy:
Too many patients, too little time
Pune, May 11: Living with AIDS for three years, Pandurang (name changed), has been
ostracised by his parents and given food in separate utensils. Today, as the farmer
from Parner waits for free medicines at the Anti-Retroviral (ARV) therapy centre at
Sassoon General Hospital, he is scared to reveal that his 30-year-old wife and eight-
year-old son are also sero positive.
Neeta lost her husband to HIV two years ago. Last November, she fell sick and start-
ed losing weight. Tests revealed that she too had contracted the virus. With just a
class X pass certificate, she is unemployed, worries constantly and makes weekly
rounds at the ART centre hoping that her name will be considered for the free drugs.
Pandurang and Neeta are among the several patients queuing up at the Anti-retrovi-
ral (ARV) therapy centre at Sassoon, hoping to be included in the programme that
provides free medicines to HIV positive patients. Even as five or six patients are reg-
istered every day, the medical worker at the centre is patient with the others, prom-
ising to enroll them soon.
An ambitious anti-AIDS initiative by the government aided by the World Bank, the ARV
programme aims to provide free medicines - a combination of three drugs (see box)
supplied by the National AIDS Control Organisation (NACO) - to HIV patients whose
CD4 count is less than 200. There are 33 centres all over the country.
In Pune, the ARV centre was set up in January and according to Dr A L Kakrani, Head,
Department of Medicine, Sassoon, 1,011 patients (588 men, 403 women) have
been screened. Of these, free medicines are given to 131 patients. ‘’We have writ-
ten to the Maharashtra State AIDS Control Society who have promised to upscale
the programme,’’ Kakrani told Newsline when asked about the long queues outside
his centre everyday.
Given that Maharashtra with an estimated 7.5 lakh patients has the highest number
of infections, making a success of ARV therapy is a daunting task. Also, once start-
ed, ARV therapy cannot be stopped midway. Hence the need to ensure that whoever
is enrolled is supplied drugs for a lifetime.
Dr V L Kulkarni, Deputy Director, Sexually Transmitted Diseases and in-charge of the
ARV programme in Maharashtra, explains the issues. ‘’We are going slow on the ART
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Seeking the Right Prescription 99
programme,’’ he admits pointing out there should be sufficient stock of drugs to
ensure that the lifelong programme is successful. ‘’It is dangerous to discontinue
the programme once patients are administered the drugs.’’
Dr Mukund Penurkar, Senior Medical Officer with the ARV centre in Pune, agrees.
‘’We feel bad turning away patients. People from as far as Latur, Aurangabad and
Ahmednagar come here seeking free ARVs,’’ he says. Though they have to select
their patients carefully, depending upon the CD4 count, wives of HIV patients who
have also contracted the virus are admitted on priority. So far, there is one child
on ARVs at SGH.
But the government has plans to upscale the ARVs programme. According to New
Delhi-based Ajay Khera, Joint Director for Training and ARV, the idea is to have 100
centres across the country by the year-end and treat at least 25,000 HIV infected
persons this year.
Apart from ARV centres at Mumbai (1,750 patients), Miraj (350 patients), Pune (131
patients) and Nagpur (140 patients), the other centres will come up at Yavatmal,
Akola, Aurangabad, Ambejogai and Kolhapur.
THE REGIMEN
ARV: Anti-retroviral therapy is a government programme that aims to provide free
drugs to AIDS patients with CD4 count less than 200. In Pune, 131 patients are on
ARVs. But there are more who need it.
Medicines: The cheapest combination of drugs Stavudine, Lamivudine and
Nevaripine comes in a capsule ‘’Tri Omune’’ costing Rs 1,239 for a month.
The other combination is Duvoir-N that includes Zidovudine and Lamivudine.
Nevaripine has to be taken separately. This costs Rs 1,350 per month. So far, 10
patients in Pune are on this treatment.
Efavir 600 is the costliest at Rs 2,826 per month. This includes Efavirenz (suitable
for patients on anti-TB drugs), Lamivudine and Stavudine.
According to recent media reports the reality of free ARVs and the government’s plans
to expand it is wrought with challenges - actual amounts of drugs and making sure
treatment goes uninterrupted, once begun, ensuring coverage of those who are the
most needy . A lot of patients are turned away in Pune centres for free ARVs and patient
selection based on CD4 counts is also difficult.
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100 HIV/AIDS in News – Journalists as Catalysts
Treatment for HIV/AIDS has become centre-stage not only with the political leadership,
but with the governmental machinery, medical fraternity and the non-governmental sec-
tor. There has been a lot of effort recently to make treatment a part of the comprehen-
sive package to deal with the epidemic. According to UNAIDS and WHO, in December
2003 the focus was on upscaling ARVs in 49 countries under the ‘3 by 5 initiative.’
India is in this select group. In these 49 countries live 87 % of all adults and children
infected with HIV/AIDS. Over half the world’s infected population that needs treatment
lives in six nations - Ethiopia, India, Nigeria, South Africa, Tanzania and Zimbabwe.
India began its first
Phase-I AIDS vaccine trial
in early 2005. It hopes
to stay engaged with this
cutting-edge global
endeavour in as close a
manner as possible, but
a vaccine against AIDS is
proving to be one of the
scientific and medical
community’s biggest chal-
lenge
Meanwhile, the Indian Government wants to explore other technological options for
combatting HIV/AIDS, especially vaccines and microbicides. Several vaccine candi-
dates are being studied in clinical trials worldwide, but the search is still very much in
stages of experimentation. Hundreds of clinical trials of more than 30 different vaccine
candidates have been completed, but there are no breakthroughs yet.
India began its first Phase-I AIDS vaccine trial in early 2005. It hopes to stay engaged with
this cutting-edge global endeavour in as close a manner as possible, but a vaccine against
AIDS is proving to be one of the scientific and medical community’s biggest challenge.
Microbicides — chemical substances that can be used to keep sexually transmitted infec-
tions away - are also being tried in various phases, but again, no breakthroughs yet.
It is obvious that these efforts need tremendous political and social support. There are
now so many commonalities between advocacy for treatment and novel technologies
like microbicides and vaccines that the world has coined for itself a new phrase - MTV
- advocacy for Microbicides, Treatment and Vaccines for HIV/AIDS. The idea behind MTV
of course, is to be able to combine the strengths of these three complex and active
fields to influence and shape worldwide political opinion, and to build the much-need-
ed support and encouragement to continue research to achieve these goals. MTV advo-
cacy is expected to break barriers and allow for strong collaboration that can eventual-
ly take the world closer to answers in tackling HIV/AIDS.
So, what lies ahead? Treating HIV/AIDS has just entered a new era - and the immedi-
ate focus is a need for drugs that are simpler, offering stronger barriers to resistance,
and with minimum side effects. In India, there is now an opportunity to incorporate
interventions for prevention in treatment settings. The issue of how involved NGOs can
be in the provision of ARVs is being addressed, as well as the question of the extent
to which ARVs can be upscaled. The Indian Network of People living with HIV/AIDS is
involved in a rapid assessment of the progress of ARV scale up. The Indian government
along with WHO has begun a process of monitoring and evaluation of the ARV rollout,
starting with a national consultation held in April 2005.
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Seeking the Right Prescription 101
Drugs to Combat HIV/AIDS
There is yet no cure for HIV/AIDS. ARVs work on disrupting the replication of HIV
within the human body but cannot rid the body of the virus. In 1986-87, scientists
found a drug that could affect the viral life cycle of HIV by becoming an impediment
in its replication. This was a drug designed to act on an enzyme called reverse tran-
scriptase enzyme, thereby blocking the formation of a pro virus DNA. Since then, var-
ious drugs acting on reverse transcriptase have been discovered. These drugs gen-
erally fall into two groups – Nucleoside Analogue and Non-nucleoside Analogue
drugs. In the late nineties, a new line of ARVs that would act on the enzyme protease
were discovered. Protease is an enzyme that helps in the maturation of m-RNA to
mature virions or viral particles, and these drugs are called protease inhibitors.
According to NACO, though most of these drugs are available in India, these are
expensive. They cost Rs. 11,000 - Rs 15,000 per month per patient. The drugs avail-
able in India are:
Reverse transcriptase inhibitors
Nucleoside analogue
AZT (azidothymidine, zidovudine) - 100 mg. each tablet
DDC (zalcitadine) - 75 mg. each tablet
Stavudine - 100 mg. each tablet each
Lamivudine - 150 mg. each tablet
Non-nucleoside analogue
Nevirapine - 200 mg. each tablet
Protease inhibitors
Saquinavir
Ritonavir
Indinavir
Post exposure prophylaxis
The following drugs are only used for post exposure prophylaxis and supported by
the Government of India:
Zidovudine - 300 mg. twice daily for 4 weeks
Lamivudine - 150 mg. twice daily for a period of 4 weeks
Indinavir - 800mg. thrice daily (only when indicated as part of expanded regime)
Detailed guidelines have been issued to all State AIDS Control Societies (SACS) for
further dissemination to all hospitals in the public, private and voluntary sectors. The
Central Government has provided funds to all the state societies with the direction
that the drugs should be made available in all government hospitals.
(Source: www.nacoonline.org)
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102 HIV/AIDS in News – Journalists as Catalysts
ARVs for Children
Without treatment, half the world’s HIV positive children will die before their second
birthday. Today there are 660,000 children who need ARVs and roughly four million
need cotrimoxazole prophylaxis. There isn’t sufficient ground knowledge medically
regarding the treatment of children and this capacity must be built urgently.
Recombinant HIV is
beginning to complicate
matters and calls for bet-
ter scientific understand-
ing, and some measure
of urgency
There are technical posers too. Recombinant HIV – a variant of HIV that contains genet-
ic materials from more than one subtype of the virus – is beginning to complicate mat-
ters and calls for better scientific understanding, and some measure of urgency. How
can we make treatment as convenient and efficient as possible and reduce toxicity? In
fact, this is an important question being posed to medical science today – can we
improve on current HIV drugs and create better drugs that will have less toxicity?
Reduction of drug toxicity is a major field of pharmaceutical research. Other questions
are – Does interrupted treatment work better?
It is obvious that India has accepted the challenge presented by ARVs and treatment
of HIV/AIDS. However it will take some time before the country will be able to use to
its advantage indigenous expertise – be it in the pharma sector or from the medical
and public health fraternity.
For Further Reading
1. www.nacoonline.org
2. AIDS India e Forum
3. www.aidslaw.ca
4. www.aidsinfo.nih.gov
Dr Subhadra Menon
Senior Health Journalist
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Standing Up for Their Rights 103
Standing Up for
Their Rights
Since 2004 there has been significant activity both internationally and in India on gar-
nering a media response to the HIV/AIDS epidemic. In early 2004, the UN Secretary
General announced the ‘Global AIDS Media Initiative’ to fight HIV/AIDS by using the
media for public education.
Closer home, in January 2005, a high level meeting chaired by the Prime Minister saw
media agencies commit resources including air time, coverage and reporting to address
HIV/AIDS. While the news media agreed to encourage ‘AIDS journalism’, entertainment
channels volunteered to weave in HIV/AIDS related themes into popular soaps, serials etc
to reach mainstream audiences. Undoubtedly, a heightened media response to HIV/AIDS
will help shed misconceptions, ignorance and apathy to HIV/AIDS among the masses.
How differently the ‘new, informed’ audience will respond to HIV/AIDS and to people
affected by it will depend on the nature and manner of HIV/AIDS reportage. To ensure
that the audience respond with less prejudice, ridicule and intolerance towards affect-
ed people than before, reporters need to be informed of the complex socio-economic
and legal factors that underlie the HIV/AIDS epidemic.
This article highlights some of the key legal and human rights concerns that have aris-
en over the last two decades in the context of HIV/AIDS in India. The essay tracks the
defining legal interventions on HIV/AIDS and examines their role in addressing HIV
related discrimination. It attempts to foster a better understanding of the interface
between human rights, law and HIV/AIDS so as to inform and influence media debates
on the epidemic.
To ensure that the audi-
ence respond with less
prejudice, ridicule and
intolerance towards
affected people than
before, reporters need to
be informed of the com-
plex socio-economic and
legal factors that underlie
the HIV/AIDS epidemic
HIV/AIDS AND HUMAN RIGHTS – AN INEXTRICABLE LINK
“ Paradoxically enough, the only way in which we will deal effectively with
the rapid spread of HIV/AIDS is by respecting and protecting the rights of
those already exposed to it and those most at risk.”
Justice Michael Kirby
The incontrovertible public health lesson emerging from the epidemic is that protecting
rights of those affected by HIV/AIDS is the best way of protecting the rest of the society.
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104 HIV/AIDS in News – Journalists as Catalysts
The rationale behind this
‘rights-based’ approach
is that HIV prevention,
care and treatment will
be accessed by the com-
munity only if the individ-
ual is assured of the
right to autonomy and
consent, privacy and con-
fidentiality, equality and
non-discrimination
This lesson translates into programmes and services that are voluntary, confidential
and non-discriminatory in nature. The rationale behind this ‘rights-based’ approach,
which is now supported by ample evidence from the ground is that HIV prevention, care
and treatment will be accessed by the community only if the individual is assured of
the right to autonomy and consent, privacy and confidentiality, equality and non-discrim-
ination. In actual terms, it implies that a sex worker visiting a health clinic is not com-
pelled to undergo an HIV test, merely because her ‘behaviour’ exposes her to HIV infec-
tion. Or, that the school is not automatically ‘notified’ of the HIV positive status of a
student whose mother dies of HIV/AIDS related illness. And, that a factory worker who
tests positive for HIV does not lose his job simply because he is infected. It means that
communities, social and state institutions - families, neighbourhoods, schools, hospi-
tals, workplaces treat HIV/AIDS without fear, prejudice and discrimination.
Actualising a ‘rights based’ response
Fortunately, the National AIDS Control Programme in India is built on a rights
based or ‘integrationist’ health model. Preventive education, voluntary and confiden-
tial testing, harm reduction interventions for groups at greater risk of infection,
non-discriminatory treatment, care and support for positive people constitute the
core of the government’s HIV/AIDS programme and are compatible with universally
accepted health and human rights standards.
Yet, despite the conceptual indoctrination of rights in policies and programmes, the
reality for people affected by HIV/AIDS is very different. It is not uncommon for women
attending antenatal clinics to get tested for HIV/AIDS without being informed and to be
thrown out after a positive test result. Many hospitals till date publicly identify people
living with HIV/AIDS by placing boards with “AIDS Patient” boldly imprinted on the bed-
side. People testing positive for HIV continue to be refused treatment and inpatient
care, lose their jobs and denied other rightful claims. Violence against marginalised and
vulnerable communities including sex workers, injecting drug users and gay/transgen-
dered persons is not only condoned but also often approved.
These are a handful of illustrations of rights violations related to one’s actual and/or
perceived HIV status. The list is long and encompasses violations in multiple spheres
- family, neighbourhood, school, workplace, and hospital.
The two differing approaches described next show that rights have a decisive role to
play in preventing the spread of HIV/AIDS and mitigating its effect. Promotion of public
health rests on the protection accorded to individual rights. Thus, securing rights of
people living with and affected by HIV/AIDS is not only an important end in itself but
also serves as a means to a larger end, that is, safeguarding public health.
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Standing Up for Their Rights 105
Protection of ‘individual rights’ = Promotion of ‘community health’
1996: A red light area in Mumbai is
raided by the police to eliminate
unscrupulous, criminal elements that
thrive on prostitution. All 450 sex work-
ers detained and arrested during the
operation are forcibly tested for
HIV/AIDS. The hospital where the sex
workers are tested discloses the
results in an attempt to ‘warn’ the pub-
lic about the risk that ‘breeds’ in the
red light area. Local municipal authori-
ties consider steps to deal with the
hazard that HIV positive sex workers
pose to the local public. One sugges-
tion is to imprison those infected with
HIV/AIDS. This proposal is turned
down, as it may put prison authorities
at risk. Another suggestion is to incar-
cerate them in the infectious disease
hospital; but the hospital staff is not
prepared to admit AIDS infected sex
workers. A third suggestion is to stamp
“HIV positive” in indelible ink on the
sex workers’ faces so that the public is
easily able to identify the menace.
Months later, the issue dies down.
Meanwhile, some sex workers remain
confined to the correctional home with-
out access to medical or other support
while others are back on the streets
desperately soliciting customers, the
risk of HIV/AIDS notwithstanding.
1991: An STD/HIV survey conducted in
a brothel area in Kolkata reveals a high
prevalence of STD infection and dismal
condom use - conditions ‘ripe’ for the
rapid spread of HIV/AIDS. A public
health specialist is summoned to pre-
vent and control the spread of STD/HIV
among sex workers and their clients.
The intervention is designed premised
on respect, recognition and rights of sex
workers. A health centre is started with-
in the area providing check up and treat-
ment for STDs among other health ail-
ments. A core group of sex workers is
trained to develop and disseminate
information on HIV prevention. Soon, the
group begins educating others on cor-
rect condom use and protected sex. As
the community begins to take control
over its own health and life, condom
negotiation, which was a daunting task
for most, becomes a given, as all sex
workers abide by the self-created “no
condoms, no sex” rule. Over a span of
five years, the prevalence of STD
declines while condom use is near uni-
versal. Sex workers coalesce to articu-
late and address concerns of violence,
goonda and police harassment, chil-
dren’s education, income and livelihood -
the very same factors that underlie risk
and vulnerability to HIV/AIDS.
1999: HIV prevalence among sex work- 1998: HIV prevalence among sex work-
ers in Mumbai over 60%.
ers in Kolkata is five per cent.
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106 HIV/AIDS in News – Journalists as Catalysts
It is in this context that we examine some of the topical legal cases that have set prece-
dence and shaped the legal response to HIV/AIDS till date.
1987: Legal challenge to the ‘isolationist’ response
Soon after the detection of the first HIV/AIDS case in Chennai, the legislature of Goa
enacted the Goa Public Health (Amendment) Act, 1986 to include provisions that
allowed health authorities to forcibly test anyone suspected with AIDS. Furthermore, the
Act authorised the State to isolate persons with HIV/AIDS. Exercising powers under the
Act, Dominic D’Souza, an HIV positive activist, was quarantined in a TB sanitorium for
over three months in complete disregard of his fundamental, legal and civil rights. From
a public health perspective, the Act set a dangerous precedent of instituting an irra-
tional, fearful and forcible reaction to HIV/AIDS. Dominic’s arrest and confinement as
also provisions of the Act that allowed the State to do so were challenged before the
Bombay High Court (Goa Bench).1 Although the Court ordered Dominic’s release, it did
not see any infirmity in the impugned legislation. The legal challenge, though unsuc-
cessful in revoking the provisions inimical to rights, prevented the isolationist response
as espoused in Goa from being replicated elsewhere in the country.
1997: Affirming the right to work
In 1993, MX, a casual labourer employed with a public sector corporation was detected
with HIV/AIDS during a routine medical check up. Soon after, he received a notice from
the employer asking him not to report to work. A writ petition was filed before the
Bombay High Court contesting MX’s dismissal on the grounds of his HIV positive status.
The petition contended that MX’s termination was unjust, arbitrary and wrongful
since he was physically fit to work. In defense, the Corporation averred that employ-
ing a person suffering from a serious disease like HIV/AIDS would pose undue
financial and administrative burden and that it cannot be saddled with such respon-
sibility/liability. In a landmark judgment2 delivered in 1997, the Bombay High Court
held that the Corporation’s refusal to employ MX on the grounds of his HIV positive
status constituted a violation of his fundamental rights to equality, non-discrimina-
tion, life and livelihood. The Court upheld the right to employment of an HIV positive
person subject to the condition that such person is otherwise qualified person, med-
ically fit to perform the job functions and does not pose a significant risk to others
at work.
The High Court order not only led to MX’s reinstatement but also, on broader note, laid
down an affirmative legal principle with regard to employment and HIV/AIDS. Courts in
1 Lucy v. State of Goa, 1990 Mah LJ 714
2 MX v ZY AIR 1997 Bom 406
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Standing Up for Their Rights 107
India and abroad have, since, followed the MX v ZY decision while adjudicating on HIV
related employment cases.
Enabling access to justice
Additionally, MX v ZY saw the evolution of a beneficent litigation strategy that enables peo-
ple living with HIV/AIDS to seek redressal without revealing their identity. HIV positive per-
sons refrained from approaching courts, even in situations of abject infringement of
rights, because of potential social ostracism resulting from the disclosure of their status
in legal proceedings. Recognising that the stigma associated with HIV/AIDS was a formi-
dable barrier for people with HIV/AIDS in filing claims, the Bombay High Court allowed the
petitioner to litigate under a pseudonym. The court accepted that suppression of identity
might be allowed in the interest of justice though it impinges on the administration of jus-
tice, which demands that trials be open to public scrutiny. Allowing HIV positive litigants
to sue without revealing their identity has now become standard practice in most courts.
1998: To marry or not to marry
In a judgment3 that came as a setback for people living with HIV/AIDS, AIDS service
organisations and rights activists, the Supreme Court, suspended the right to marry of
people living with HIV/AIDS in 1998. The facts of the case resulting in this pronounce-
ment were such: - Mr X was engaged to Ms. Y when he tested positive for HIV/AIDS.
The hospital authorities did not inform him of his status but instead revealed this infor-
mation to a third party known to Ms. Y’s family. The news spread in the village commu-
nity like wild fire causing much anguish to Mr X and his family. The social stigma,
ridicule and ostracism compelled him to leave the village.
Mr X sued the Hospital for breach of confidentiality of his HIV status. The matter
reached the Supreme Court on a technical question of jurisdiction. The court, however,
went into the merits of the case rejecting Mr X’s claim for damages. The court went fur-
ther and ruled that persons inflicted with HIV/AIDS could not marry.
The seeming rationale behind the apex court’s order precluding positive persons from
marrying was that being a sexually transmissible and life-threatening disease, a person
with HIV/AIDS cannot be allowed to imperil the right to life of a prospective spouse.
The implications of the court order for marriage between two positive persons or even
between sero-discordant partners, where such marriage was with full and informed con-
sent, were not clear. A few people however, welcomed the decision believing that it was
a sound way of protecting women, who get infected by their husbands and, who in most
situations, do not have a say in choosing a partner.
3 Mr. X v Hospital Z (1998) 8 SCC 296
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108 HIV/AIDS in News – Journalists as Catalysts
Following a legal intervention, which saw emphatic arguments dispelling the fallacy
behind ‘polarisation of rights’ in the HIV/AIDS context, the Supreme Court restored the
right to marry in December 2002.
Awaiting decision
Other critical legal issues affecting people living with HIV/AIDS that are pending decision
from the courts include the right to receive medical care without discrimination, the right
to access HIV/AIDS treatment and medication, and the right to continue in military and
police service. Besides, there are numerous cases filed by or on behalf of people living
with HIV/AIDS for individual relief pending adjudication in family, labour and district courts.
Securing rights but not restitution
Though legal aid/litigation has enabled HIV affected persons to seek what they are enti-
tled to, there are several limitations to legal redressal. Foremost, Constitutional claims
of equality and non-discrimination lie against the State or government bodies only.
There are no legal measures that prohibit discrimination in private health care, employ-
ment, education and other services. Moreover, rights envisioned and articulated in pol-
icy documents do not carry legal force. An HIV positive patient refused treatment by a
private doctor cannot take legal action on the basis of a policy provision alone.
Furthermore, legal protection for marginalised groups such as sex workers, drug users
and sexual minorities is virtually non-existent.
And then there are situations where rights cannot be realised despite a legal interven-
tion. A woman can claim residence in her matrimonial home through a judicial order but
the family may continue to avoid her because of HIV/AIDS. A court cannot get co-work-
ers to share a table with an HIV positive colleague even though it may reinstate him in
the job. While a court may uphold the right of HIV positive children to receive educa-
tion, it cannot compel other children in the school to embrace them. A legal framework
that protects and promotes rights is imperative to counter AIDS related stigma and dis-
A Media Triggered Response
A few years ago, a national daily published an article over repeated refusal by hos-
pitals to operate on an HIV positive person, who required immediate medical atten-
tion. The article caught the attention of a sitting judge in the Delhi High Court, who,
suo motto issued notices to the concerned medical authorities to explain this bla-
tant act of discrimination. Additionally, the story evoked an immediate response from
the Chief Minister’s office resulting in the provision of prompt medical and surgical
care to the HIV infected person.
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Standing Up for Their Rights 109
crimination, as are forces like the media that influence attitudes, opinions and even
action.
Clearly then, rights need to be mainstreamed and adopted across the board for a con-
sistent, coordinated and cogent response to HIV/AIDS.
Tripti Tandon
Senior Project Officer, Lawyers Collective HIV/AIDS Unit, New Delhi
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110 HIV/AIDS in News – Journalists as Catalysts
Media messages advo-
cating abstinence, single
partner sex or faithful-
ness to the spouse as
preventives only end up
linking sexual morality
with the virus
Positive
Voices
For those living with the virus, the image of HIV positive people as portrayed by the
media compounds their problems. The coordinator of the Asia Pacific PLWHA Resource
Centre in Delhi, 35-year-old Manoj Pardesi has interacted extensively with journalists.
Living with the infection for 13 years now, he says, “In the press we are either made to
look like villains spreading infection or as victims grovelling in misery. The media has
tremendous reach and influence. It’s high time that it presented a realistic picture of
the HIV infection as a manageable health concern.”
Stories of discrimination against HIV positive people make good reading and are easy
to report on, but they would have intrinsically more value if linked to real issues, says
Manoj. The bigger question in a country that has 5.1 million infections is how to live
with the virus? Are people actually getting treatment? These are the dimensions sur-
rounding an infection that can be managed more simply than diabetes, asthama or
heart ailments.
Media and morality
Those infected say that the link of HIV/AIDS with sex has been overpowering. It has
diverted media attention from the real concerns that need to be addressed. Media
messages advocating abstinence, single partner sex or faithfulness to the spouse as
preventives only end up linking sexual morality with the virus, points out Manoj. It
imposes a question mark about their character and stigmatises infected persons. It
makes it difficult for a man to tell his wife he is HIV positive. It’s a dilemma activist Ram
Kumar (name changed) grapples with daily. After losing his factory job in Delhi when his
HIV status became public, he returned to his village in Azamgarh district, UP. Five years
have lapsed but Ram has not had the courage to inform his wife about his positive sta-
tus. “Being unemployed and depressed, I joined a support group of affected people in
the state and now cycle from village to village everyday spreading awareness. Ironically,
I feel my own wife will find it difficult to accept I am infected. I am preparing her by shar-
ing with her experiences of other infected people I meet in the course of my work.”
Manoj does not support the government’s targetted intervention programmes and its
focus on select groups like sex workers and homosexuals. The media focus remained
on these groups that were seen as having deviant behaviour and this backfired on all
those infected by the virus. Awareness, he maintains, must be built around safe sex
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Positive Voices 111
Manoj Pardesi
rather than unrealistic expectations advocating denial of sex that, in turn, could have
other repercussions.
The constant equation of HIV/AIDS with death by newspapers and television channels
keeps the virus from being detected. NACO estimates that about 90-95% of the epi-
demic is undetected and is therefore spreading unknowingly. The fear of the infection
stops people from getting tested even if they feel they may be at risk. The language
used by the media also conjures up a dreadful image of the infection. HIV/AIDS is often
referred to as an “untreatable disease” so even if a person picks up courage to get
tested at the Voluntary Counselling and Confidential Testing Centres (VCCTCs), he/she
often does not return to pick up the report. The person is unable to overcome the fear
of testing positive. The stigma and discrimination caused by the perception of it being
incurable is an issue that confronts them.
For those of us living with the infection, says Manoj, the repercussions of this portray-
al are multiple. “We are denied our rightful share in property by family members; doc-
tors don’t want to treat us because they consider it a waste of resources and those we
live with also feel it is a waste of money looking after us.” A stitch in time saves nine.
So it is with HIV positive people. Timely diagnosis and treatment enables them to stay
healthy and work with gusto.
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112 HIV/AIDS in News – Journalists as Catalysts
The constant equation
of HIV/AIDS with death
by newspapers and
television channels
keeps the virus from
being detected. NACO
estimates that about
90-95% of the epidemic
is undetected and is
therefore spreading
unknowingly
The media’s obsession with being the first to break the news and make it salacious,
makes it neglect investigation of a whole range of facts related to an event like the sui-
cide of a person who is told he/she is positive. Was the person counselled that it was a
health problem that could be handled like any chronic ailment such as diabetes or blood
pressure? Counselling is mandatory with an HIV/AIDS test undertaken anywhere. Instead,
sections of the media often grab stories on baseless rumours, such as one put out in
Chennai in 2003 of an HIV positive man secretly injecting with infected blood motorcy-
clists from whom he would take lifts. The scare created by a spate of such stories result-
ed in the lynching to death in Chennai of an anonymous man found with a syringe. Says
activist R Elango who was in Chennai at the time for a seminar, “Fear and hatred against
infected people like us was running so high because of these media ‘reports’ that we
were afraid to attend the seminar on HIV/AIDS or step out on the streets.”
The media giving credence to unfounded information causes incalculable harm, claims
Elango. Diagnosed HIV positive in 1988, Elango says he developed diabetes because
of harmful ‘ayurvedic medicines’ from a well-known quack in Kerala whose so-called
miracle cure for HIV/AIDS was highlighted by many newspapers and magazines.
“Though the quack was later exposed by a consumer rights group, the media rectified
its mistake by putting out a small regret notice instead of the full-page features that
had been carried on the man earlier.” Having helped to set up the Karnataka Network
of Positive People, Elango has been tracking reports on the epidemic for over a decade.
R Elango
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He feels the media must put itself in the shoes of affected people to understand how
its coverage can be a matter of life and death for them.
Getting the media’s attention is a big challenge. Space constraints, the urgency of news
and the need for ‘catchy’ headlines often result in wrong messages being sent out.
Says Ranjit, (name changed) an infected person in Punjab: “I hesitate to reveal my
name to the media because I am afraid that my case would be sensationalised and my
story twisted. This would hurt my family. As part of civil society, the media too has a
responsibility towards us. It must not exploit our situation for pandering to its readers
or viewers.”
Manoj points out that good programmes and news reports, however, can do marvels for
building public awareness on social and medical issues. A BBC World programme,
Haath Se Haath Milao, is a sensitively prepared series highlighting the infection.
Another BBC-produced serial Vijay Jasoos, packaged with adventure and suspense is
also popular with kids.
People not ‘victims’
Loon Gangte, working as Regional Coordinator with the South Asia Collaborative Fund
for HIV/AIDS Treatment, is livid with the media’s insistence on clubbing HIV positive
people as patients. “I am not ill by any yardstick,” he fumes. “I probably work hard-
er than many other people and yet every time the press terms a person like me as
a ‘patient,’ ‘sufferer’ or ‘victim.’ I am definitely not diseased, helpless or dying.” He
describes an incident in Kochi where he participated in a rally of 130-odd HIV posi-
tive people. “We were shouting slogans at the top of our voices and marched through
the city in the heat, yet the next day newspapers reported - ‘AIDS patients take out
rally’! A patient should be on a wheelchair or in hospital. But this is what happens
all the time.”
Rather than an obsession with death and dying, there should be stories on HIV posi-
tive people laughing, coping, living, says Loon. This can only happen when the media
understands the virus and its impact in totality. It must now actively try to educate
itself. “There is all-round ignorance here compared to many other countries,” says
Loon. “When I met a group of 11 Swedish parliamentarians, for instance, I was amazed
at how much they knew of HIV/AIDS. They were as knowledgeable as any counsellor.
With its huge reach the media can play a very important role in spreading informed
awareness of the epidemic.”
The key lies in journalists giving ‘informed’ news rather than allowing baseless preju-
dices to colour their copy. For this, sustained interaction with HIV positive people is a
Positive Voices 113
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114 HIV/AIDS in News – Journalists as Catalysts
The key lies in journalists
giving ‘informed’ news
rather than allowing
baseless prejudices to
colour their copy. For
this, sustained interac-
tion with HIV positive
people is a must
must. “How can you go to the market
and buy clothes for someone you have
never met! They will always be ill-fit-
ting. In the same way, journalists must
get to know us well if they want to por-
tray us correctly,” says Loon. “They
already have the skills to make a story
readable. If they have the right under-
standing then they can sensitise the
public in the right direction.” Rather
than dramatising single fear-based
incidents, macro issues need to be
addressed simultaneously.
For instance, has the health system
in the states geared up to handle the
snowballing epidemic? Thousands of
affected people with little idea of
Loon Gangte
what has happened to them travel
from villages to cities for medical
treatment. Their experiences find little reflection in media discourses that could
shape the formulation of public policy. Soni (name changed) of Ludhiana district in
Punjab accompanies her infected husband every month to PGI, Chandigarh, for med-
ical treatment for HIV/AIDS. Looking worn out and harassed, she laments, “Why is
the procedure here not simpler? It took two days just to get the card made in PGI -
and officials stared and sniggered when I said it was for AIDS. Only on the third day
could we meet the doctor who wrote out the tests for my husband.
We stand in line all day for each test, and if our turn comes even one minute after the
department’s closing time then the day’s effort goes waste. Reports are to be collect-
ed from another part of this huge hospital. My husband cannot stand for too long. We
have nowhere to stay when we come from the village. Private treatment is too expen-
sive. We will go back to jadi-bootis available in the village instead of going through all
this trouble.”
Soni feels there is a lot of difference between those who are ill with HIV/AIDS and those
suffering other ailments. “People run away from us. Secondly, our economic stability has
been completely destroyed. My husband was a truck driver who cannot work any more.
Our savings have finished in his treatment. Our daughter is not going to school anymore.
I do part time work when I can to support ourselves, besides taking care of him.”
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Positive Voices 115
The fear of not being able to make a living in his prime is also haunting Dharamvir
(name changed) of a paramilitary force, who discovered he was infected four years ago.
“Though the unit helped me at the time, now they are trying to throw me out. I found
out about my infection when I had fever continuously for 26 days and my weight plunged
from 75 kg to 35 kg. I was posted in Barmer in Rajasthan and broke down completely
when my HIV status was revealed. I did not even tell my family in Gwalior. But gradual-
ly I recovered.”
Dharamvir finds that life is being made difficult for him at work. “Many of my seniors
and others came to know about the infection because I underwent a lot of mental
stress. Also, I am not as strong as I was before and cannot do the same duties.
Treatment costs are cut from my salary and the holidays I need because of my treat-
ment are also being deducted from my pay. I took my case to the highest levels of the
force and though some people supported me, I am afraid I will soon be out of job. The
media must talk about our rights and fair treatment for us.”
“Treatment costs are cut
from my salary and the
holidays I need because
of my treatment are also
being deducted from my
pay. I took my case to
the highest levels of the
force and though some
people supported me, I
am afraid I will soon be
out of job”
If not economic troubles, it is the stigmatising reactions from all around that bother
many of those infected. Says Ranjit (name changed), a dealer in spare motor parts,
“I required blood transfusion after an accident in 1992. In 2000 I became so sick
that my weight went down to 25 kgs and I found out I was infected. But the worst
was the suspicious response of my friends and acquaintances. Only my parents, who
are well-educated, were supportive. With their help I managed to erase what society
was saying and decided to live for my wife and son.” Visiting PGI, Chandigarh and get-
ting medication for the last five years now, Ranjit’s CD count has gone up from a dan-
gerous low of 62 to 280. “These are the things the media should highlight, instead
of giving everyone the impression that we are potent weapons of destruction let
loose on the public.”
A development concern
An important component of the epidemic is its impact on women. This has hardly been
reflected in the media. The hardships women face are double. While infected men are
rarely abandoned by their wives or families. Women put up with greater stigma and dis-
crimination. Celina D’Costa who works as an Advocacy Officer with an international
NGO cites her personal experience. “When my husband died 12 years ago and I came
to know that I too was infected, my first reaction was that there is nothing to hide. I did
not conceal my status from family members, neighbours and the church. But with so
little information about this new ‘disease’, my in-laws just threw me out of the home. I
don’t hold it against them any longer. There was no way they could have known that the
infection is not spread by just being in the same house with me, nor is it transmitted
by the sharing of bathrooms or through mosquito bites. There was also a lot of social
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116 HIV/AIDS in News – Journalists as Catalysts
“Women often do not
enjoy equality in their
marital relationships
such as being able to
negotiate safe sex or sex
on their own terms, or
they fear being thrown
out of home for no fault
of theirs”
Anandi Yuvaraj
pressure on them that my brother-in-law would find it difficult to get married if I contin-
ued to stay with the family.”
Celina’s openness about her status is not shared by Neera, a seamstress from
Chandigarh, who kept her HIV positive status from her husband for eight years. “During
pregnancy I came to know I was infected. The doctor warned me that if I told my hus-
band he or his family could blame me. I feel I did the right thing in not revealing my HIV
status to my husband who had been suffering from TB.” He came to know of his HIV
positive status only when he was admitted to PGI after eight years of frequent illness.
Its been a year since her husband died, but his mother refuses to acknowledge he was
HIV positive.
Activist Anandi Yuvaraj who has emerged as a role model for other infected women,
says it is social attitudes which created a situation where Neera preferred silence. “HIV
cannot be tackled in isolation. It has to be linked with the entire process of women’s
empowerment. It brings out that women often do not enjoy equality in their marital rela-
tionships such as being able to negotiate safe sex or sex on their own terms, or they
fear being thrown out of home for no fault of theirs. Empowering women by providing
them education, skills and resources would also address their vulnerability to HIV.”
Women’s groups and those working in the development sector need to include
HIV/AIDS in their mandate. As Anandi points out, the virus is intimately linked with
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Positive Voices 117
social and development indices. Yet few mainstream organisations put it on their agen-
da. “If the media initiated a debate on these lines then the profile of the virus would
change. Currently there is a narrow keyhole view of HIV/AIDS that also informs the
strategies meant to counter it. Instead, it needs to be put into the larger development
context which should be tackled in a holistic way by everyone.”
Anandi claims she has rarely encountered stigma. Diagnosed as HIV positive in 1997,
she subsequently separated from her abusive husband and struck out on her own. “I
gained courage from my mother’s reply when I told her of my status. She told me, ‘When
you were born did you think you would live forever? Make the best of the time you
have.’” Educated upto college and having worked before marriage, Anandi took up a job
again. It was with an NGO working on HIV too. Eventually she joined the Positive
Women’s Network in Chennai that was involved in educating affected women about
their rights and helping to build district level networks of infected women.
“The head of the organi-
sation that worked for
HIV positive people, him-
self objected to an HIV
positive man serving tea.
Everyone was shocked
when I intervened but
they were forced to
change their stand”
Presently working with the India HIV/AIDS Alliance, the 41-year-old Anandi is not on
medication. She tours the country and frequently presents the Indian situation at inter-
national forums. She says, “Personally I have hardly ever experienced derogatory treat-
ment because of being infected. But I know what many others face. In fact I first pub-
licly revealed my positive status when I stood up for an infected peon in an NGO where
I worked. Can you believe it, the head of the organisation that worked for HIV positive
people, himself objected to an HIV positive man serving tea. Everyone was shocked
when I intervened but they were forced to change their stand. My parents had always
pushed me to stand on my own and that really built my self-esteem. How a woman is
treated in her own family is how she will be treated later by others.” She says it is her
education, independence and upfront attitude that elevated her from a salary of Rs 400
a month to her present job in an international NGO.
Addressing those living with HIV
The media must go into all issues around an epidemic that is presently discussed by
it in the single context of transmission and prevention, a simplistic portrayal of the
virus. “In the West, for instance, where HIV has been accepted in society, the media
has also mainstreamed the epidemic. Sensitisation issues do not make news any more
and neither is there any hype about HIV related stories. Most of the stories are related
to resource allocation for the epidemic at the global level,” says Anandi.
However, here the media fuels many of the general misinformed notions. Says Celina,
“Like everyone else, I too had the impression that as one who has HIV/AIDS I would
soon die. I waited to die...but even 12 years later here I am, completely healthy with-
out needing medication of any kind.”
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118 HIV/AIDS in News – Journalists as Catalysts
Affected people would like
to read about the right
nutrition and diets for
those who are infected.
Healthy food can
minimise or delay the
damage caused by the
virus. They want to know
how to enjoy a safe
married life, more about
medication and
information about their
rights on issues like
inheritance and custody
of children
Information is given out only about prevention and modes of transmission. There is
nothing for those who are living with it. What does one do if you find out you are HIV
positive? Whom to contact about more information on the virus? More importantly,
how to live and not die with the virus? Celina says affected people would like to read
about the right nutrition and diets for those who are infected. Healthy food can min-
imise or delay the damage caused by the virus. They want to know how to enjoy a
safe married life, more about medication and information about their rights on issues
like inheritance and custody of children. “Some people argue that it may be damag-
ing to carry news about us. They feel that unless there is the fear of death and ill-
ness associated with HIV/AIDS people will be lax in taking precautions or it will
encourage promiscuity!”
Wanting to reassure others living in silence with the infection, Celina decided to speak
out about herself. But she says the press was just interested in a juicy story. They pub-
lished her photo and gave out information on where she lived. “The media primarily
focussed on how I got the infection. I had ‘come out’ with the intent of raising my voice
against fear and discrimination. It turns out this was the last thing on the media’s
mind.” She also has a word of caution for those willing to expose themselves to public
gaze. Proper counselling is needed about the social and emotional consequences of
revealing one’s identity, says Celina.
Media wary
Many of the networks of HIV positive people are wary of interacting with the media.
Mike Tonsing has been working for the past six years with the Sahara Care Home in
Delhi on its management of information systems. The NGO runs 35 projects all over
the country, catering primarily to drug users and people living with HIV/AIDS. Over 25
years old, Sahara was one of the first organisations to start working with those
affected by the virus and employs many of them. Says Mike, “The way society looks
at us is shaped by what it sees in the media. In the past HIV/AIDS was seen only as
a symbol of death. That has changed somewhat now. HIV/AIDS is brought up when
incidents of stigma and discrimination come to light. There is still nothing in the
media about our living well, taking care of families and contributing to society, which
would be very encouraging news to all affected people. It would also alter communi-
ty perception about us.”
Such stories hardly appear because there is no bond between the press and the net-
works of HIV positive people. “We have not used the media adequately in sensitising
it and putting out our point of view. There is no rapport with the press because we felt
it always projected us negatively or twisted the information.” Every year there is a spate
of stories around World AIDS Day on December 1, but little after that. “The media
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Positive Voices 119
“Look at HIV/AIDS not
just as a health condition
but as a development
issue affecting the
country in many
different ways”
Mike Tonsing
knows a little bit about us but not enough to give a full picture. We must change this,”
says Mike.
Activists like Manoj exhort, “I would like to say to the media - be our advocate, join
with us to reduce stigma and discrimination, try to spread correct and scientific infor-
mation on HIV/AIDS by removing myths and misconceptions. Use language that is
sensitive to us. Depict it as a manageable disease.” He suggests it should be looked
at not just as a health condition but as a development issue affecting the country in
many different ways.
Rimjhim Jain
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120 HIV/AIDS in News – Journalists as Catalysts
The Importance of the Red Ribbon
Symbols are extremely important in any campaign to create awareness and fight a
perceived public threat. India is full of symbols, many of them religious. Political
parties have their symbols, so do social movements. The Red Ribbon is an inter-
national symbol of HIV/AIDS awareness. It is used to express solidarity with those
affected by HIV/AIDS and indicates a commitment to fight its spread.
The Red Ribbon was conceived in 1991 by Visual AIDS, a New York based charity
group of art professionals who sought to recognise and honour friends and col-
leagues who had died or were dying of the infection. Today it is the internationally
accepted symbol to publicise the needs of persons with HIV/AIDS and to call for
greater funding of services and research.
Inspired by the yellow ribbons honouring American soldiers of the Gulf War, the
colour red was chosen for its “connection to blood and the idea of passion - not
only anger, but love, like a valentine,” said Frank Moore of Visual AIDS.
However, in India the symbol is not as well known and it is not used that frequent-
ly. Ten of the 15 students seeking admission to a course in journalism in Delhi
did not know what it stood for. In the general public there is total ignorance about
it. Quite obviously it needs to be used much more by newspapers and TV channels
when printing or broadcasting stories on HIV/AIDS.
The importance of symbols cannot be overlooked. The Red Triangle, the symbol of
the family planning movement in India, is better known. The campaign to fight polio
is known by the symbolic two drops. The Indian media needs to engrave the Red
Ribbon symbol in the public mind by using it themselves.
Usha Rai
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Section III
Useful Information
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The Ethics of Reporting on HIV/AIDS 123
Do’s and Don’ts:
The Ethics of Reporting on HIV/AIDS
WHAT TO LOOK OUT FOR WHEN DOING AN HIV/AIDS STORY
Do I have the scientific fundamentals right?
Good coverage of HIV/AIDS is about quality coverage of science, numbers and pol-
itics. Reporters essentially discuss one or another of these basics as we present
the epidemic to the public through a lens of our choice such as human rights and
law, medicine, policy and programme, gender, income, equity, geography or security
or even when we prefer to skim the surface once in a while, through a sketchy cov-
erage of functions and announcements. The starting point, however, is empathy for
those infected and affected. Then, it is important to know the scientific fundamen-
tals, medical definitions and concepts of the epidemic so that we are equipped to
examine, critique or reject them as we interpret the epidemic.
Am I able to convey these fundamentals to my readers in a simple, accu-
rate fashion?
A useful way to be comfortable with medical definitions and concepts is to surf reliable
websites such as those run by UNAIDS, World Health Organisation or Centre for
Disease Control, and discuss them often with qualified medical personnel. It is impor-
tant to discuss the definitions in simple everyday language that we consider appropri-
ate for readers and check them with experts to ensure that accuracy is not sacrificed.
Have I developed a system to keep myself updated of major developments
and HIV news from other parts of the world, irrespective of my beat?
As the HIV/AIDS epidemics continue to manifest, they throw up new issues, complicate
or negate concepts that we took for granted and often make us rethink our views of
society, culture and values. In short, we often find ourselves on a steep learning curve,
despite experience in covering the issue for years. Regular updating on global, region-
al and local developments, keeping abreast of new research and fresh happenings from
the field and extensive reading helps insure that we stay in step with HIV/AIDS as it
charts its course. All too often, such reading is left to the science/health reporter, if,
indeed, a media house has the luxury of that exclusive position.
HIV/AIDS leaves few domains untouched, however, and it is reporters specialising in
business, economics, foreign affairs, human rights/law or plain politics who can help
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124 HIV/AIDS in News – Journalists as Catalysts
raise the quality of analysis and interpretation of the epidemic. The complex nature of
the HIV/AIDS epidemic deserves greater and deeper scrutiny.
Subscriptions to reputed journals and publications from specialist organisations work-
ing in HIV, TB, reproductive health, sexuality and drug use are a standard way to remain
abreast of new developments. Many of these publications are mailed free to the media
on request.
List-serves that deal specifically with HIV/AIDS are another way to follow the latest
trends in thinking, the local reactions and controversies in the field and other media
coverage on HIV/AIDS. Some useful list-serves include SAATHI (Solidarity and Action
Against the HIV epidemic in India) and AIDS-INDIA. To guard the mailbox against a
deluge of e-exchanges on these list-serves, it may be helpful to assign an exclusive
hotmail or yahoo account to the list-serve which could be accessed on a regular
basis.
What are the journalistic ethics when I report on HIV/AIDS?
After all, HIV/AIDS stories are about people. The task of writing on people living with
HIV or their near ones, or on people who seem to be disproportionately infected or vul-
nerable sometimes appears like negotiating an ethical minefield. Many of the booby
traps have to do with expression:
1. Language and prejudice:
All handbooks on HIV/AIDS reporting usually carry a list of ‘offensive’ terms that are
commonly used in HIV/AIDS reporting with a parallel list of politically correct or sensi-
tive alternatives that we could substitute. Some common ones which have now been
popularised by the media and figure in drawing room conversations include sex worker
(rather than prostitute), injecting drug user (rather than drug addict) and multiple part-
ner sex (rather than promiscuous).
Its not that the original terms were inaccurate, it’s that they come loaded with the bag-
gage of derogatory usage. Several other terms may need similar alteration so that they
are reinvested with a new respectability in the age of HIV/AIDS. See how many you can
think of.
2. Language and accuracy:
A second set of terms that are commonly used are inaccurate because they fail to
capture adequately the reality. Some common ones include AIDS patient for a person
infected with HIV but still healthy. Such people prefer to be addressed as People
Living With HIV, a term emphasising life and hope, rather than death and sickness
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The Ethics of Reporting on HIV/AIDS 125
which are inappropriate and misleading for their condition. High risk groups for peo-
ple who manifest high risk behaviour is another misnomer that fails to take into
account the dynamic nature of human behaviour. The term ‘vulnerable populations’
seems more appropriate.
Another misnomer is the label homosexual to any person who has sex with someone
of his /her own sex. While the term may be entirely accurate in some cases, the reali-
ty in India is broader and more varied. Some men and women manifest homosexual
behaviour some times and heterosexual behaviour at other times and still may not com-
fortably fit the ‘bisexual’ label as these behaviours are not always a matter of their
choice or natural inclination. Many men who prefer to have sex with other men may be
married and have children due to social pressures. Such men nevertheless manage to
have sex occasionally with men, in secret. Other shades of homosexual behaviour
include men who prefer to cross dress and have sex with men, trans-sexuals who
appear masculine and later play up their innate feminine desires and qualities and men
who choose to carry that to the extreme step of castration. The term that seems flexi-
ble and accurate enough to capture these many shades of behavior is men who have
sex with men (MSM). We may yet come up with new terms for those manifesting unique-
ly trans-sexual behaviour.
Similarly, not all women who sell sex do so regularly, like sex workers. A flexible term
to describe women who sell sex whether regularly or occasionally is Women in
Prostitution (WIP). It seems like the term ‘prostitution’ is gaining acceptability as we
get more comfortable with it and the word is not ‘dirty’ anymore. This may also have to
do with the vocal and increasingly visible activism of sex-workers who are today organ-
ised and have begun to lobby for a legitimate space in society.
Scan the common terms used when reporting on AIDS and check them for accuracy. It
is also useful to speak with human rights specialists, sexologists and linguistic experts
to gain useful pointers to sharpen the accuracy of the terms we use.
3. Language and metaphor:
Metaphors are dangerous by definition as they reflect personal perceptions and distor-
tions. Among the common metaphors in use when referring to the HIV epidemic are
plague and scourge. The first refers to another disease entirely and reflects inaccurate
usage. It also throws the mind back to the images of helplessness, ignorance and
despair of the dark ages, imagery that seems dangerously inappropriate in the age of
condoms, anti-retroviral treatment and infection control. Scourge reeks of retribution,
again dangerously unsuitable in these times when health is being increasingly viewed
through the framework of human rights.
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126 HIV/AIDS in News – Journalists as Catalysts
We also need to be on the alert about the reverse usage of disease as a metaphor.
The metaphorical use of medical terms starting with virus, disease, cancer, malignan-
cy, AIDS, pox and diarrhoea, are well worn and continue to tempt the reporter. How jus-
tified are we in referring to corruption as the incurable cancer of society, in an age when
our understanding of cancer has undergone a sea change and it is no more that mon-
ster that eats us inexorably from within? Likewise, can we truthfully refer to HIV/AIDS
as a killer or an angel of death, when medicine has already found the tools to make it
a chronic manageable disorder, similar to, although vitally different from diabetes or
hypertension?
4. Language and translation:
The reporters who work in the local language has a tremendous advantage when it
comes to finding a language and set of words to describe our experience with HIV/AIDS.
Not for them the need to unlearn the loaded inaccuracies that have peppered coverage
of HIV/AIDS over the last 20 years. Working with NGOs, high quality medical information
straight from reliable sources and learning to follow the intricacies of the human rights
discourse around AIDS can help them embark on a journey of explanatory journalism
rather than a style that seeks to impress with its evocative terminology or pre deter-
mined views, a weak and distorted translation of English coverage.
There exists in India rich vocabulary on sexuality, illness, home based care, support,
responsibility and acceptance. It is up to the local language reporters to uncover the
terms in common use and check their appropriateness for HIV/AIDS reporting, relying
on explanatory writing as much as possible to ensure that the reader is not misled.
ETHICS CHECKLIST:
Here is a beginning of a list of questions concerning ethics, to ask ourselves as we
work on covering HIV/AIDS. The list is by no means rigid or complete and we could mod-
ify and add/delete as we deem appropriate. While all the questions are relevant, we
could begin applying those we need or feel convinced about, depending on the time
available and the nature of the report we work on. Over time, the consistent application
of these ethical filters would become second nature and would automatically influence
the way we conceive of, research and construct the reports. These have been num-
bered in more or less logical progression.
1. Have I thought about what might be the need for, or goal of my report?
2. Are there specific confidentiality related guidelines/media related policies that exist
in the organisations I approach for information/interviews? Or are there HIV/AIDS
related media policies available with journalists associations?
3. Have I ensured that my report presents a set of perspectives that are distinct and
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The Ethics of Reporting on HIV/AIDS 127
help construct a comprehensive picture? Have I given space to views that I don’t
personally subscribe to?
4. Have I thought about what could be the impact of my report in the near and distant
future, on the people I have quoted or covered, on the situations I have described
and the conclusions drawn?
5. Who might my report affect and why? Would that be a legitimately desirable impact?
6. What if the roles were reversed and I was not the reporter but the person/organi-
sation covered. How would I feel and what consequences might I face from family,
friends, community and at workplace?
7. What strategies might I employ to ensure that the report is accurate and effective
at the same time as well as sensitive and minimally destructive or hurtful?
8. Is my approach, reasoning and discussion clearly based on evidence and thorough
research? Would it be justifiable in the face of rigorous scrutiny by people living with
HIV and stakeholders such as those working in prevention, care or related issues?
How does one get a good HIV/AIDS story, one that goes beyond the num-
bers game?
When it comes to HIV/AIDS, as in any health reporting, there’s no getting away from
numbers. Reporters catch the figures flu every year when NACO and UNAIDS release
their national estimates on HIV prevalence. The result is a flurry of reportage mostly of
the paralysis-by-analysis variety which blows over following well meaning calls from
activists and officials entreating us not to ‘waste news space on numbers, but to learn
to see beyond them.’
Reporters are addicted to numbers whether we understand them or not, the larger the
figures, the better. Numbers serve as a tempting opening to any reporting on HIV/AIDS,
irrespective of the angle the story explores. Reporters constantly demand to know the
‘true numbers’ about HIV/AIDS from UN agencies, NGO and others, not realising that
only a door to door community prevalence survey that tests every man, woman and
child can ever yield the ‘truth’. The unique nature of the HIV epidemic, the size of the
populations and certainly human rights considerations tell us that such a survey is nei-
ther possible nor warranted. We have little choice but to work with estimates that at
best offer only an informed guess about the ‘truth’ and at worst mislead us to jump to
the wrong conclusions. This is perhaps one of the best contexts that illustrates the fun-
damental uncertainties of epidemology in particular and scientific research in general.
We need to get used to asking questions and conveying the tentative quality of what
we uncover rather than be obsessed with closing the minds of our readers into a cul-
de-sac of dead certainty.
The insensitive use of metaphors and labels distorts the picture. It gives a false
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128 HIV/AIDS in News – Journalists as Catalysts
impression when we interpret the numbers with colourful metaphors such as ‘scourge’.
Ethics demands that we analyse, not simply repeat, the estimates and projections
made by local and international agencies. This is important to explain to readers the
methods used to arrive at the projections, so that their capacity to respond intelligent-
ly to these numbers is enhanced. In short, ethics demands that we convey to readers
exactly what these numbers represent and what they do not.
Numbers add shock value and a newsy quality to reports and if presented convincing-
ly and repeated often enough, add a ring of authenticity, deserved or not. One of my
favourite stories refers to the ‘annual increase in the trafficking of young girls from
Nepal to India.’ The oft repeated numbers signifying the ‘annual increase’ vary widely
between 5 to 20,000, sometimes more, but at some point simple math intervenes to
remind us that these numbers may mean nothing. Nepal would probably have no young
girls left, at this rate. A useful question is to ask if a reliable baseline estimate exists
in the first place.
A skillful use of numbers ultimately constitutes the substance of quality news and
analysis, provided the numbers reflect novelty, proportion, time, context and above all,
the human face.
Below is a small list of reminders that help better the quality of commentary on num-
bers. We could add to this list as our experience grows. The general goal is to strive
for a degree of comprehensiveness, no matter how little space we get.
To help present a fuller picture to readers we could avoid using numbers unnec-
essarily.
Explain why we are providing a particular statistic on what that figure means, in sim-
ple, accurate language.
Compare that figure usefully to some other numbers so that the reader can make
a reasonable/near realistic inference about proportion, criticality and logic.
Place statistics on a time scale so that the reader can follow a development over time.
Indicate what a number means to policy or the public giving concrete examples.
Who are the people journalists should contact to get an offbeat story?
Almost all stories on HIV/AIDS rely on a limited range of sources: reporters contact or
are contacted by NGOs and UN agencies and sometimes health ministry officials and
people living with HIV.
Dr Jaya Lakshmi Shreedhar
Technical Health Advisor, Internews Network
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Media Guidelines from Consultations 129
Media Guidelines from
Consultations
All alarming stories on issues related to HIV/AIDS will carry a public service message
which will reiterate that HIV is a manageable infection like any other chronic ailment
and will give a helpline number alongside.
This commitment, made by the editor of Udayavani, a leading Kannada daily newspa-
per, was one of the many guidelines that were suggested at the state consultations in
Chandigarh, Lucknow and Bangalore to share research findings on the media coverage
of HIV/AIDS by the Population Foundation of India.
This study was shared with journalists, NGOs working in this sector, representatives of
the state AIDS societies and HIV positive people.
In Chandigarh, while the consultation was able to bring together these four groups on
a common platform to discuss the impact of the media on HIV positive people, in
Lucknow it facilitated the setting up of a joint group that would work towards more
responsible media coverage. In Bangalore, fellowships for English and language media
were suggested to motivate more journalists to write on this subject.
Some of the other key suggestions made by the participants to bridge the communica-
tion gaps and facilitate accurate media coverage were:
Access needed to a database to validate information received by journalists on
HIV/AIDS and help to understand and analyse data. For example, the difference
between HIV and AIDS, projections and actual figures of HIV/AIDS prevalence etc.
A nodal point, established by either state AIDS societies or NGOs, to serve as a reli-
able source of information for journalists.
A style book for media organisations outlining correct terminology for English and
regional press. This must be updated periodically to include new terms. Examples
of good and bad reporting on the issue needed to clear confusion.
A code of ethics with regard to confidentiality and informed consent of People Living
With HIV/AIDS (PLWHAs) must be included.
Dissemination of Press Council guidelines on HIV/AIDS coverage only after updat-
ing them to include latest developments. There is a need to alert the Press Council
on this.
Policies governing HIV positive media employees by media houses.
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130 HIV/AIDS in News – Journalists as Catalysts
Sensitisation of all media staff including the editor, sub-editors and journalists in
district editions and language newspapers to ensure headlines not alarmist or judg-
mental and retain the spirit of the story. Refresher courses for journalists one good
way to help portray HIV positive people sensitively.
Inclusion of HIV/AIDS as a subject in journalism school curricula.
Feedback from infected people, field workers and health authorities on media sto-
ries to improve quality of coverage.
Inclusion of gender perspective to reduce stigma and discrimination.
A resource book with names of health journalists, concerned NGOs and government
officials to bridge communication gap.
Ten story suggestions by NGOs and state AIDS organisations on issues related to
HIV/AIDS that may have been missed.
Field trips organised by NGOs and state AIDS bodies to include voices from grass-
roots.
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Quiz on Facts and Myths of HIV/AIDS
Quiz 131
1. A person can get HIV/AIDS from sit-
ting next to a person who has it.
Yes
No
2. A person can get HIV/AIDS by having
sex with a commercial sex worker.
Yes
No
8. You can get HIV/AIDS if a person with
HIV/AIDS coughs or sneezes near
you or by using the same toilet seat.
Yes
No
9. If you kiss a person with HIV/AIDS on
the cheek or drink from the same
glass, you can get the disease.
15. Persons who have sex with many dif-
ferent people are at risk of getting
HIV/AIDS.
Yes
No
16. You can get HIV/AIDS by eating
food, which is cooked by someone
who has HIV/AIDS.
3. An unborn child can get HIV/AIDS if
his/her mother is infected.
Yes
No
4. Insects like bedbugs, cockroaches or
mosquitoes can be HIV/AIDS carri-
ers and give it to people.
Yes
No
5. A person diagnosed with HIV/AIDS
will die within 12 months .
Yes
No
6. Men with HIV/AIDS may sexually
transmit it to women.
Yes
No
7. You can get HIV/AIDS by using a
phone, which was just used by
someone with AIDS.
Yes
No
10. An HIV/AIDS patient may die due to TB.
Yes
No
11. HIV/AIDS is not a disease, but a
condition making a person vulnera-
ble to infections.
Yes
No
12. There is no cure for HIV infected persons.
Yes
No
13. If a person with HIV/AIDS cries and
his/her tears touch you, you can get
HIV/AIDS.
Yes
No
14. It is safest to avoid having a blood
transfusion.
Yes
No
17. You can get HIV/AIDS from swim-
ming pools.
Yes
No
18. You are likely to get HIV/AIDS if
you sleep in the same bed
as someone with HIV/AIDS
without having sexual inter-
course.
Yes
No
19.You can get HIV/AIDS by
hugging a person who has it.
Yes
No
20.Children can get HIV/AIDS by
sitting next to or playing ball
with a student, who has HIV/
AIDS.
Yes
No
Yes
No
Yes
No
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132 HIV/AIDS in News – Journalists as Catalysts
21. A person can get HIV/AIDS by hav-
ing sexual intercourse with an HIV-
infected person.
Yes
No
22.Brothers and sisters of children
with HIV/AIDS usually also get
HIV/AIDS.
Yes
No
23. Doctors and nurses who treat
HIV/AIDS patients often get
HIV/AIDS as well.
Yes
No
24. Everyone infected by HIV gets AIDS.
Yes
No
25. HIV is the name of the virus, AIDS is
the disease caused by HIV.
Yes
No
26. Countries with a high rate of rape cases
also have a high HIV/AIDS prevalence.
Yes
No
27.Herbal/Organic food and/or vitamins
will shield or cure you from HIV/AIDS.
Yes
No
28. People who suffer from sexualy trans-
mitted diseases (STDs) are much
more likely to contract HIV/AIDS.
Yes
No
29. Certain sexual practises like “dry
sex” supports the spread of HIV/AIDS
Yes
No
30. A HIV positive person has to be
treated by specialist doctors.
Yes
No
Score
26-30: Congratulations! You should start doing seminars on HIV/AIDS!
25-21: Very good! You are involved in the HIV/AIDS issue. Keep up that good work!
20 -16: Good! You are interested. Find out which questions you answered wrong and get your knowledge updated!
15 -10: There are large gaps in your knowledge about HIV/AIDS and you know it! Find out which questions you answered
wrong and update your knowledge!
9-5:You think you know enough about HIV/AIDS - but you don’t! Find out which questions you answered wrong and get your
knowledge updated! Repeat the test afterwards!
Less than 5: Until now you have not realised that HIV/AIDS is a fatal disease that may also affect you. Find out which ques-
tions you answered wrong and update your knowledge! Repeat the test!
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Facts &
Myths
Myth: HIV/AIDS is mostly an African problem.
Fact: Of the 42 million people around the world who live with HIV/AIDS, 70% are in
sub-Saharan Africa. But HIV/AIDS is not an African problem alone. It is a worldwide phe-
nomena.
HIV/AIDS exists and is spreading in Africa.
HIV/AIDS continues to spread more rapidly in countries or communities within coun-
tries where poverty, inequality, and conflict are prevalent. Eastern Europe and
Central Asia have the fastest rates of spread, followed by countries in Asia and the
Pacific, the Caribbean, and Latin America.
Myth: To stop the spread of HIV, people simply need to give up promiscuous sex and
drug use.
Fact: Socio-economic structures around the world constrain many people’s ability to
make free choices regarding the behaviours that put them at risk for contracting
HIV/AIDS. Economic insecurity, gender and racial inequalities, labour migration, and
armed conflict all limit people’s ability to avoid exposure to the virus.
Myth: The best way to control HIV/AIDS is through prevention. Costly treatment
should wait until prevention programmes have been fully funded and deployed.
Fact: Prevention and treatment should have equal roles in the fight against
HIV/AIDS:
Since wealthy individuals have the chance to prolong and improve their lives with
ARVs, it contradicts the principles of equity and human rights to allow tens of mil-
lions of others to die without treatment.
Countries in which large numbers of working and parenting age adults die have suf-
fered and will continue to suffer enormous social and economic losses, from which
it will be increasingly difficult to recover.
Efficacy of prevention programmes is limited. Prevention efforts often clash with a
socio-economic situation that does not allow people to control their exposure to the
virus. Furthermore, even a very successful prevention programme cannot fully stop
the spread of the virus in high-prevalence countries.
Prevention and treatment together have a synergistic effect. Voluntary counselling
and testing, a key prevention strategy, is much more successful when tied to a treat-
ment programme for those who test positive.
Facts & Myths 133
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134 HIV/AIDS in News – Journalists as Catalysts
Myth: HIV/AIDS treatment is impossible because antiretroviral drugs are too expensive
and because developing countries lack the sophisticated infrastructure necessary to
deliver the drugs. In addition, mishandling of ARVs will lead to increased HIV drug
resistance.
Fact: ARVs should be a cornerstone in fighting HIV/AIDS in the developing world:
Treatment for the poor is no longer prohibitively expensive, due to recent sharp
drops in drug prices. Both generics and cheaper brand names have become
available.
The enormous economic costs of no treatment outweigh the costs of treatment.
Evidence shows that treating patients with ARVs can save health systems
money.
Relevant infrastructure is actually present in many regions.
The delivery of ARVs can be simplified and modified for resource-poor settings
New partnerships between resource-poor and resource-rich groups are helping to
create infrastructure in places it is lacking.
Drug resistance can be minimised by the creation of locally-appropriate guidelines
for treatment. Much of the infrastructure created for national TB programmes can
be used to administer ARV therapy.
Myth: An HIV vaccine will soon be available, and this will solve the AIDS crisis.
Fact: A vaccine will not solve the HIV/AIDS crisis:
While many advances have been made in vaccine research, significant gaps remain
in the scientific knowledge needed to develop an effective vaccine.
The pace of HIV/AIDS vaccine research is often slow due to lack of financial incen-
tives to develop such a vaccine. Lack of coordination among researching groups
exacerbates the problem.
Due to the difficulties in creating an effective vaccine, the first vaccines deployed
will probably be of low efficacy.
By the time a vaccine has been developed and fully deployed in developing coun-
tries, millions and millions of people will have become infected and died of
HIV/AIDS if no other steps are taken.
Myth: The pharmaceutical industry’s drive for high profits, together with its political
power, means that pricing policies will never change to benefit poor people with
HIV/AIDS.
Fact: ARVs are becoming cheaper.
Generic versions of ARVs are produced in some countries and are exported to other
countries.
Myth: If you live in a household with a family member who is infected then you may
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also be infected.
Fact: Just living in the household of an infected family member does not mean you will
be too. You can only be infected through sex, sharing needles or exchanging body flu-
ids with somebody who has HIV/AIDS.
Myth: Only gay men can be infected with HIV/AIDS.
Fact: Straight men, women and children are also susceptible to infection, not only
gay men.
Myth: Since resources are limited, officials should concentrate on problems that effect
large segments of the population, such as nutrition, clean water, maternal and child
health, and immunisations, rather than expensive and complex HIV/AIDS treatment
that helps only a few.
Fact: HIV/AIDS treatment would have far-reaching benefits, since the disease has such
devastating social, economic, and general health effects:
HIV/AIDS kills mainly young adults in their prime working years; these deaths are
devastating to economies.
Agriculture is gravely threatened by HIV/AIDS. As workers die, food production falls,
the nutritional status of the population is undermined, and all aspects of health are
affected.
Young children are often left parentless, leading to hunger, poor health, lost educa-
tional opportunities, economic and sexual exploitation, and loss of future
prospects.
HIV/AIDS fuels the spread of other infectious diseases, such as tuberculosis.
HIV/AIDS treatment will help reduce pressure on health facilities by reducing oppor-
tunistic infections.
Myth: If your child goes to school with someone who has a relative who is ill your child
may also be at risk.
Fact: This is untrue. There is no way someone can pass the illness on unless they actu-
ally have it. If a family member is ill it doesn’t mean they are too.
Myth: Sharing a cup with someone who is infected with HIV/AIDS will put you at risk of
being infected.
Fact: There is no proven fact that you will be at risk of getting HIV/AIDS if you share a
cup with someone who is sick. It’s almost impossible to get sick this way because there
would have to be open wounds in your mouth and blood would have to be exchanged.
You cannot get HIV/AIDS through saliva. You can kiss someone who is sick and you
won’t get sick.
Facts & Myths 135
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136 HIV/AIDS in News – Journalists as Catalysts
Info Nuggets
Of the estimated 7.4 m people in Asia living with HIV/AIDS, 5.1 m are in India.
Out of the people living with HIV/AIDS in India, 36% are women.
Out of the total number of newly infected individuals in developing countries, 67%
are between the age group of 15-24 years.
Globally, young women and girls are 2.5 times more susceptible to HIV than men
and boys.
In 1985, one third of adults living with HIV/AIDS were women. In 2004, nearly
half of the adults living with HIV/AIDS are young women.
Biological
During sexual intercourse a larger surface area is exposed in women and therefore
it heightens the chances of infection.
Semen has a higher concentration of virus than vaginal fluid. Therefore, the infec-
tion of women by men is twice as likely as infection of men by women.
The chances of laceration, which provide entry to the virus, are heightened in
women because of early and/or forced sexual intercourse as in child marriages.
Frequent pregnancies lead to reproductive tract infections (RTIs) which increase
chances of women being infected because the symptoms are not very visible in
women.
Mode of Transmission
Sexual
Perinatal
Blood
IDU
Not known
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In India the first case was reported in 1986 in Chennai
India has the second highest number of people living with HIV/AIDS in the world after
South Africa. India accounts for almost 10% of the 40 million people living with
HIV/AIDS globally and over 60% of the 7.4 million people living with HIV/AIDS in the
Asia and Pacific region.
Heterosexual transmission is driving India’s HIV/AIDS epidemic. This route
accounts for approximately 85% of the HIV infections in the country. The
remaining 15% are accounted to other routes such as blood transfusion and inject-
ing drug use (particularly in India’s north eastern states and some metropolitan
cities).
Young people in India are among those most vulnerable to HIV. Over 35% of all
reported HIV/AIDS cases in India occur among young people in the age group of 15
to 24 years
High prevalence: Maharashtra, Tamil Nadu, Manipur, Andhra Pradesh, Karnataka
and Nagaland have HIV prevalence rates exceeding five per cent among groups with
high-risk behaviour and one per cent among women attending antenatal clinics in
public hospitals.
Concentrated epidemics: In Gujarat, Pondicherry and Goa where the HIV prevalence
rate among populations designated as high-risk has been found to be five per cent or
more, but HIV prevalence rates remains below one per cent among women attending
ante-natal clinics.
Low prevalence: All other States and Union Territories fall into the low prevalence
category because HIV prevalence rates among vulnerable population is below
five per cent and less than one per cent among women attending antenatal
clinics.
The epidemic continues to shift towards women and young people with about 25% of
all HIV infections occurring in women, increasing the potential of paediatric HIV in the
future.
Facts & Myths 137
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138 HIV/AIDS in News – Journalists as Catalysts
HIV in India – A fast spreading epidemic
1986: First case of HIV identified in Chennai.
1990: HIV levels among groups designated high risk like sex workers and STD clin-
ic attendants in Maharashtra and amongst injecting drug users in Manipur reaches
over five per cent.
1994: HIV no longer restricted to high risk groups in Maharashtra, but spreading
into the general population. HIV also spreading to the states of Gujarat and Tamil
Nadu where high risk groups have over five per cent HIV prevalence.
1998: Rapid HIV spread in the four large southern states, not only in groups desig-
nated high risk but also in the general population where it has reached over one per
cent. Infection rate among antenatal women reaches 3.3% in Namakkal in Tamil
Nadu and 5.3% in Churachandpur in Manipur. Among IDUs in Churachandpur it
crosses 76% and in Mumbai, 64.4%.
1999: The infection rate in antenatal women in Namakkal rises to 6.5%. About
60% of the sex workers in some areas in Mumbai are infected. Infection rates
among STD patients have reached up to 30% in Andhra Pradesh and 14-60% in
Maharashtra. About 64.4% IDUs at one of the sites in Mumbai and 68.4% in
Churachandpur are infected.
2001: Infection crosses one per cent in six states. These states account for
75% of the country’s estimated HIV cases. The Prime Minister addresses the
Chief Ministers of high prevalence states and urges them to intensify prevention
activities.
2003: Increase of about six lakh infections (4.58 million). This increase noticed
primarily in Karnataka, Rajasthan, West Bengal, Tamil Nadu, Gujarat, Bihar,
Madhya Pradesh and Rajasthan. There is no significant increase in HIV infections
in the country. India continues to be in the category of low prevalence countries
with overall prevalence of less than one per cent.
2005: NACO reports 5.13 million infections.
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Frequently Asked Questions 139
Frequently
Asked Questions
What is HIV?
HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus may be
passed from one person to another when infected blood, semen, or vaginal secretions
come in contact with an uninfected person’s broken skin or mucous membranes. In
addition, infected pregnant women can pass HIV to their baby during pregnancy or deliv-
ery, as well as through breast-feeding.
What is AIDS?
AIDS stands for Acquired Immunodeficiency Syndrome.
Acquired means that the disease is not hereditary but develops after birth from con-
tact with a disease causing agent (in this case, HIV).
Immunodeficiency means that the disease is characterised by a weakening of the
immune system.
Syndrome refers to a group of symptoms that collectively indicate or characterise a
disease. In the case of AIDS this can include the development of certain infections
and/or cancers, as well as a decrease in the number of certain cells in a person’s
immune system.
What causes AIDS?
AIDS is caused by an infection with a virus called human immunodeficiency virus
(HIV). This virus is passed from one person to another through blood-to-blood and
sexual contact. In addition, infected pregnant women can pass HIV to their babies
during pregnancy or delivery, as well as through breast feeding. People with HIV have
what is called HIV infection. Some of these people will develop AIDS as a result of
their HIV infection.
How does HIV cause AIDS?
HIV destroys a certain kind of blood cell (CD4+ T cells) which is crucial to the normal
function of the human immune system. In fact, loss of these cells in people with HIV
is an extremely powerful predictor of the development of AIDS. Studies of thousands
of people have revealed that most people infected with HIV carry the virus for years
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140 HIV/AIDS in News – Journalists as Catalysts
before enough damage is done to the immune system for AIDS to develop. However,
sensitive tests have shown a strong connection between the amount of HIV in the
blood and the decline in CD4+T cells and the development of AIDS. Reducing the
amount of virus in the body with anti-retroviral therapies can dramatically slow the
destruction of a person’s immune system. Being HIV positive is not the same as hav-
ing AIDS. The HIV actually goes inside the white blood cells and lies there quietly.
After about 5 to 10 years the HIV virus tricks the cell to start making the viral pro-
teins, this results in the formation of a huge number of viral particles inside the white
cells and eventually the cells burst releasing thousands of new viruses in the blood.
The released viruses infect new white cells. This cycle goes on and on, and eventu-
ally the immune system of the body is overwhelmed and is no longer capable of fight-
ing the infections.
Eventually the infected person may lose weight and become ill with diseases like per-
sistent severe diarrhoea, fever, pneumonia or skin cancer. He or she has now devel-
oped AIDS. People with AIDS can be helped with medicines for the different infec-
tions. At the moment though, in spite of much research, there is no cure for HIV or
for AIDS.
How long does it take for HIV to cause AIDS?
Prior to 1996, scientists estimated that about half the people with HIV would develop
AIDS within 10 years after becoming infected. This time varied greatly from person to
person and depended on many factors, including a person’s health status and their
health-related behaviours.
Since 1996, the introduction of powerful anti-retroviral therapies has dramatically
changed the progression time between HIV infection and the development of AIDS.
There are also other medical treatments that can prevent or cure some of the illness-
es associated with AIDS, though the treatments do not cure AIDS itself. Because of
these advances in drug therapies and other medical treatments, estimates of how
many people will develop AIDS and how soon are being recalculated, revised, or are cur-
rently under study.
As with other diseases, early detection of infection allows for more options for treat-
ment and preventive health care.
Why do some people make statements that HIV does not cause AIDS?
The epidemic of HIV and AIDS has attracted much attention both within and outside
the medical and scientific communities. Much of this attention comes from the many
social issues related to this disease such as sexuality, drug use and poverty. Although
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Frequently Asked Questions 141
the scientific evidence is overwhelming and compelling that HIV is the cause of AIDS,
the disease process is still not completely understood. This incomplete understand-
ing has led some persons to make statements that AIDS is not caused by an infec-
tious agent or is caused by a virus that is not HIV. This is not only misleading, but may
have dangerous consequences. Before the discovery of HIV, evidence from epidemio-
logical studies involving tracing of patients’ sex partners and cases occurring in per-
sons receiving transfusions of blood or blood clotting products had clearly indicated
that the underlying cause of the condition was an infectious agent. Infection with HIV
has been the sole common factor shared by AIDS cases throughout the world among
men who have sex with men, transfusion recipients, persons with haemophilia, sex
partners of infected persons, children born to infected women, and occupationally
exposed health care workers.
The conclusion after more than 20 years of scientific research is that people, if
exposed to HIV through sexual contact or injecting drug use for example, may become
infected with HIV. If they become infected, most will eventually develop AIDS.
How well does HIV survive outside the body?
Scientists and medical authorities agree that HIV does not survive well outside the
body, making the possibility of environmental transmission remote. HIV is found in
varying concentrations or amounts in blood, semen, vaginal fluid, breast milk, saliva,
and tears. To obtain data on the survival of HIV, laboratory studies have required the
use of artificially high concentrations of laboratory-grown virus. Although these unnat-
ural concentrations of HIV can be kept alive for days or even weeks under precisely
controlled and limited laboratory conditions, Centre for Disease Control (CDC) stud-
ies have shown that drying of even these high concentrations of HIV reduces the
amount of infectious virus by 90 to 99% within several hours. Since the HIV concen-
trations used in laboratory studies are much higher than those actually found in
blood or other specimens, drying of HIV-infected human blood or other body fluids
reduces the theoretical risk of environmental transmission to essentially zero.
Incorrect interpretations of conclusions drawn from laboratory studies have in some
instances caused unnecessary alarm.
Results from laboratory studies should not be used to assess specific personal risk of
infection because (1) the amount of virus studied is not found in human specimens or
elsewhere in nature, and (2) no one has been identified as infected with HIV due to con-
tact with an environmental surface. Additionally, HIV is unable to reproduce outside its
living host (unlike many bacteria or fungi, which may do so under suitable conditions),
except under laboratory conditions; therefore, it does not spread or maintain infectious-
ness outside its host.
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142 HIV/AIDS in News – Journalists as Catalysts
How is HIV passed from one person to another?
HIV transmission can occur when blood, semen, pre-seminal fluid, vaginal fluid, or
breast milk from an infected person enters the body of an uninfected person.
HIV can enter the body through a vein (injecting drug use), the lining of the anus or rec-
tum, the lining of the vagina and/or cervix, the opening to the penis, the mouth, other
mucous membranes (eyes or inside of the nose), or cuts and sores. Healthy skin is an
excellent barrier against HIV and other viruses and bacteria.
These are the most common ways that HIV is transmitted from one person to another:
by having sex (anal, vaginal or oral) with an HIV-infected person;
by sharing needles or injection equipment with an injecting drug user who is infect-
ed with HIV; or
from HIV-infected women to their babies before or during birth, or through breast-
feeding after birth.
Is there a connection between HIV and other sexually transmitted
diseases?
Yes. Having a sexually transmitted disease (STD) can increase a person’s risk of
becoming infected with HIV, whether the STD causes open sores or breaks in the skin
(like syphilis, herpes, chancroid) or does not cause breaks in the skin (like chlamydia,
gonorrhea).
If the STD infection causes irritation of the skin, breaks or sores may make it easier for
HIV to enter the body during sexual contact. Even when the STD causes no breaks or
open sores, the infection can stimulate an immune response in the genital area that
can make HIV transmission more likely.
In addition, if an HIV-infected person is also infected with STD, that person is three to five
times more likely than other HIV-infected persons to transmit HIV through sexual contact.
Can I get HIV from getting a tattoo or through body piercing?
A risk of HIV transmission does exist if instruments contaminated with blood are either
not sterilised or disinfected or are used inappropriately between clients.
Can I get HIV from casual contact (shaking hands, hugging, using a toilet,
drinking from the same glass, or the sneezing and coughing of an infected
person)?
No. HIV is not transmitted by day-to-day contact in the workplace, schools, or social set-
tings. HIV is not transmitted through shaking hands, hugging, or a casual kiss. You can-
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Frequently Asked Questions 143
not become infected from a toilet seat, a drinking fountain, a door knob, dishes, drink-
ing glasses, food, or pets.
HIV is not an airborne or food-borne virus, and it does not live long outside the body.
HIV can be found in the blood, semen, or vaginal fluid of an infected person.
Are women who have sex with women at risk for HIV?
Female-to-female transmission of HIV appears to be a rare occurrence. However, there
are case reports of female-to-female transmission of HIV. Vaginal secretions and men-
strual blood may contain the virus and that mucous membrane (oral, vaginal) exposure
to these secretions has the potential to lead to HIV infection.
In order to reduce the risk of HIV transmission, women who have sex with women
should do the following:
Avoid exposure of a mucous membrane, such as the mouth, (especially non-intact
tissue) to vaginal secretions and menstrual blood.
Know your own and your partner’s HIV status. This knowledge can help uninfected
women begin and maintain behavioural changes that reduce the risk of becoming
infected. For women who are found to be infected, it can assist in getting early treat-
ment and avoid infecting others.
Are health care workers at risk of getting HIV on the job?
The risk of health care workers being exposed to HIV on the job is very low, especially if
they carefully follow universal precautions (using protective practices and personal protec-
tive equipment to prevent HIV and other blood-borne infections). It is important to remem-
ber that casual, everyday contact with an HIV-infected person does not expose health care
workers or anyone else to HIV. For health care workers on the job, the main risk of HIV trans-
mission is through accidental injuries from needles and other sharp instruments that may
be contaminated with the virus; however this risk is small. Scientists estimate that the risk
of infection from a needle-stick is less than one per cent, a figure based on the findings of
several studies of health care workers who received punctures from HIV-contaminated nee-
dles or were otherwise exposed to HIV-contaminated blood
Which body fluids transmit HIV?
Fluids with high concentrations of HIV are:
blood
semen
vaginal fluid
breast milk
other body fluids containing blood
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144 HIV/AIDS in News – Journalists as Catalysts
The following are additional body fluids that may transmit the virus that health care
workers may come into contact with:
fluid surrounding the brain and the spinal cord
fluid surrounding bone joints
fluid surrounding an unborn baby
HIV has been found in the saliva and tears of some persons living with HIV, but in very
low quantities. It is important to understand that finding a small amount of HIV in a
body fluid does not necessarily mean that HIV can be transmitted by that body fluid.
HIV has not been recovered from the sweat of HIV-infected persons. Contact with sali-
va, tears, or sweat has never been shown to result in transmission of HIV.
Can I get HIV from kissing?
On the Cheek: HIV is not transmitted casually, so kissing on the cheek is very safe. Even
if the other person has the virus, your unbroken skin is a good barrier. No one has become
infected from such ordinary social contact as dry kisses, hugs, and handshakes.
Open-Mouth Kissing: Open-mouth kissing is considered a very low-risk activity for the
transmission of HIV. However, prolonged open-mouth kissing could damage the mouth
or lips and allow HIV to pass from an infected person to a partner and then enter the
body through cuts or sores in the mouth. Because of this possible risk, open-mouth
kissing with an infected partner is not recommended.
One case suggests that a woman became infected with HIV from her sex partner
through exposure to contaminated blood during open-mouth kissing.
Can I get HIV from anal sex?
Yes. In fact, unprotected (without a condom) anal sex (intercourse) is considered to
be very risky behavior. It is possible for either sex partner to become infected with
HIV during anal sex. HIV can be found in the blood, semen, pre-seminal fluid, or vagi-
nal fluid of a person infected with the virus. In general, the person receiving the
semen is at greater risk of getting HIV because the lining of the rectum is thin and
may allow the virus to enter the body during anal sex. However, a person who inserts
his penis into an infected partner also is at risk because HIV can enter through the
urethra (the opening at the tip of the penis) or through small cuts, abrasions, or open
sores on the penis.
Not having (abstaining from) sex is the most effective way to avoid HIV. If people choose
to have anal sex, they should use a condom. Most of the time, condoms work well.
However, condoms are more likely to break during anal sex than during vaginal sex.
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Frequently Asked Questions 145
Thus, even with a condom, anal sex can be risky. A person should use generous
amounts of water-based lubricant in addition to the condom to reduce the chances of
the condom breaking.
Can I get HIV while playing sports?
There are no documented cases of HIV being transmitted during participation in sports.
The very low risk of transmission during sports participation would involve sports with
direct body contact in which bleeding might be expected to occur. There is no risk of
HIV transmission through sports activities where bleeding does not occur.
How do people get infected with HIV?
HIV is transmitted mostly through semen and vaginal fluids during unprotected sex with-
out the use of condoms. Besides sexual intercourse, HIV can also be transmitted dur-
ing drug injection by the sharing of needles contaminated with infected blood; by the
transfusion of infected blood or blood products; and from an infected woman to her
baby before birth, during birth or just after delivery.
How can I avoid being infected through sex?
You can avoid HIV infection by abstaining from sex, by having a mutually faithful monog-
amous sexual relationship with an uninfected partner or by practicing safer sex. Safer
sex involves the correct use of a condom during each sexual encounter and also
includes non-penetrative sex.
Is oral sex unsafe?
Oral sex (one person kissing, licking or sucking the sexual areas of another person)
does carry some risk of infection. If a person sucks the penis of an infected man, for
example, infected fluid could get into the mouth. The virus could then get into the blood
if you have bleeding gums or tiny sores somewhere in the mouth. The same is true if
infected sexual fluids from a woman get into the mouth of her partner. But infection
from oral sex alone seems to be very rare.
How does HIV affect the body?
HIV destroys a particular variety of white blood cells that are essential for destroying
disease-causing germs. There are several varieties of white blood cells in the body. Of
these, lymphocytes form about 25% of the total white blood cell count. They normally
increase in number in response to any infection. There are two types of lymphocytes:
(a) B cells and (b) T cells. When the B cells come in contact with a disease-causing
agent such as bacteria or virus, they secrete large volumes of antibodies - chemical
substances that can destroy the disease-causing germs. The main functions of B cells
are to search, identify and then bind with the disease causing germs.
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146 HIV/AIDS in News – Journalists as Catalysts
The T cells are lymphocytes that have travelled through a small gland called the thy-
mus gland, which is situated in the middle and upper part of the bony cage of the
chest. When a disease -causing germ enters the body, the T cells produce several
new copies of itself. Each T cell contains chemical substances that can destroy
the specific disease-causing germs. T cells are also called “killer cells” because of
their two main actions, which are (a) they secrete chemical substances necessary
for destroying the disease-causing germs and (b) they help the B cells in destroying
the agents.
How does HIV spread in the body?
The HIV virus multiplies and affects some cells of the immune system contain a mol-
ecule called CD4 on their surface. CD4 molecules are also found on the T cells.
When the HIV virus enters the body, it first identifies cells with CD4 and attaches
itself to them.
Does HIV/AIDS affect children?
Yes. Children can be both infected and affected by HIV/AIDS. Over 2.5 million children
worldwide are now infected with HIV.
How does a mother transmit HIV to her unborn child?
An HIV-infected mother can infect the child in her womb through her blood. The baby is
more at risk if the mother has been recently infected or is in a late stage of AIDS.
Transmission can also occur at the time of birth when the baby is exposed to the moth-
er’s blood and to some extent transmission can occur through breast milk.
Transmission from an infected mother to her baby occurs in about 30% of cases.
Can HIV be transmitted through breast-feeding?
Yes. The virus has been found in breast milk in low concentrations and studies have
shown that children of HIV-infected mothers can get HIV infection through breast milk.
Can blood transfusions transmit HIV infection?
Yes, if the blood contains HIV. In many places blood is now screened for HIV before it
is transfused. If you need a transfusion, try to ensure that screened blood is used.
Can injections transmit HIV infection?
Yes, if the injecting equipment is contaminated with blood containing HIV. Avoid injections
unless absolutely necessary. If you must have an injection, make sure the needle and
syringe come straight from a sterile package or have been sterilised properly; a needle
and syringe that has been cleaned and then boiled for 20 minutes is ready for reuse.
Finally, if you inject drugs, of whatever kind, never use anyone else’s injecting equipment.
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Frequently Asked Questions 147
Can I get infected with HIV from mosquitoes?
No. From the start of the HIV epidemic there has been concern about HIV transmis-
sion of the virus by biting and bloodsucking insects, such as mosquitoes. However,
studies have shown no evidence of HIV transmission through mosquitoes or any
other insects — even in areas where there are many cases of HIV/AIDS and large
populations of mosquitoes.
When an insect bites a person, it does not inject its own or a previously bitten person’s
or animal’s blood into the next person. Rather, it injects saliva, which acts as a lubricant
so the insect can feed efficiently. HIV lives for only a short time inside an insect and,
unlike organisms that are transmitted via insect bites, HIV does not reproduce (and does
not survive) in insects. Thus, even if the virus enters a mosquito or another insect, the
insect does not become infected and cannot transmit HIV to the next human it bites.
If a person becomes infected with HIV, does that mean they have AIDS?
No. HIV is an unusual virus because a person can be infected with it for many years
and yet appear to be perfectly healthy. But the virus gradually multiplies inside the body
and eventually destroys the body’s ability to fight off illness.
It is still not certain that everyone with HIV infection will get AIDS. It seems likely that
most people with HIV will develop serious problems with their health. But this may be
after many years. A person with HIV may not know they are infected but can pass the
virus on to other people.
Is there a vaccine for HIV/AIDS?
While there is currently no vaccine for HIV/AIDS, research is under way. Many
candidate vaccines are presently undergoing either phase I or phase II clinical trials
in various countries, including India. Field trials to determine efficacy will take anoth-
er 3-5 years or more. Hence, a vaccine for general use is unlikely to be available in
the near future.
Is there a treatment for HIV/AIDS?
All the currently licensed anti-retroviral drugs, namely AZT, ddI and ddC, have effects which
last only for a limited duration. In addition, these drugs are very expensive and have
severe adverse reactions while the virus tends to develop resistance rather quickly with
single-drug therapy. The emphasis is now on giving a combination of drugs including newer
drugs called protease inhibitors; but this makes treatment even more expensive.
Better care programmes have been shown to prolong survival and improve the quality
of life of people living with HIV/AIDS.
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148 HIV/AIDS in News – Journalists as Catalysts
How can I tell if I have HIV infection?
The only way to know for sure if you have this virus is by taking a blood test called the
“HIV Antibody Test.” “The HIV Test” or the “AIDS Test” alone cannot tell you if you have
the infection. The HIV test can tell you if you have the virus and can pass it to others
in the ways already described. The test is not a part of your regular blood tests-you have
to ask for it by name. It is a very accurate test.
If your test result is “positive,” it means you have the HIV infection. Additional tests can
tell you how strong your immune system is and whether drug therapy is indicated.
If your test is “negative,” and you have not had any possible risk for HIV for six months
prior to taking the test, it means you do not have HIV infection. You can stay free of HIV
by following prevention guidelines.
If I am HIV positive, what should I do?
If you’ve tested positive for HIV, consider the following:
See a health care professional for a complete medical work-up for HIV infection and
advice on treatment and health maintainance. Make sure you are tested for TB and
other STDs. For women, this includes a regular gynaecological examination.
Inform your sexual partner(s) about their possible risk for HIV.
Protect others from the virus by following precautions.
Protect yourself from any additional exposure to HIV.
Avoid drug and alcohol use, practice good nutrition, and avoid fatigue and stress.
Seek support from trustworthy friends and family when possible, and consider get-
ting professional counselling.
Find a support group of people who are going through similar experiences.
Do not donate blood, plasma, semen, body organs or other tissue.
What are the symptoms of HIV/AIDS?
A person infected with HIV is not likely to have any symptoms for about three to ten
years. This period may be longer if the natural defense mechanism of the body is good.
Although a person infected with HIV does not have any symptoms, he/she can spread
the infection to others. This is why it is recommended that any one who has sex with
a partner who is not in a mutually faithful relationship should practice safe sex. This
means using a condom.
A person is said to have AIDS if he/she has at least two major signs and at least one
minor sign and there is no other cause of poor immune mechanism.
Major signs: Diarrhoea is very common in people with HIV/AIDS. It is normally clear
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Frequently Asked Questions 149
and watery and may be associated with cramp-like pain in the abdomen and vomiting.
Chronic diarrhoea with excessive loss of weight is one of the important features of
HIV/AIDS. There may also be continuous fever and increased sweating at nights.
Weight loss is also one of the signs.
Minor Signs: Chronic cough that does not respond to routine treatment, enlargement
of the lymph nodes, fungal infection of the mouth called candidiasis, recurrent infec-
tions of herpes group of viruses.
What are the opportunistic infections in AIDS?
Poor defence mechanism of the body allows several disease-causing germs to infect
people with HIV/AIDS. One of the common opportunistic infections seen in people with
HIV/AIDS is tuberculosis.
Tuberculosis: This is a bacterial infection and is normally transmitted when a person
with active tuberculosis coughs or sneezes. Common symptoms of tuberculosis include
cough, fever, increased sweating at nights, loss of weight and excessive fatigue.
Tuberculosis often occurs in the early stages of HIV infection. Since tuberculosis is
already one of the major health problems in India, people with HIV are at a higher risk of
getting it. Very often, tuberculosis is the first indication that a person has HIV infection.
Tuberculosis is more common in people with HIV infection who have less than two hun-
dred CD4+ count.
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150 HIV/AIDS in News – Journalists as Catalysts
Appropriate Terminology
✔
People Living With HIV/AIDS
HIV positive
HIV/
AIDS
Died from HIV/AIDS related illness
Multiple sex partners
HIV test
Contract HIV
Transmitting HIV infection
Virus/Infection/Epidemic
Children orphaned by AIDS
Injecting drug users
✗
HIV/AIDS victim/sufferers/carriers
HIV patient
AIDS virus
Full-blown AIDS/ AIDS positive
Died of AIDS
Promiscuous
AIDS test
Catch HIV
Transferring AIDS
Disease
AIDS orphans
Drug addicts
AVOID:
Term
High risk groups
Terminal disease/Deadly/Ticking
time bomb/The demon of AIDS/
Scourge/Threat/Menace/Halting
the march of AIDS/Viral Tsunami/
Plague/Death sentence/Jaws of death/
Circle of death/World fell apart/
Country’s AIDS capital/Counting
remaining days/Severely afflicted
by the curse/Pandemic
Innocent victims
Why
Everybody is at risk today, not just sexworkers or truck drivers
Causes scare and alarm instead of
informing
It insinuates that the rest deserve it
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NGOs, Networks of HIV Positive People & Websites 151
NGOs, Networks of HIV Positive People & Websites
NGOs in Punjab
Yuvsatta
H.No. 3363, Sec-35D,
Chandigarh
Tel.: 0172-614951
Surya Foundation
(Survival of Young & Adolescent
Foundation)
No. 3139, Sector N 28 D,
Chandigarh
Tel.: 0172-655661
All India Women’s Conference
Indira Gandhi Bhawan, No. 286,
Sec-11 A, Chandigarh
Tel.: 0172-747061
Progressive Education Society
No. 283, Sec-48 B,
Kendriya Vihar,
Chandigarh
Tel.: 0172-890643
Indian Council for Social Welfare
Room No. 16, Ist Floor,
Karuna Sadan Building,
Sec-11, Chandigarh
Tel.: 0172-745914
Servants of the People Society
Lajpat Rai Bhawan,
Sec-15B,
Chandigarh
Tel.: 0172-780611
Voluntary Health Association of
Punjab
SCF 18/1, Sec-10 D,
Chandigarh,
Tel.: 0172-743557
Citizen’s Awareness Group
No. 2812, Sec-38 C
Chandigarh
Tel.: 0172-604253
Family Planning Association of India
Kothi No. 637, Phase N II, Mohali
Tel.: 0172-273791
Indian Council for Social Welfare
Room No. 16, Ist Floor,
Karuna Sadan Building
Sec-11 Chandigarh
Tel.: 0172 745914
Society for Service to
Voluntary Agencies
Room No. 18-20, Ist Floor,
Karuna Sadan, Sec-11B
Chandigarh
Tel.: 0172-746258
Jan Shiksha Sansthan
SCO No. 313(FF), Sector-38D,
Chandigarh
Tel.: 0172-697740
Christian Aids
Fatehgarh Sahib, Punjab
Tel.: 1726-271504
Arpan Trust
Nangal (Ropar), Punjab
Tel.: 01887-224741
Umeed Khanna Foundation
Gaushala Road, Opp,
Grain Market, Sangrur
Tel.: 01673-36744, 40663, 32148
Association for Social & Rural
Advancement
VPO Dher-140123 (ASRA)
District Ropar
Tel.: No 01882 Ò 260611, 260211
Family Planning Association of India
Kothi No 637
Phase 2, SAS Nagar, Mohali (Ropar)
Tel.: 0172- 273791
International Council of Ayurveda
Jagraon Sharma Hospital & Nursing
Home
Jagraon, Ludhiana
Tel.: 01624- 23399, 34109
International Forum for Education
and Development
27 Adarsh Nagar, RT Road, Amritsar
Tel.: 0172-221414
Malwa Education Society for Social
Interventions & Health Activities
(MESSIHA)
Natt Road, Talwandi Saboo, Bathinda
Tel.: 01655- 38486, 20608
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152 HIV/AIDS in News – Journalists as Catalysts
SGN Medical Society
Shed No. 50, Sector N 3 Talwar
Township, Hoshiarpur
Tel.: 01883 37388
NGOs in Uttar Pradesh
Naz Foundation International
9 Gulzar Colony, New Berry Lane,
Lucknow 226 001, India
Tel.: +91 (0)522 205781
Sarvajan Kalyan Samiti
275, Katghar, Allahabad- 211003
Tel.: 0532-2414520, 2416921
Sukriti Sewa Sansthan
886 G, Brahmapuri, Meerut
Tel.: 1021-613451, 611683
Pragati Sewa Sansthan
117/798, N Block ,
Kakadeo, Kanpur
Ph: 0512- 50048, 240148
Nav Jyoti Samaj Kalyan Samiti
MIG 87, Indra Nagar, Kalyanpur,
Kanpur Nagar- 208026
Tel.: 0512 575061
Global Science Academy
Malviya Road
(Near Pikaura Dattu Rai)
Basti - 272001
Tel.: 05542 85060
Sarvahara Kalyan Samiti
9/35, Ahata Nidhan Singh,
Guriyabad, Aligarh
Tel.: 0571 521168
Gramin Seva Sansthan
19, 1st Floor , Opp Nurse Hostel,
Town Hall, Gorakhpur - 273001
Tel.: 0551-344381, 258880
Milana
98, Old Race Course Road,
Austin Town, Bangalore
Tel.: 25545691
Sapna Kalyan Samiti
Zilla Panchayat Inspection House Road,
Near D.M. Crossing, Baharaich - 27180
Tel.: 05252 - 35594
Swargia Ram Sevak Sewa Samiti
4/478, Avas Vikas Colony , Near
Panchayat Bhawan,
Barabanki - 225001
Tel.: 05248 - 20111
Jai Hospital & Research Centre
Near Shree Talkies Bypass,
Agra- 282002
Tel.: 0562 - 520381, 520167
Deep Jan Kalyan Samiti
15, Krishnaman Colony,
Delapir, Bareilly
Tel.: 0581 - 445087
FRIENDS
27, Sheel Nagar Extension,
Mahmoorganj, Varanasi
UPVHA
5/459, Viram Khand
Gomti Nagar, Lucknow
Tel.: 2725539
NGOs in Karnataka
Swasti
No 52, Postal Colony,
Sanjay Nagar, Bangalore
Community Health Centre (CHC)
No 367, Srinivasa Nilaya,
Jakkasandra 1 Main,
1 Block, Koramangala,
Bangalore 560 034
Tel.: 080 - 2546 1920
Freedom Foundation
Site No 30, Survey No 17/2,
Hennur Village Post,
Hennur Bande,
Bangalore 560 043
Tel.: 080 - 2544 0134/2544 0135
Samraksha
No 522, 2nd Floor, Block 5,
Ranka Park Apartments 4, 5 and 6,
Lalbaugh Road, Bangalore 560 022
Tel.: 080-23546965/23546961
Society for People’s Action for
Development (SPAD)
Flat No 1-13, Orient Manor,
15, Highstreet,
Cooke Town,
Frazer Town Post,
Bangalore 560 005,
Tel.: 080 - 2547 1680
Vimochana
No 33/1-9, Thyagaraja Layout,
Jai Bharat Nagar,
Maruthi Seva Nagar PO,
Bangalore 560 033,
Tel.: 080 - 2549 2781/2549 2783
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ICHAP
Pisces Building
#4/13-1, Crescent Road
High Grounds
Bangalore - 560 001
Tel.: 080 - 23562028
Jagruthi
Jyothi Complex,
C3, 2nd Floor, 134/1,
Infantry Road,
Bangalore - 560001.
Tel.: 080 - 22860346
Odanadi Seva Samsthe
15/2B, S.R.S Colony,
Hootagalli Village,
Belavadi Post,
Hunsur - Mysore Road,
Mysore - 571 186.
Tel.: 0821 - 2402155
Population Foundation of India’s
Global Trust Fund
Tel.: 93411 38609
B-28, Qutab Institutional Area,
New Delhi-110 016
Action Aid
(HIV/AIDS Thematic Unit)
No 3, Rest House Road
Bangalore - 560001
Tel.: 080 - 25586682
Asha Foundation
No. 58, SBM Colony,
3rd Main,
Anand Nagar,
Bangalore - 560024
Tel.: 080 - 23332921
NGOs, Networks of HIV Positive People & Websites 153
PATH
11/3-5, 2nd floor, Palace loop road,
Vasanth Nagar, Bangalore - 560052
Tel.: 080 - 51518858/57
Kolkata - 700 074
Tel: 033 - 26864466
email: bnpplus_05@rediffmail.com
Indian Medical Association
(Karnataka Chapter)
Katyayini Building, Near CBT, KEB Road,
Hubli - 580 020
Tel.: 0 94482 73256
Karnataka Health Promotion Trust
Bangalore
Tel.: 0 94482 39363
Human Rights Law Network
Bangalore
Tel.: 57624757
Murray Culshaw Consulting
314/1, 7th Cross Road,
Bangalore
Tel.: 080 - 25352003
Country-wide List of Networks of
People Living with HIV/AIDS
ANP+ (Assam Network for People liv-
ing with HIV/ AIDS)
Rangpur Path, Sundarpur,
Opp. Blue Flame Gas Agency,
PNDC Building, 2nd Floor
RG Bodhua Road, Guwahati - 781 005
Tel: 0361-2585104
email: anpplus@yahoo.com
CPK+ (Council of People living with
HIV/AIDS)
Ist floor, Noor Mansion,
St. Albert’s High School Road
Ernakulam - 682 035
Tel: 0484 - 2367685, 2384462
email: cpkcpkin@yahoo.co.in
GSNP+ (Gujarat State Network of
People Living with HIV/ AIDS)
No 35, Surat Municipal Medical College
& Hospital (Simmer)
Near Sahara Darwaja, Surat
Tel: 0261- 5594700
email: gsnpplus@yahoo.co.in
KNP+ (Karnataka Network of Positive
People)
No. 113, 1st floor,
8th Main Road, 15th Cross,
Wilson Garden, Bangalore
Tel: 080- 22120409
email: knpplus@vsnl.net
MNP+ (Manipur Network of Positive
People)
Yaiskul Hiruhanba Leikai Imphal,
West Imphal, Manipur - 755 001
Tel: 0385- 2440828, 2440469
email: mnpplus_145@hotmail.com
BNP+ (Bengal Network for People
living with HIV/ AIDS)
432, Jawpur Road,
Jagadish Polly,
NMP+ (Network of Maharashtra by
People living with HIV/AIDS)
Kashiba Shinda Sabha Graha,
Waghere Vasti, Pimprigoan,
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154 HIV/AIDS in News – Journalists as Catalysts
Pimpri - 17, Pune
Tel: 020- 27411020
email: nmpplus@vsnl.net
PWN+ (Positive Women’s Network)
9/5, Avenue Road,
Shanti Apartments,
Nungambakkam,
Chennai - 600 034
Tel: 044 - 28270204, 28203959
email: poswonet@hotmail.com
PNP+ (Pondicherry Network of
Positive People Welfare Society)
No.19, Ayyanar Koil Street,
Raja Nagar,
Pondicherry - 605 013
Tel: 0413 - 2200769
email: pondypositivenet@yahoo.co.in
RNP+ (Rajasthan Network for Positive
People)
Plot No: 15-B, RSEB Colony
Vaishali Nagar, Jaipur, Rajasthan
Tel.: 0141- 2351108, 2358396,
2348667
email: rnpplus@yahoo.co.in
TNP+ (Telugu Network of People
Living with HIV/AIDS)
No.31-12-5, Gopala Krishnaiah
St. Machavaram,
Vijayawada - 522 004.
Tel.: 0866 - 2432306
email: tnp58ap@indiatimes.com
UNP+(Utkal Network of People Living
with HIV/AIDS)
‘DEVI DAYA’ Plot 2983, Anantpur,
Bes. Chintamaniswarar Temple
Bhubaneshwar 751 006, Orissa
Tel: 0674-2404238, 2404132
ZINDAGI GOA
2nd floor, Behind MPT Ground,
Uma Shankar Building,
Patrong, Baina
Vasco-da-gama 403 802
Tel: 0832- 3095122, 5645729(PP)
email: zindagigoa@yahoo.com
M-PLAS
C/o Lianvunga Durtlang,
Leitan South, Aizawl,
Mizoram - 796 005
Tel: 0389- 2317088
email: mplas_mplas@yahoo.co.in
NNP+ (Network of Naga People
Living with HIV/AIDS)
82, East View, ‘D’ Block
Kohima, Nagaland - 797 001
Tel: 0370 - 2108759
email: nnpplus@yahoo.co.in
TNP+ Tamil Nadu Network for
People Living with HIV/AIDS
Kalki Bhawan,
16, 4th Street,
Viswasapuram,
Jnanalivapuram,
Madurai - 16
NPH+ Network of People Living
with HIV/AIDS in Haryana
445/23, Opp. Dev High School,
Hira Nagar, Khansa Road,
Gurgaon - 112 001
Tel: 0124- 3952217
www.unicef.org
www.unaids.org
www.undp.org
www.redribbon.com
www.plwhs.org
www.indianngo’s.com
www.nfi.net
www.unifem.org.in
www.unesco.org
www.youandaids.org
www.kaisernetwork.com
www.icasi.org
Websites
www.cdc.gov/hiv/dhap.htm
www.hsph.harvard.edu/hai/home.html
www.icrw.org
www.hivpositive.com
www.strashope.org
www.hivtest.org
www.info.com/hiv
www.napwa.org
www.aidsinfo.hih.gov
www.aegis.com
www.aids.com
www.aids-india.org
www.hivanonymous.com
www.gnpplus.net
www.ias.se
www.avert.org/aidsindia.htm
www.saathii.org/stapp/searchIndia.jsp
www.aidsalliance.org
www.whoindia.org/cds/cd/hiv
www.nacoonline.org
www.lawyerscollective.org
www.panos.org.uk
www.hdnet.org
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Helpline Assistance
Helpline Assistance 155
North India
AAG
Monday to Saturday 10.00 am - 5.30 pm
AIDS Awareness Group
Ms. Elizabeth Vatsyayan
119, Humayunpur,
Safdurjung Enclave,
New Delhi - 110029
Tel.: 011-26187953
Fax: 011-51650029
Email: aagindya@yahoo.co.in
Shubhchintak
Monday to Friday 10.00 am - 5.00 pm
Saturday 10.00 am - 1.00 pm
AIDS Education & Training Cell,
Centre for Community Medicine
Dr. Bir Singh
All India Institute of Medical Sciences
(AIIMS),
New Delhi - 110029
Tel.: 011-26588333
Fax: 011-26588663
Email: birsingh43@hotmail.com
Website: www.aiims.edu
SOFOSH
Monday to Saturday 8.00 am - 10.00
am and 7.00 pm - 9.00 pm
Society for Social Health (SOFOSH)
Dr. Naresh Anand
H.No. 206/2, Sector-41A
Chandigarh - 160041
Tel.: 011-0172-2627310
Email: sofosh@yahoo.co.in
Sparsh
Monday to Saturday 9.00 am - 5.00 pm
Parivar Seva Sanstha
Ms. Nirmala Mishra
C-374, Defence Colony
New Delhi - 110024
Tel.: 011-24332524 / 24337712
South India
ACCEPT
Monday to Saturday 10.00 am - 5.30 pm
245, KRC Road, Near Visthar, Dodda
Gubbi P.O., Bangalore - 562149
Tel.: 080-22714110 / 56990452
Email: accept@vsnl.com
AIDS Desk, GuruClin
Monday to Friday 9.00 am - 5.00 pm
National Lutheran Health and
Medical Board
Dr. Shiela Shyamprasad
5 Purasavalkam High Road, Kilpauk,
Chennai - 600010
Tel.: 044-26480933
Email: sheilashyamprasad@yahoo.co.in
/ guruclin@vsnl.com
Website: www.aidsdesk.org
Asha Foundation HIV/AIDS Helpline
Monday to Friday 9.30 am - 4.30 pm
Saturday 9.30 am - 1.00 pm
Dr. Glory Alexander
No.58, III Main, SBM Colony,
Anandnagar,
Bangalore - 560024
Tel.: 080-23543333 / 23545050 /
23332921
Fax: 080-23332921
Email: ashafblr@yahoo.co.in
Website: www.ashas.org
DESH
Monday to Saturday 9.30 am - 5.15 pm
Deepam Educational Society for Health
Mr. Sarvannan
3/655 B Kuppam Road,
Kaveri Nagar Kottyvakkam,
Chennai - 600041
Tel.: 044-24511187 / 2411188
Fax: 24511112
Email: desh@vsnl.com
Website: www.deshhealth.org
Divya Disha HIV/AIDS Helpline
All days 8.00 am - 11.00 pm
Mr. Isadore Philips
H.No.9-1-103A, Tatachari Compound,
Secunderabad - 500025
Email: divyadisha@rediffmail.com /
isiphil@gmail.com
Freedom Foundation (FF) HIV/AIDS
Helpline
All days 9.00 am - 5.00 pm
FF Bangalore Office
Mr. Ashok K. Rau
1st Floor Site No.30,
Survey No.17/2, Hennur Bande,
Bangalore - 560043
Tel.: 080-25443101 / 25440135
Email: freedom_found@vsnl.net
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156 HIV/AIDS in News – Journalists as Catalysts
FF Secunderabad Office
Mr. Narendran
21 Carriappa Street, Bolarum,
Secunderabad - 500010
Tel: 040-27861023
Website:
www.thefreedomfoundation.org
Positive Help
Monday to Saturday 10.00 am - 5.00 pm
YRG Care
Voluntary Health Service,
Taramani,
Chennai - 600113
Tel.: 044-22542929
Fax: 044-22542939
Email: info@yrgcare.org
Saadhan Helpline
Monday to Friday 8.30 am - 7.30 pm
Saturday 8.30 am - 5.30 pm
Population Service International
Chennai
Mr. J. Joson Mellot
6/80, Luz Avenue, Mylapore,
Chennai - 600004
Tel.: 044-24996131 / 24995808
Email: chennaihelpline@psi.org.in
Population Service International
Vishakapatnam
Monday to Friday 10.00 am - 8.00 pm
Saturday 10.00 am - 4.00 pm
Ms. Jessy Choudhury
Flat no.1, 2nd Floor,
Satya Sridevi Enclave,
Third Line, Dwarka Nagar,
Vishakapatnam - 500016
Tel.: 0891-5560192
Email: vizaghelpline@psi.org.in
East India
OSERD
Monday to Saturday 10.00 am - 5.00 pm
Organization for Socio-Economic and
Rural Development
Mr. S. Pankaj
144 F Sri Krishna Puri, Boring Road,
Patna - 800001, Bihar
Tel.: 0612-2211423
Email: oserd45@rediffmail.com /
pankaj55@sancharnet.net
Saadhan
Monday to Saturday 9.30 am - 8.00 pm
Population Service International (PSI)
Ms. Satamita Dutt
Kolkata, Unit 6 & 7, 4th Floor, Phase 1
New Alipore, Marketing Complex,
Block M, New Alipore,
Kolkata - 700053
Tel.: 033-243003945 / 243003946
SASO
Monday to Saturday 9.30 am - 4.00 pm
Social AIDS Service Organization
Khwai Lalambung, Makhong,
Rims Road(s)
Imphal - 5795001
Tel.: 0385-2411408
Email: oharikumar@yahoo.co.in
Website: www.sasoimphal.org
West India
Asha
Monday to Friday 9.00 am - 4.00 pm
Asha Project
Municipal Eye Hospital, 2nd Floor, M.S.
Ali Road, Near Two Tank, Grant Road,
Mumbai - 400008
Tel.: 022-23080486 / 23050796
Email: asha_fhi@yahoo.com
FPAI Helpline
Monday to Friday 10.00 am - 5.00 pm
Family Planning Association of India
Dr. Usha Krishna
5th Floor, Cecil Court, Near Regal
Cinema, Colaba, Mumbai - 400001
Tel.: 022-22874689 / 22871856
Email: fpaimum@hathway.com
Website: www.fpaindia.com
Glaxo AIDS Helpline
Monday to Saturday 9.30 am - 7.30 pm
Ms. Pooja Dave
Glaxo Smithkline Pharmaceutical Ltd
Worli, Mumbai - 400025
Tel.: 022-24983444
Email: gskhivaidshelpline@yahoo.co.in
Goa State AIDS Control Society
HIV/AIDS Helpline
Monday to Saturday 9.30 am - 5.45 pm
Mr. Jerome Dias
1st Floor, Dayanand Smruti Building,
Swami Vivekanand Road,
Panaji - 403001
Tel.: 0832-2427286 / 2422518
Fax: 0832-2422518
Email: sacs_goa@nacoindia.org /
goasacs@sancharnet.in
Positive People
Monday to Saturday 9.30 am - 7.00 pm
Mr. John Pinheiro
Maithili Apts., St. Inez, Panjim
Tel.: 0832-2431827 / 2424396 /
2425404
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Helpline Assistance 157
Prakhakar Helpline
Monday to Saturday 10.00 am - 4.00 pm
Ms. Anuradha Karegar
Nana Palkar Smruti, Rugna Seva
Sadan, 158 Rugna Seva Sandan Marg,
Off Dr. Ambedkar Road, Parel,
Mumbai - 400020
Tel.: 022-24173233
Email: pkkk_npss@yahoo.co.in
Rotary Kripa AIDS Helpline
Everyday 9.00 am - 9.00 pm
Kripa Foundation
Mr. G.S. Srinivas
81/A, Chapel Road,
Mount Carmel Church,
Near Lilavati Hospital,
Bandra (W),
Mumbai - 400050
Tel.: 022-26429158
Email: kripadarc@vsnl.net
Saadhan
Monday to Saturday 9.00 am - 9.00 pm
Sunday 10.00 am - 6.00 pm
Population Service International (PSI)
Dr. Shilpa
18 Kunjai Cooperative Society,
V.P. Road, Khotachiwadi,
Girgaun,
Mumbai – 400004
Tel.: 022-23870883 / 39540753 /
30964278
Email: helpline@psi.org.in
The Salvation Army
Monday to Friday 10.00 am – 5.00 pm
Manoj Pawar
84, Sankale Street,
Madanpura,
Mumbai – 400008
Tel.: 022-23093566
Email: msalaids@vsnl.net
SNDT Helpline
Monday to Friday 2.00 pm – 4.00 pm
SNDT Women’s University, Population
Education Resource Centre
Dr. Vandana Chakravathy
SNDT Women’s University, 1st Floor,
Above Parkar Hall, New Marine Lines,
Mumbai – 400020
Tel.: 022-22081497 / 22066892
Email: sndtperc@bom3.vsnl.net.in
UMRC
Monday to Saturday 10.00 am–6.00 pm
Unison Medicare and Research Centre
Dr. I.S. Gilada
Maharukh Mansion, Alibhai Premji
Marg, Grant Road (East),
Mumbai – 400007
Tel.: 022-23061616
Email: ihoaids@vsnl.com
Website: www.unisonmedicare.com
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158 HIV/AIDS in News – Journalists as Catalysts
Writing Positively
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Writing Positively 159
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160 HIV/AIDS in News – Journalists as Catalysts
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The New Indian Express
Writing Positively 161
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162 HIV/AIDS in News – Journalists as Catalysts
Two-Day Media Workshop Structure
Journalists arrive by 6 p.m. on the day before the workshop and check into hotel.
Participants get to meet and know each other. Film Phir Milenge or My Brother Nikhil shown followed by dinner.
Day 1
10 am to 10.15 am
10.15 am to 10.35 am
10.40 am to 11.15 am
11.15 am to 11.30 am
11.30 am to 12 noon
12 noon to 12.15 pm
12.15 pm to 1.15 pm
Registration & Coffee
PFI’s presentation on media research findings
Inauguration by NACO Director – How NACP-II has fared and what is expected of NACP-III
Q&A
Overview of the HIV/AIDS scenario in the state
Q&A
Positive people to share their perspectives with the media. Followed by Q&A
1.15 pm to 2 pm
Lunch
2 pm to 3 pm
3 pm to 5 pm
An interactive session on Facts and Myths on HIV/AIDS
Group activity
Three or four groups to be formed; will brain storm on subjects allotted to them and work
out radio programmes, radio jingles, poster campaigns and do a street play.
Group 1: In a district where a network of Positive people has been formed for the first time, several people from the villages
of the district join the network. The Ludhiana station of All India Radio organises a panel discussion with three Positive
people. It is a 15-minute programme.
Group 2: An advertising company has been entrusted by the state AIDS Control Society to conduct a poster campaign on
raising HIV/AIDS awareness. The campaign has to promote use of condoms and safe sex. Please prepare a set of four to
five posters.
Group 3: A young mother discovers late in her pregnancy that she is HIV positive. Do a 20 minutes street play around the issue
to bring out the stigma and discrimination that she faces and how she tackles the situation. The entire group participates.
Day Two
8 am to 2pm
2.30 pm to 5 pm
5 pm to 5.30 pm
Field trip for journalists to a care and support project
Group presentations. Awards will be given for the best two presentations.
A newspaper editor will talk briefly about the media’s responsibilities in providing adequate
space for HIV/AIDS related stories and an enlightened debate in the media. He/she will
present certificates to journalists who have participated in the workshop.
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Peer Review Team:
Ms Kalpana Jain
Ms Mona Mishra
Mr Noble Thalari
Mr Rajesh Nair
Ms Alka Narang
UNDP Support Team:
Dr Ash Pachauri, Mr Aniruddha Brahmachari & Ms Malini Mittal
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Population Foundation of India