India is one of the 2nd largest populated countries in the world, with over one billion inhabitants. Of this number, it’s estimated that more or less 7 million Indians are currently living with HIV. HIV emerged later in India than it did in many other countries.

Infection rates soared throughout the 1990s, and today the epidemic affects all sectors of Indian society, not just the groups – such as sex workers and truck drivers – with which it was originally associated. The vast size of India makes it difficult to examine the effects of HIV on the country as a whole. The majority of states within India have a higher population than most African countries, so a more detailed picture of the crisis can be gained by looking at each state individually.

In a country where poverty, illiteracy and poor health are rife, the spread of HIV presents a daunting challenge. The Indian epidemic continues to be concentrated in populations with high risk behavior characterized by unprotected paid sex, anal sex, and injecting drug use with contaminated injecting equipment. Several high risk groups have high HIV prevalence, and sexual networks are wide and actively working. According to India’s National AIDS Control Organization (NACO), the bulk of HIV infections in India occur during unprotected heterosexual intercourse.

Consequently, and as the epidemic has matured, women account for a growing proportion of people living with HIV (38 percent in 2005), especially in rural areas. The low rate of multiple partner concurrent sexual relationships among the wider community seem to have, so far, protected the larger body of people with 99 percent of the adult Indian population being HIV negative. However, although overall prevalence remains low, even relatively minor increases in HIV infection rates in a country of more than one billion people could translate into large numbers of people becoming infected.

The ‘Rainbow Nari O Shishu Kallyan Foundation’ identified four major approaches in a groundbreaking study on spread out HIV in Asia. This study undertook by comparing of social-economic norm, family pattern, economic dependency, cause of mounting sex industries, gender discrimination status & global analysis fact. There are four factors that appear to play a crucial role in HIV transmission in Asian Countries: Injection/ intravenous drug use (By sharing needle), female sex work (Due to lack of safe sex knowledge), gender discrimination (which indirectly force females commercial or non-commercial sex), Same sex/ homosexually/ Hizra (Due to lack of HIV/AIDS information, because they act invisible in this society). Poverty & illiteracy fueled it proportionally.

At the beginning of the 1990s, as infection rates continued to rise, responses were strengthened. In 1992 the government set up NACO (the National AIDS Control Organisation), to oversee the formulation of policies, prevention work and control programmes relating to HIV and AIDS. In the same year, the government launched a Strategic Plan for HIV prevention.

This plan established the administrative and technical basis for programme management and also set up State AIDS bodies in 25 states and 7 union territories. It was able to make a number of important improvements in HIV prevention such as improving blood safety. The HIV/AIDS programme specialist Mr. Mohammad Khairul Alam said, “several social norms and immature behavior fueled of this disease to scatter rapidly. There are several social components link to develop this harmful situation. Poverty-behind to force it, Gender discrimination plays a vital role; Frustration & risk behavior help to sink humanity resulting infection.

The link between poverty & gender discrimination are help to decline socio economic prosperity. This link creates several anti social poisonous issues also. Such as trafficking to prostitute, sell sex for earn or living, break down family norm to create frustration and driven drug point. We notice easily that Illiteracy is the main watchword of all circumstance. So it is not easy to remove it from the society, several programs & strategy are needed to gain sustainable position”.

At the beginning of 1986, despite over 20,000 reported AIDS cases worldwide, India had no reported cases of HIV or AIDS. There was recognition, though, that this would not be the case for long, and concerns were raised about how India would cope once HIV and AIDS cases started to emerge. Recent data suggests there are signs of a decline in HIV prevalence among sex workers in areas where focused interventions have been implemented, particularly in the southern states although overall prevalence levels among this group continues to be high.

Data also indicate that there is a slow decrease in HIV prevalence among the general population in southern states. Although more analysis is required, this probably means that the number of people becoming newly infected with HIV is decreasing. This decrease is more perceptible in states such as Tamil Nadu where the intensity of HIV prevention efforts has been high.

People living with HIV in India come from incredibly diverse backgrounds, cultures and lifestyles. The vast majority of infections occur through heterosexual sex, and most of those who become infected would not fall into the category of ‘high-risk groups’ - although members of such groups, including sex workers, men who have sex with men, truck drivers and migrant workers, do face a proportionately higher risk of infection. See our page on affected groups in India for more information.