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Mainstreaming HIV - A Shared Responsibility

The HIV /AIDS situation in India is serious with the epidemic no longer
confined to high-risk groups alone. It has penetrated into the general
population & it is fast spreading to rural areas, placing women and youth
at much greater risk. The increasing vulnerability of the general
population calls for a well-coordinated national effort.

HIV/AIDS in India: Statistics

 An estimated 5.206 million people were living with HIV/AIDS at the
end of 2005
 Close to 40% of those living with HIV, are women. 22% HIV cases
were amongst housewives with a single partner (2004).
 35 % of reported cases are among young people in the 15-24 yr. age
groups.
 HIV has been reported from every state and is moving from groups
at high- risks to the general population and from urban to rural
areas.

The HIV epidemic in India is complex and heterogeneous, impacted by
intricate and varied social structures. As a result there is not one HIV
epidemic but 'many ' concurrent and interrelated HIV epidemics each of
which needs a localized and sensitive response. HIV has an important
impact on development. For example, HIV largely affects the most
productive age group (15-49 yrs.) as 89% of HIV infections are in
this age group. It also has an impact on vulnerable and marginalized
sections of the population -the poor, women, migrants, sex workers and
men who have sex with men. Factors such as poverty and gender
inequality fuel the spread of HIV. It is therefore not possible to target HIV
without addressing the deeper and underlying causes and impacts related
to other socio -economic factors. Mainstreaming HIV in non-HIV and non
-health sectors is therefore an effective strategy to ensure that both direct
and indirect causes are addressed.

HIV/AIDS in Rajasthan

First case of HIV was detected in Pushkar in mid eighties and the state
implemented HIV programme as part of NACP-I and than NACP-II with
1284 AIDS cases till March 2005. While 2664 AIDS cases have been
reported upto Aug.07.
There are strong Indications that Rajasthan is indeed a highly
vulnerable state: These include:

One Nation, One Resolve, We will defeat HIV/AIDS Together 1
 HIV already exists in the state, especially among vulnerable sub-
populations.
 Given the large population of Rajasthan (56.4 million), even a small
increase in HIV would translate into a large number of cases.
 Emerging Rajasthan data indicates HIV and AIDS is equally a rural
as an urban epidemic.
 Rajasthan has thousands of people annually out-migrating to
higher prevalence states such as Maharashtra, Gujarat, etc., and in
turn, thousands in-migrate making it net out migration state.
Migration, though seems a temporary phenomena, has become a
generation trap for migrant people.
 Rajasthan accounts for 19 percent of all mines in India, employing
over 500,000 workers, many of them in-migrants.
 An estimated 25,000 trucks travel daily through Rajasthan on
National Highway 8 alone.
 Rajasthan is the site for many religious fairs and festivals, and
attracts 25 percent of all Indian tourism (both domestic and
foreign).

Rajasthan is implementing National AIDS control program III (2007-
2012) in the state “To halt and reverse the HIV epidemic in India”
through a four-pronged strategy of:

 Preventing new infections in high risk groups and general
Population through:
I. Saturation of coverage of high-risk groups with targeted
intervention (TIs)
II. Scaled up interventions in the general population
 Providing greater care, support and treatment to larger number of
PLHA (People Living With HIV/AIDS)
 Strengthening the infrastructure, systems and human resources for
Scaling -up prevention, care support and treatment programmes at
the district and state level.
 Strengthening the Statewide strategic information system

Mainstreaming: An Effective Strategy

Mainstreaming HIV/AIDS into the programmes /agendas of every
stakeholder will be the most effective strategy to build multisectoral
partnership and to enthuse the highest level of communication needed
to defeat HIV/AIDS. Mainstreaming HIV/AIDS is a process, which
allows ministries, government departments, private sector
organisations, media and civil society organizations to integrate
HIV/AIDS awareness, education and training into their agendas,

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ongoing activities and programmes. They can either mainstream
HIV/AIDS into their existing programmes and formats or create new
fora/platform to take up the issues, which could impact their
organization or workplace in the years to come.

How Can It Support?

1. Makes HIV/AIDS response a multisectoral effort.
2. Expands coverage of HIV prevention programmes by integrating
HIV/AIDS within existing activities and schemes.
3. Ensures that prevention messages reach people and thereby helps
protect and save many lives.
4. Is cost effective and sustainable in the long term, since it builds on
existing programmes.
5. Prevents aggravation of poverty, gender inequality and
discrimination.
6. Avoids duplication, overlap and allows greater scope for
collaborative efforts.

Role of Ministers/Secretaries/Departmental heads:

Government departments, have extensive reach and penetration.
By integrating HIV/AIDS into their existing programmes, they can
reach millions of households in urban and rural areas.

 Identify programmes which can have the largest reach, cutting
across gender, caste and hierarchical boundaries
 Sensitize key stakeholders on HIV/AIDS
 Set up an internal committee /nodal person to develop HIV/AIDS
workplace policy, based on ILO code of practice and programmes.

And all this will be possible with

 Continued political commitment
 Participation by all stakeholders
 Coordination and implementation of the shared vision
 Shared accountability

One Nation, One Resolve, We will defeat HIV/AIDS Together 3