LET’S TALK ABOUT SEX
Programme has volunteers reaching out to highrisk groups in spas, on dating apps, in an effort to promote early testing
Somesh (name changed on request) is a regular at spas in Delhi-NCR. But he’s doesn’t go for the healing therapies. He’s an HIV counsellor and his mission is to reach out to people at high risk and encourage them to get tested. He doesn’t reveal his identity at first. Sometimes he is shut down as soon as he does. Of the 90 people he has befriended and counselled at three spas over eight months, though, seven tested positive for the Human Immunodeficiency Virus.
“It takes three or four visits for the staff to open up. It takes longer for clients,” he says. “I stay in touch with them, build a rapport, and gradually broach the topic of HIV testing.”
It’s not just spas. Anti-HIV activists are penetrating dating sites and open-for-allparties too, as part of a government-run community-led effort to think out of the box when it comes to the disease.
The friend-counsellor initiative is part of a wider effort by the government’s flagship National AIDS Control Organisation (NACO) to counsel people who would otherwise likely not get tested since they don’t consider themselves at risk.
“This is a section that doesn’t consider itself vulnerable but runs the risk of getting infected or infecting others. They are not open to direct counselling and so we had to come up with novel methods,” says a senior health ministry official, requesting anonymity.
These high-risk groups include men who have sex with men (MSM), female sex workers (FSW), transgenders (TGs) and members of the open-door dating and party circuits.
“We have made profiles on popular dating apps to communicate with people. I connected with about 70 people through one of the apps, of whom three tested positive,” Somesh says.
This is important because early testing and diagnosis are crucial for HIV treatment; HIV-positive people can have long and rich lives once they begin treatment— and, of course, they can’t prevent its spread if they don’t know they have it.
“I frequently get blocked on the dating Truckers Migrants Injecting drug users
Women at antenatal clinics (considered a proxy for the general population) NA* NA* 13.15 6.92 2017 6.26
India uses UNAIDS-supported software to provide modelled estimates on its HIV-positive population.
About 4.45 lakh blood tests were done at 1,323 sentinel sites across 650 districts to reach the estimates for 2017.
India’s HIV epidemic continues to be concentrated among people who inject drugs, transgenders, men who have sex with men, and female sex workers and their clients.
(All figures are % of population)
* Not categorized as a separate group then
Source: HIV Sentinel Surveillance 2016-17, National AIDS Control Organisation
app as many people don’t want to interact once they know who I am,” says Somesh. “But some of them respond positively. In such cases, there is a consent form to be filled for testing, and total confidentiality, of course, regarding the results and future conversations they might want to have.” Of the 600 people he interacted with on a popular dating app, 60 agreed to get tested.
OUT OF THE BOX
Somesh works with India HIV/AIDS Alliance, an NGO supported by NACO and selected for the ongoing trial run of Project Samarth (Hindi for Capable). “The peer group approach works well and hopefully this project will show good results,” says Alok Saxena, joint secretary of NACO.
“There is a gap in HIV testing among identified high-risk groups — our target is to get 90% of the people we reach out to, to agree to get tested. India HIV/AIDS Alliance has a presence across the country and we are hopeful that this will help.”
India currently has the world’s thirdlargest HIV-positive population (2.1 million people) — after South Africa (7.1 million) and Nigeria (3.2 million). But the number of people living with HIV in India has dropped by more than half, from 5.1 million in 2003.
As the numbers decline, one of the sideeffects
is a sense of invincibility among a very young population that is becoming increasingly experimental when it comes to sex, sexuality and multiple partners. And there are concerns that what worked before will not work this time.
The epidemic started levelling off in India in the early 2000s as a result of a two-pronged strategy of intensive HIV prevention campaigns and free testing and treatment.
By 2004, India had expanded targeted interventions for FSWs, injecting drug users, MSMs, transgender people, single male migrants, long-distance truckers etc in the six high-prevalence states of Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra, Nagaland and Manipur.
But how do you reach the average urban youngster, the recreational drug user, the college student looking to experiment? This last mile is proving to be a challenge, Saxena says.
“In the 1980s and ’90s, HIV/AIDS was a burning issue and almost everyone was aware of it. With the rate of new infections coming down, we are now dealing with a generation that doesn’t consider HIV/ AIDS as big a threat,” he adds. “They have technology at their disposal and we also will have to make use of this technology to reach out to them.”
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