SOCIETY
Surviving stigma
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`While there are a number of books on HIV/AIDS, and "advice" books too, D'Cruz's study is a more serious attempt to look beyond the clinical side of the epidemic to the human factor.'
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A RECENT UNAIDS and WHO joint report, "AIDS Epidemic Update 2003", released before the World AIDS Day on December 1, reveals that the global epidemic shows no signs of abating. Five million people became infected with HIV worldwide and 3 million died last year alone - the highest ever.
India today stands second only to South Africa in the number of people affected with the virus: an estimated 4.58 million of Indians. More worryingly, the epidemic is now spreading to the general population from those purportedly practising risky behaviour.
Among the general population, an increasing number are married women. Though the majority of them are into monogamous relationships as per societal norms, the risk behaviour of their husbands makes them easy carriers. As a consequence, mother to child transmission is also on the rise.
What happens when the depressing news is broken to the family that one of the members has contacted the virus? What kind of economic and mental distress these people go through in a country where HIV medication is not yet free as in Brazil , though it's a developing country too? What about the social stigmatisation that inevitably follows?
Interesting insights
Premilla D'Cruz's book tries to probe these questions. Seven representative nuclear families from Mumbai, from lower to middle class, were chosen in various situations: families with wives who were HIV negative but with seropositive husbands, or where both were seropositive.
Interesting insights into human behaviour and inter-personal relationships also come out in the first-hand interviews. Husbands complaining, for example, about wives not paying attention, but ignoring that their sexual behaviour, which was the undoing, could affect any woman psychologically.
As for the wife, she gets the stick from both ends. Listen to Vinita (name changed): "There is no one to help me — his family is upset to hear the diagnosis and my family feels that I did not control him and so this has happened." On top of it, she cannot hope to get the same care and treatment as her husband if she is infected. The voices articulated here are sure to be echoed in many other societies, particularly in south Asia, where patriarchal values still dominate communities.
A serious study
The book is based, the author says, on a study that formed part of her M.Phil degree. Hence the style is more like a research paper with charts, data and abundant references to other studies. While there are a number of books on HIV/AIDS, and "advice" books too, D'Cruz's study is a more serious attempt to look beyond the clinical side of the epidemic to the human factor.
The author does well to go beyond academics to examine the scope of intervention programmes to improve the care and treatment for HIV patients. Stigmatisation and discrimination are a major problem. Educating healthcare workers would go a long way, as also counselling to families of seropositive persons to cope with a disease that still awaits a vaccine.
RANJITA BISWAS
In Sickness and in Health: The Family Experience of HIV/AIDS in India, Premilla D'Cruz, Stree,Rs. 185.
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