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FAR EASTERN ECONOMIC REVIEW. 1992 Feb 20; 28-9.As the AIDS epidemic and HIV transmission in India increasingly resembles that observed in sub-Saharan Africa, Indian society's arrogant perception of invulnerability to the pandemic is proving to be considerably ill-conceived. The dimensions of the epidemic have multiplied greatly since AIDS was 1st identified among prostitutes in Madras, with the trends observed in Maharashtra and Tamil Nadu being especially ominous. AIDS has forced Indian society and research professionals to acknowledge the existence of domestic prostitution, homosexuals, and drug users. While only 103 AIDS cases and 6,400 HIV infections have been officially identified, it is clear that these cases represent only a tiny fraction of the true extent of the epidemic in India. The government will therefore spend up to US$7.75 million on an anti-AIDS program aimed at ensuring secure blood supplies, and checking heterosexual transmission through education and the promotion of condoms. The program also targets IV-drug users and truck drivers for education and behavioral change. India is the 2nd country after Zaire to accept foreign loans for such a purpose. It will receive US$85 million over 5 years from the World Bank in addition to supplemental funds from the WHO and the U.S. Weak attempts, however, have been made to test blood supplies, with only 15% being tested in Tamil Nadu. A large gap also remains between health educators and needy target groups. Finally, while some top officials realize the need for immediate action against AIDS, broad public awareness and coping will come only after AIDS mortality begins to mount in the population.
WORLDAIDS. 1992 Jan; (19):10.White, U.S. homosexual males were primarily affected in the early stages of the AIDS pandemic. Some Western researchers argued, however, that the syndrome originated in Africa. Strong political and social response to this notion resulted in only an anemic response to the growing AIDS epidemic in Nigeria. Nonetheless, the Stop AIDS Organization finally launched the Motor Park AIDS Education Program (MPAEP) in 1988, for health and education outreach to populations at risk of STDs and HIV infection. Specifically targeted are long-distance truck drivers, their young male assistants known as motor boys, and the barmaids, prostitutes, and homeless juveniles who frequent motor parks where these drivers rest while on the road. Many of these long-haul drivers have unprotected casual and commercial sex, both homosexual and heterosexual, take drugs, and suffer high rates of STDs. Marginalized, 75% illiterate, and speaking a variety of languages, these populations tend to be largely ignorant of the incurable nature of AIDS. Over 45% of motor park populations are estimated to be infected with an STD, or to have a future re-infection. These drivers are optimal vectors for the spread of HIV both internationally and within Nigeria. MPAEP workers work 6 days/week in the larger interstate motor parks to reach out to their predominantly male customers. They meet a host of primary health needs, and refer STD clients for testing and treatment. Drug use and homosexuality are 2 topics of discussion especially taboo in African society which have nonetheless been vigorously researched by MPAEP. Many drivers are unacknowledged bisexuals who have sex with their motor boys. Workers therefore explain the need to use condoms in same-sex activity without specifically mentioning homosexuality. Many Nigerians deny the existence of HIV and AIDS, are reluctant to speak about sex, and consider MPAEP workers to be intruders. Despite opposition in Muslim- dominated Northern Nigeria, however, program efforts continue.
INDIA TODAY. 1988 Jul 31; 66-8.The peoples in India are largely unawareness of AIDS, and health threat which it poses to the country. Awareness of AIDA rests largely among readers of Time of Newsweek, with even doctors, hospitals, and administrative officials not knowing what to do about or for AIDS patients and those testing positive for exposure to HIV. Reports of the infected come from across India, and are not limited to a specific urban center. With 332 person HIV+, and 24 dead, however, the government of India has not yet placed great priority on dealing with AIDS and the potential future national epidemic. The budget for AIDS-related research and activities is substantially less than that for malaria, leprosy, and blindness, yet nonetheless represents a 500% increase over the previous year's budget. Debate is ongoing in India over AIDS, with opinions ranging from those who recognize the presence of promiscuity, homosexuality, and drug abuse as potentially contributory to the widespread transmission of AIDS; to A.S. Paintal, director-general of the Indian Council for Medical Research, who calls for a law banning sex with foreigners and NRIs. Steps taken thus far to check the spread of AIDS include the creation of 42 surveillance centers, hematologic testing, and prohibiting foreign students from being admitted to Indian universities without being tested for AIDS. Research has shown AIDS to stem primarily from heterosexual intercourse, with eunuchs, prostitutes, IV-drug users, and those attending STD clinics identified as high-risk groups. The National AIDS Control Program began in 1986, and plans to add another 100 surveillance sites over the next 2 years. The Central Health Education Bureau has also been instructed to launch an extensive mass media awareness campaign, while the creation of a national AIDS research center and state AIDS cells to monitor personal sexual relations is under consideration. Doctors also advise members of high risk groups with repeated infections of any kind to be tested for HIV. In fighting to increase public discussion and awareness of AIDS, promoters and campaigns can expect cultural taboos, beliefs, and conservatism regarding sex and sexual relations to hamper progress. An interview with Mr. Paintal is included in the article.
[Unpublished] 1989 Jan. ii, 60,  p. (USAID Contract No. DPE-3028-C-00-4079-00)Results and recommendations are presented from an island-wide survey of knowledge, attitudes, and practices (KAP) regarding sexually transmitted diseases (STD) and AIDS in Jamaica. In addition to providing broad baseline data for future studies of changes in KAP related to STDs and AIDS, the survey was conducted to examine the effect of earlier communication programs upon KAP, and family planning attitudes and practice. Researchers were specifically interested in the extent to which the image of the condom was affected as a family planning method and prophylactic. 1,200 interviews were completed for the survey. Findings are presented on the demographic and social characteristics of the sample; knowledge and awareness of STDs, AIDS, AIDS symptoms, and AIDS tests; impressions about AIDS cures; attitudes toward a person with AIDS; AIDS information sources; knowledge of measures to prevent or reduce the rick of contracting AIDS; perceptions of personal risk; changes in AIDS-related behavior; and the knowledge, image, use, and availability of condoms. Recommendations address the development of new revised media messages, education for the prevention of HIV infection, and the need to ensure the public of the safety of blood supplies in Jamaica. Interventions should be targeted to a broad audience, and efforts made to discourage fatalistic views on contracting HIV.
HEALTH FOR THE MILLIONS. 1991 Aug; 17(4):20-3.Until recently, the only sustained AIDS activity in India has been alarmist media attention complemented by occasional messages calling for comfort and dignity. Public perception of the AIDS epidemic in India has been effectively shaped by mass media. Press reports have, however, bolstered awareness of the problem among literate elements of urban populations. In the absence of sustained guidance in the campaign against AIDS, responsibility has fallen to voluntary health activists who have become catalysts for community awareness and participation. This voluntary initiative, in effect, seems to be the only immediate avenue for constructive public action, and signals the gradual development of an AIDS network in India. Proceedings from a seminar in Ahmedabad are discussed, and include plans for an information and education program targeting sex workers, health and communication programs for 150 commercial blood donors and their agents, surveillance and awareness programs for safer blood and blood products, and dialogue with the business community and trade unions. Despite the lack of coordination among volunteers and activists, every major city in India now has an AIDS group. A controversial bill on AIDS has ben circulating through government ministries and committees since mid-1989, a national AIDS committee exists with the Secretary of Health as its director, and a 3-year medium-term national plan exists for the reduction of AIDS and HIV infection and morbidity. UNICEF programs target mothers and children for AIDS awareness, and blood testing facilities are expected to be expanded. The article considers the present chaos effectively productive in forcing the Indian population to face up to previously taboo issued of sexuality, sex education, and sexually transmitted disease.