Key affected communities in India have expressed disappointment following the introduction of the “HIV/AIDS (Prevention and Control) Bill,” which passed through the Rajya Sabha on 21 March. Community members have spoken out saying it allows governments to escape their obligation to provide complete treatment to people living with HIV. Article 21 [Right to Life] of the Indian Constitution was previously used to hold the government accountable and advocate for rights to life saving treatment. However, a clause in the new law means that government can argue that their commitment is to provide treatment ‘as far as possible.’
Although the bill purportedly seeks to prevent and control the spread of HIV and AIDS and prohibits discrimination against people living with HIV/AIDS, health and human rights activists say the bill is more about excusing and justifying shortcomings by the government.
The Wire quoted Loon Gangte, regional coordinator for South Asia at the International Treatment Preparedness Coalition who summarised the reaction of many people living with HIV. They said, “I am very sad and angry. We, the community of people living with HIV, cannot and will not accept this Bill, as the contentious clause ‘as far as possible’ is not removed. This HIV Bill, instead of protecting and safeguarding our welfare, is now protecting the government and politicians. This is not our Bill; we don’t accept it.”
Shortages of HIV medicines are a common reality in India. Scroll.in reported the results of a joint study by the Delhi Network of Positive People and MSF Access Campaign which found people living with HIV often missed out on the required amount of prescribed medicine, or others missed out on receiving medication all together. Another study, reported by Scroll.in found that 18.8 percent of patients received insufficient quantities of drugs even after two or more visits to ART clinics and 13 percent of the patients did not receive drugs at all.
Many cities and other areas face worse shortages than Delhi. For sex workers and hijra (transgender) communities these figures are often even worse. “The harsh reality is despite being aware of the nature of HIV virus, the medical fraternity often chooses not to treat an infected patient. The stigma is even more deep-rooted when the patient happens to be a sex worker,” said Dr Shashidhar Buggy to Times of India. "We cannot expect others to stop discriminating against sex workers if the doctor community itself is biased.”
One recent case saw a sex worker living with HIV initially denied treatment in a public hospital in Nair, Mumbai. However since coverage of the incident, health officials have said the new law will address discrimination against people living with HIV in medical settings. The new law legislates anti-discrimination coverage for people living with HIV across many areas of life, including healthcare and employment. However, it is unclear how many sex workers living with HIV may benefit from these protections. Sex work is still criminalised, discrimination is still high, and people living with HIV still face lack of access to adequate treatment.
The recent demonetization policy has only added to the plight of transgender people as far as treatment is concerned. "It has become very difficult to meet medical and travel expenses. I recently had to undergo a uterus operation, which was an expensive procedure. The tests and follow-up visits have drilled a hole in my pocket and scrapping of the Rs 500 and Rs 1,000 notes has only made it worse," said Usha, an HIV positive transgender sex work, to The Times of India.
Manta, another transgender sex worker said, "I am HIV positive but I have learnt to take care of my health. However, after demonetization, my income has drastically reduced. Either the clients don't pay or they hand over high denomination notes. Either way, I am left with no money."
The Durbar Mahila Samanwaya Committee has been working in red-light areas of West Bengal, including Sonagachi in Kolkata, for two decades to reduce HIV infection among sex workers.
Samina Bibi, a sex worker in the Sonagachi district told reporters that since she was detected as living with HIV ten years ago she has been taking medicines from the ART centre. Salina told reporters that “whenever there is a stock-out, we fight as an organisation and get medicines sooner than otherwise.”
In Kamathipura, Mumbai, sex workers living with HIV look out for each other and support each other whether its sharing information on medication, nutrition and hospital checkups or providing solidarity and agitating in cases of discrimination. As Bonita Thakur explained, “when I heard of how one woman had been thrown out by her brothel owner, we created a ruckus till she was given her clothes and money.” She says that there is still much ignorance and fear about HIV and AIDS.