India: How Sex Workers, MSMs And Trans People Have Consistently Been Denied Timely HIV/AIDS Treatment

According to Avert studies, between 2010 and 2016, the global number of new HIV infections dropped by a significant 16%. But three years later, in 2016, the number of people living with HIV (PLHIV) rose from 35 million to to 36.7 million. Of that, a significant portion are in India.

Since 1996, when the first antiretroviral treatments were introduced in the country, we have been trying to address one of the world’s most deadly ailments. Even today, India has committed to ending the epidemic by 2030. But there are obstacles aplenty.

Back in 2004, the government began providing free antiretroviral drugs to PLHIVs. But, as educationist and activist Vishwa Schoolwalla notes, “the paperwork and government regulations for approval of such treatment cause delay in effective provision of HIV treatment.”

All of this is seriously being watered down by a new HIV bill. Clause 14 (1) of the bill limply says medical help can only be provided “as far as possible”. And the statement has drawn sharp criticism. Tripti Tandon of Lawyers’ Collective says, “[it] gives an opening to the governments to evade any responsibility to treat patients.”

So if you can’t rely on the state for even the first line of HIV/AIDS drugs, what then? Well, be prepared to shell out INR 3,000 for a month’s supply! Many of you reading may be privileged enough to afford these treatments, but does everyone have that luxury? At-risk populations like female sex workers, men who have sex with men (MSM), and trans youth certainly do not.

Economic barriers and discrimination drastically affect one’s access to sexual and reproductive healthcare. “People do not know where to get HIV-AIDS treatment for free or at subsidized rates,” explains Schoolwalla. “Patients have to travel considerable distances to get their treatment because every healthcare center (private or public) does not cater to HIV-AIDS.”

Street-based sex workers, or those who are unattached to community-based organisations, are extremely vulnerable.: two out of five are affected by HIV/AIDS. They often receive no information, forget being able to pay for condoms or treatment. But even access to condoms may not be a deterrent . In a publication by the Interagency Working Group on Key Populations, a young sex worker said: “If we insist, some customer will ask ‘why you are asking me to use condom? Do you have any disease? Better I go to another girl.’” In the interest of her own livelihood, a sex worker may simply have to compromise her health, and, in turn, that of her clients, their partners, future children, and so on and so forth.

The economic barriers, and the risk of transmitting the illness is also true in the case of men who have sex with men (MSM), many of whom are engaged in sex work. But even for those who are not, the threats remain much the same. When Section 377 paints same-sex relations as illicit, trying to access healthcare comes at a serious risk. It’s not just facing homophobia from health professionals. We’re talking about actual arrest.

This combination of stigma and the law affects many transgender PLHIVs too. Another publication by the same Working Group revealed that “transgender people have competing health needs and may prioritize medical treatment related to gender transition, particularly if they perceive that HIV testing or treatment will cost money.”

All three populations appear to be stuck between a rock and a hard place, having to trade-off one ‘safety’ for another, but never truly being granted the right to both. These injustices aren’t the only complications.  Read more via YKA