(Courtesy: San Francisco Chronicle, By John Ward Anderson, Washington Post)

CALCUTTA: Mohammed Israel has been a truck driver for 21/2 years, carrying loads across India and visiting four to five prostitutes a week to satisfy his voracious appetite for sex— created, he says, by the hot, spicy food served in roadside restaurants, He has never used a condom, and he has never heard of AIDS.

Truckers such as Israel are an important catalyst for the rapid spread of AIDS, carrying the HIV virus that causes the deadly disease along India’s highways from urban red light district is to small town flophouses to their family homes in remote rural villages. Recent surveys of truckers in and around Calcutta found that more than 5 percent of the drivers had the HIV virus, more than 90 percent visited at least one prostitute a week, and 68 percent never used a condom.

But it is not just truckers who are uninformed about AIDS and HIV. In a survey of 57 doctors in Bangalore often described as India’s most technologically advanced city 25 percent said HIV: could be spread by casual contact, 35 percent said HIV patients should be denied first aid, and 81 percent believed that a syringe could be reused if the needle were changed.

Such ignorance has helped make India ground zero in the newest phase of the global AIDS epidemic, which has killed 3 million people since the late 1970s. By some estimates, India now has more HIV carriers than any other nation, propelling South and Southeast Asia to a gruesome milestone: For the first time, more people will contract HIV in Asia this year than in Africa, the world’s AIDS hot spot, where entire nations are being ravaged by the sickness.

“Clearly, the center of gravity of the world’s AIDS epidemic is moving rapidly toward Asia,” Columbia University economist and AIDS specialist David Bloom said in a recent speech, “Many experts now believe that India will soon have the unfortunate distinction of being the AIDS capital of the world.”

The epidemic comes to India as the nation is trying to integrate its self into world markets with economic reforms that are creating huge social changes, ushering in better transportation and quicker exchanges of goods and services that could contribute to the spread of AIDS, making projections about the disease daunting.

There are about 80,000 AIDS cases in India and 1.5 million people infected with HIV, according to recent statistics from the World Health Organization and the Indian government. By the year 2000, experts predict, 1 million people will have AIDS in India and 5 million will be HIV pive. And, if trends hold, India could have as many as 30 million people with HIV by the year 2010 about ice today’s worldwide total.

“If the pattern of an expanding HIV epidemic that has been observed in other parts of the world continues to occur in India, the consequences for this country of 858 million people will be catastrophic,” said a recent

article in Medicine magazine “The HIV/ AIDS epidemic in India now threatens to undermine the considerable achievements in public health made over the past 60 years,” when life expectancy in India more than doubled and the infant mortality rate was more than halved, the story said.

It can take as Jong as 10 years for HIV to tum into AIDS, for which there is no cure and no vaccine. There have been about 4.5 million AIDS cases since the early 1970s, and 13 million to 14 million comment HIV cases globally, according to the World Health Organization. Nearly two thirds of all the current HIV cases are in Africa.

AIDS came late to Asia—about 10 years after it first began ravaging the Americas, Europe and Africa. Now, as the spread of the disease in those areas is leveling off or declining, AIDS is charging full throttle into Asia, an underdeveloped region with an undereducated populace, representing more than half the world’s population.

If the disease spreads in Asia the way it spread in Africa and experts believe it will, given similarities such as high illiteracy, slow government response, discrimination against women and sexual promiscuity—tens of millions of adults could die, creating millions of orphans and overwhelming government health facilities and social services, Currently, only 0.2 percent of India’s population has HIV or AIDS, in the worst hit countries of Africa, almost 20 percent of the adult population is infected.

Unlike in the United States and other developed Western countries, where the disease initially was spread primarily through homosexual contact, AIDS is spreading in India primarily through heterosexual contact, as was the experience in Africa.

India also has a sizable population of intravenous drug users, like the Western countries, and a network of professional blood donors leading to the spread of AIDS between people who share needlees or to those who receive contaminated blood.

Article extracted from this publication >>September 8, 1995