AIDS in India

Today was the third caesarian section we've seen while we're here. Each one has been a somewhat unique case. In the first, the baby had respiratory distress upon birth and had to be resuscitated. The second c-section was a high risk pregnancy: the woman was older, carrying twins, had gestational diabetes, and the two babies were significantly different in size. The babies were delivered fine and are now in the NICU.

The third c-section was also high-risk, since the mother was HIV-positive. As you may know, babies born to HIV-positive mothers are at a significant risk of acquiring HIV (the virus causing AIDS). Without any treatment, about 25% of babies acquire HIV. Even by taking every measure possible (a c-section, antiretroviral medications, no breast-feeding, etc.), about 8% of babies end up acquiring HIV from the mother. All the doctors and nurses participating in the surgery wore extra gloves, a plastic face shield, and other extra layers to prevent contact with the virus.

The topic of HIV is taboo in India, since Indian society is fairly conservative. There is no mandatory HIV testing, and unless you're an HIV doctor, you often can't even bring up the topic with a patient. Unfortunately, this poses a bit of a danger to the caregivers in the hospital, since the extra protection taken for known HIV patients is not taken normally. This also leads people who know they are infected with HIV to stay silent about it. Thus, some people will get married, only to find out that despite being in a monogamous relationship, they have acquired HIV.

The danger of HIV cannot be underestimated in India. As many as 5.7 million people are infected with HIV in India. No other country in the world has that many people infected with the virus. This is partly the product of a very large population, so that the actual percentage of people infected is about half of one percent. The reason for a relatively low rate of HIV infection is primarily due to the fact that most Indians still follow the traditional social norms regarding marriage. As Indian society becomes more progressive, hopefully people will become better-educated about the dangers of HIV while keeping HIV from spreading.

Fortunately, the past 20 years have seen tremendous progress in the treatment of AIDS to the point where quality drugs have been cheap enough for many HIV-infected Indians to lead a normal life. AIDS is no longer a terminal illness; rather, it is a chronic illness that people have to deal with. AIDS has not decimated India’s population like it has in a country like Botswana, and with increased education and better medical care, it may be possible to largely stop the spread of HIV here.