Sexual behaviour in India with risk of HIV/AIDS transmission

Abstract

The estimate of cumulative HIV-positive persons in India by the end of 1994 ranges from 900,000 to 1.9 million. The corresponding figures projected for 2000 are 2.1 million to 6.7 million. The estimate of cumulative AIDS cases in India by 2000 ranges from 500,000 to 1.2 million. These figures indicate the magnitude of the problems India is going to face in the near future because of the AIDS pandemic. Although at the initial stage of the spread of HIV/AIDS in the USA and a few other Western countries, male homosexual relations and sharing of equipment by intravenous drug users were the principal modes of HIV transmission, by now the predominant mode of transmission in all countries is heterosexual relations. In India this has always been the case. It is estimated that in India about three-fourths of HIV transmission occurs through heterosexual relations and the rest occurs mainly through transfusion of infected blood and sharing of infected equipment. The role of male heterosexual relations in HIV transmission in India cannot, however, be ruled out, although evidence of such transmission so far is rare. The risk of transmission of HIV and other sexually transmitted diseases is higher in sexual relationships with multiple partners and without the use of condoms. Premarital sex often involves multiple partners, and extramarital sex, by definition, implies multi-partner relationships. The following categories of people are likely participants, voluntary or nonvoluntary, in multi-partner sexual relationships: female prostitutes and their customers, male homosexuals, hijras and male prostitutes. Avoidance of multi-partner sexual relationships, use of condoms and sexual abstinence are usually advocated for prevention of spread of HIV and other sexually transmitted diseases. This paper provides salient findings from the empirical studies made so far in India along with the historical contexts of the topics mentioned above.