October 22, 2003

Prof: AIDS risk high for India’s women

While the HIV/AIDS rate in India has not reached the staggering levels found in sub-Saharan countries, cultural factors are speeding the disease’s spread, says CSUS social work professor Jude Antonyappan.

Unofficial estimates place the number of people with HIV/AIDS in India at 8 million. Of those, it is estimated that 30 to 40 percent are women.

“The numbers are huge considering it’s such a traditional society that dictates and expects women not to engage in sexual activity outside the marital domain,” Antonyappan says. Even more startling is one of the major reasons the disease is on the increase – prostitution among the working poor.

Antonyappan spent five months looking at the problem in South India, paying particular attention to the problem in Kodaikanal, a resort town in Tamil Nadu. The major industries there – tourism, coffee farming and construction – all of which have a disproportionate number of female workers. High unemployment among men due to the rapid replacement of agricultural land with tourism-oriented industries has made women the sole or primary family breadwinners. When the women cannot make ends meet many are augmenting their income by supplying sexual favors or direct sex work.

While the possibility of being infected with HIV/AIDS is recognized among professional sex workers, women in the general population who resort to prostitution as a sideline are extremely vulnerable, Antonyappan says. They have limited access to health care, and the need to maintain their sex work secret, for fear of ostracism, prevents them from coming in contact with the public health organizations that provide even minimal services.
“It’s difficult to seek services. And when the women do receive treatment, they get medicine for their symptoms but not for the disease,” she says. “When people learn they’re HIV-positive it’s too late.”

There is also a high degree of isolation among affected women. “Sexual promiscuity among men is tolerated but it is not tolerated with women. I’ve heard stories of women who were affected who were sent to remote rural parts of India to die,” she says.

Antonyappan says the key to reducing the spread of AIDS is empowerment. “Women need to be empowered to respect their right to health and demand the use of condoms. Now women don’t have that power,” she says. “They need alternative ways to generate income to provide for their children. Poor women need to know they have power to build social capital so they don’t have to engage in sex work.”

Antonyappan says it’s important to realize that Western feminism doesn’t work in India. “There is a need to begin on a platform based on Indian ideologies, aspects of Indian culture that are empowering,” she says.

And while women’s organizations should play a role, she advocates creating a consortium of groups that work in the areas of health and social service. “One of the dangers of relying on women’s organizations alone is the specific focus on women,” Antonyappan says. “Both poor men and women share similar problems, although they are exacerbated for women.

“We need to help women first. But then men need to be actively engaged in productive economic, social and health programs.”

Antonyappan is seeking funding to bring together organizations that promote empowerment, create economic opportunities and build social capital. She hopes to launch the program in fall 2004.

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