Social stigmatization means many would rather take their own lives than try to get them back on track
Volunteers from Caritas India perform a street play in a Delhi slum to promote greater compassion for, and acceptance of, people afflicted with HIV/AIDS on Dec. 1, 2018, World AIDS Day. (Photo supplied)
Soon after being diagnosed with HIV, 38-year-old Manga Ram attempted to commit suicide twice. He wanted to save his family from the embarrassment associated with the infection in India, where UNAIDS activists claim much work is still needed to improve access to potentially lifesaving medicines.
Two years ago, the grocery shop owner in New Delhi's southern outskirts felt his health deteriorating all of a sudden. Doctors asked him to undergo some tests and he was found to be HIV positive.
"For most Indians, if someone is infected with HIV, the implication is that they are, or were, promiscuous. It's taboo in our society and it is considered very shameful to have this disease. I lacked the courage to face up to it," Ram told ucanews.com.
As he sank deeper into depression, he decided to drink some rat poison one day in a bid to end his life, but he took too little. He tried a second time by upping the dosage, but the intervention of his family got him to hospital in time to save his life.
People living with HIV continue to face stigmatization and social rejection in Indian society. As a result, many lose their jobs and become impoverished and mentally vulnerable.
The social pushback from his community led Ram to leave his shop, seriously affecting his income.
In a bid to help others like Ram in New Delhi, Caritas India, the Church's social service wing, has launched a community-based rehabilitation program for them.
HIV/AIDS sufferers in the slums have less access to healthcare facilities, which further compounds their fear of confronting the disease and seeking medical and psychological help in dealing with it, said Anjan Bag, a spokesman for Caritas.
The project aims to provide preventive education, care and support, as well as community-based rehabilitation activities.
"We have a range of activities to provide care and help reintegrate them into society with a more positive mindset," Bag said.
Such projects aim to improve their living situation and get them back on their feet financially so they can continue to support their families.
"Their economic deprivation pushes the infected and affected further to the margins of society," Anjan said.
Nutan Kumar Sogoria, who runs the Caritas program in the capital's northeast, said most of those who benefit from it live "at the very bottom of society," such as migrants, slum dwellers, rickshaw pullers and coolies.
They are often abused by people in gated colonies, thrashed by the police, driven out of their slum huts by civic authorities, forced to pay bribes to various officials, and oppressed by the elite because of their "added sin of having HIV," Sogoria said.
One of the services offered by Caritas "is effective and quality counseling to help them overcome their anxiety," he said.
"Most people see the disease as a death sentence. They also fear social rejection, and the shame associated with it," Sogoria noted. "We have seen how they just switch off the moment they learn they have HIV."
Research studies show there is a high prevalence of mental disorders among people living with the disease.
A joint study conducted by George Stuart Leibowitz from the University of Vermont and Shankar Das from the Tata Institute of Social Sciences in Mumbai underlined the need for mental health services for Indians living with HIV/AIDS.
"Mental health providers should be an indispensable part of the multidisciplinary treatment team," suggested the study.
The research showed that 98.6 percent of people living with the disease experience depression as one of the first symptoms. Between a quarter and a third of HIV patients suffer from anxiety.
Many sufferers contend with mental illness and other symptoms of a weakened immune system.
"They have stress, anxieties, depression, even suicidal thoughts. They feel lonely and [ostracized] by those close to them," found another study by Mohammad Amin Wani and Sankar R. at Annamalai University in the southern Indian state of Tamil Nadu.
The Caritas project has referred 12,161 people to government health facilities to help them get access to antiretroviral drugs.
The project also provided 140 people with vocational training and found them paid work placements.
Deepti Sharma, a beneficiary of the program, said she was working as a housemaid in New Delhi before she was fired after being found to have HIV. "They were scared I would infect them," she said.
After enduring months of mental trauma, she registered for counseling with Caritas.
"I attended many sessions before I realized having HIV isn't the end of the world. It is just another disease, and if it's treated properly we can still enjoy a good life," she told ucanews.com.
Although no cure has been found, the World Heath Organization recommends a combination of antiretroviral drugs to slow down the progress of the virus and prevent secondary infections and complications.
Health practitioners and social workers say experience has shown that with a strict regime of drugs and nutritious food, a person living with the infection can lead a normal life.
India has some 2.14 million people living with HIV/AIDS, National AIDS Control reported in its latest available estimate in 2017.
The government agency said HIV infections peaked in 1995 and then started to decline. The pace of decline has leveled off in recent years, declining by just 27 percent in total between 2010 and 2017.
The target is to achieve a 75 percent reduction in new infections by 2020 from the baseline value of 2010, it said.
Considering the country represents 16 percent of the global population, the rate of new infections remains a concern.
The situation needs thorough monitoring, social workers say.
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