India: HIV capital of the world

The Victorians have a lot to answer for in India. This is the HIV capital of the world today, with four million cases and rising fast: in a few years there will be ten times that number. Yet Indian families cannot bring themselves to discuss even normal and healthy sexual phenomena such as masturbation or what is quaintly referred to as "nightfall" as educated Indians quaintly describe wet dreams.

The Victorians have a lot to answer for in India. This is the HIV capital of the world today, with four million cases and rising fast: in a few years there will be ten times that number. Yet Indian families cannot bring themselves to discuss even normal and healthy sexual phenomena such as masturbation or what is quaintly referred to as "nightfall" as educated Indians quaintly describe wet dreams.

At a seminar in Delhi yesterday, the shock troops of the war on AIDS - social workers, teachers, medical officers - confessed that even in their own homes the subject remained taboo. "We just don't discuss AIDS with ourfamilies because then we would have to talk about physical relations," admitted Dr Shankar Chowdhury, a consultant with UNAIDS.

"Many mothers prepare their daughters for menstruation by talking about the hygienic aspects. But fathers don't tell their adolescent sons not to worry about masturbation or 'nightfall'." As a result, he said young men often visit quacks to get "cures" for these "problems". "I have had young men visiting me steeped in guilt about masturbation, having parted with small fortunes to get themselves cured..."

That sort of desperate prudishness is replicated among the millions crammed into the shantytowns of India's big cities, where drug abuse and prostitution cause AIDS to spread like fire. Recently the World Health Organization admitted that there is massive under-reporting of AIDS cases, in India, with perhaps fewer than 25 per cent of cases reported. "It is mainly because of the social stigma attached to the disease," a consultant explained.

It is like gonorrhea or syphilis in 19th century Britain: AIDS is known about, but it is social death to bring it up. So when the Indian government uses some of the huge sums it has borrowed from the World Bank to wage thepropaganda war on AIDS, there is a painful sense of worthy people going through the distasteful motions: putting out posters in English, understood by a fraction of the public, and an even smaller fraction of those at risk;setting up a helpline which gives callers a 15-minute recorded discourse.

In Thailand, AIDS has been understood both by the public and the government to be a menace to the nation's development and prosperity. A law was passed, requiring all television and radio station to devote two minutes aday to the problem. Thanks to these and other measures, the incidence of infections is more than 60 per cent lower than it was at the start of the decade.

In India, however, that shift is yet to happen. So there are cities like Vijayawada, on the east coast, where last year 21 AIDS patients committed suicide rather than live with it. And last May India made its own unique addition to the world's AIDS nightmare: the image, published in the newspapers, of a fireman playing a hose on the charred remains, scarcely recognizable as human, of a man lying on a street outside Madras: beaten and burned alive on suspicion of waving around a syringe infected with AIDS.

The terror stalks the land. How much longer before India can bring itself to face it?