Dr. Avnish Jolly,23 May:Women and children, including those who describe themselves as “Living – Positively,” are struggling to come out of the dimness that still hinder the efforts to fight HIV/AIDS.
The premises of Positive Networks in different Cities are so difficult to understand that every where I have visited. During last six months I interviewed many HIV Positive Women in different state of India and also interacted with members of Positive People Network. They share with me about their experiences with HIV and Antiretroviral Therapy (ART). They unfold many issues during the interaction. Most of the women in were unemployed. They were all receiving HIV treatment, and few of them were hiding their HIV status from their husbands or partners. Most of them experienced piercing physical, psychological or verbal or emotional abuse at the hands of their husbands, and this made it difficult for them to continue using the life-saving treatment.
India’s ART program is an impressive effort to provide free and universal HIV treatment. For this program to succeed, however, the government needs to introduce reforms in the health and legal systems to end the abuses against women that are obstructing their ability to fully benefit from life-saving HIV treatment programs.
Sita (name changed) told, “I fear to tell my husband,” a 35-year-old woman fearful of disclosing her HIV status at home. She feels that her husbands shout on her in the presence of children and divorce her. He uses abusive words with her very often.” She told me that she also hides her antiretroviral medicine. When she takes her pills, she said “I have to make sure that he is outside home. Due to this I forgot to take medicine also.”
Similarly, the country’s legal and health framework fails to address these issues sufficiently. Laws helps women in terms of allocating property upon divorce or the death of a husband, but it is ill-enforced. Who will act on behalf of effected women and children? Addressing these legal shortcomings is important not only to protect women and children, but also essential for the success of India’s HIV treatment programs.
Gurpreet (name changed) was married according to customary law, and she said that upon divorcing her, her husband appropriated all her belongings, including plates, cupboards, mattresses, cloths and sheets. She complained to the owner of the farmhouse where they lived, but her husband ran away to avoid confrontation with the owner. She gave up trying to reclaim her badly needed belongings due to ill-health. Gurpreet was due to return to the HIV clinic on the next day for further tests. Gurpreet said that although the doctors might enroll her on ART, she might not be able to bear the medication without food.
Women don’t have travelling expanses to visit ARV Clinic. Some times they have to spend the travelling, boarding, dining charges for accompanists. In few cases shoping charges also.
I asked whether healthcare workers and HIV treatment (ICTC or ARV Clinic) counselors discuss violence and other problems at home that might affect their treatment, the majority of the women and children told me that this only happened when they had noticeable marks on the faces. The training that counselors receive does not cover legal issues i.e. violence against women and children in a systematic manner, nor does the understanding of gender-based abuses factor into official counselor certification.
India lacks government protocols on how to deal with violence against women and children and other abuses within ART programs. And monitoring and evaluation systems do not track the effects of such abuse.