The pattern of prevalence is shifting towards women and young people with estimated 25% of HIV infections occurring in women.
This also adds to transmission from mother to child, leading to pediatric HIV. While gender inequality adds to the biological vulnerability of women, stigmatization compounds the problem further. The infection spreads rapidly in the informal sector, which accounts for a large part of the Indian work force.
Poor living conditions, limited social protection and low levels of income are some of the factors that lead to this scenario. While behavioural studies in India suggest that prevention efforts directed at specific high risk populations are showing encouraging results in some states (in the form of greater awareness and condom use), HIV/ AIDS continues to increase in other states. There is, therefore, a need for well-planned large-scale sustained interventions addressing the trends of sub-epidemics in some of the vulnerable groups. The impact of AIDS is becoming increasingly evident: HIV prevalence among women attending antenatal clinics was higher than 1% in Andhra Pradesh, Karnataka, Manipur, Nagaland and Tamil Nadu by the year 2001.
While HIV prevalence is still low in many other states, the presence of high levels of sexually transmitted infections (STI) along with the presence of sexual networks and migration are all indicators of high vulnerability. In 2001, the Technical Resource Team of UNAIDS (TRT) initiated collaboration with six state governments to formulate a joint UN project named ‘Charca’ (Co-ordinated HIV/AIDS and STD Response through Capacity building and Awareness). The project purpose is to contribute to the empowerment of young women (between 13—25 years of age) in six districts so that they can protect themselves against HIV/AIDS and STD. An important feature of the project has been the “bottom up” planning phase carried out in partnership with the community and other local stakeholders. This resulted in District Strategic Plans based on District Situation Assessments. Community involvement in skills building, awareness raising, strengthening of existing services and creating support structures is expected to lead to effective district response both in term of prevention; care and support.
The joint UN project CHARCA has taken shape in the TRT along with close collaboration with six state governments and district community members. District stakeholders were closely involved in the design and planning of the project implementation plan, which includes research in the form of district situation analyses and strategic plans. Implementation began during 2003 and will be carried out through a partnership between the UN agencies, National AIDS Control Organisation (NACO), State AIDS Control Societies (SACS), structures of a variety of state departments, NGOs, Community Based Organisation (CBOs) and women’s groups.