Northeast is concentrated among one of the most vulnerable populations at high risk for HIV. The concentrated epidemics are driven by unprotected sex between sex workers and their clients and by injecting drug use with contaminated injecting equipment. Several of the most at risk groups have high and still rising HIV prevalence rates.
However, although overall prevalence remains low, even relatively minor increases in HIV infection rates in a country of more than one billion people translate into large numbers of people becoming infected. Lets us find out why HIV has turned into a menace for Northeast India-
#1 Injecting Drug Use (IDU)
Injecting drugs with contaminated injecting equipment is the main risk factor for HIV infection in the north‐east (especially in the states of Manipur, Mizoram and Nagaland. Products injected include legal pharmaceuticals (e.g. buprenorphine, pentazocine and diazepam), in addition to heroin. Current interventions targeting IDU tend to be inconsistent, and too small and infrequent to yield demonstrable results. Comprehensive harm reduction programs, including clean needle and syringe exchange and opioid substitution therapy (OST) need to be extended and expanded as a matter of urgency in those parts of India with serious drug injecting‐related HIV epidemics. The recent data from HSS 2010 shows that In Northeast Manipur and Mizoram have reported more than 10% HIV prevalence among IDUs.
#2 Migration and Mobility
Migration for work takes people away from the social environment of their families and community. This can lead to an increased likelihood to engage in risky behavior. Concerted efforts are needed to address the vulnerabilities of the large migrant population. Furthermore, a high proportion of female sex workers in India are mobile. The mobility of sex workers is likely a major factor contributing to HIV transmission by connecting high‐risk sexual networks.
#3 Low Status of Women
Infection rates have been on the increase among women and their infants in some states as the epidemic spreads through bridging population groups. As in many other countries, unequal power relations and the low status of women, as expressed by limited access to human, financial, and economic assets, weakens the ability of women to protect themselves and negotiate safer sex both within and outside of marriage, thereby increasing their vulnerability.
#4 Unsafe Sex and Low Condom Use
In India, sexual transmission is responsible for 87.4 percent of reported HIV cases and HIV prevalence is high among sex workers (both male and female) and their clients. A large proportion of women with HIV appears to have acquired the virus from their regular partner who was infected during paid sex. Overall HIV prevention efforts targeted at sex workers are increasing in India. However, the context of sex work is complex and enforcement of outdated laws often act as a barrier against effective HIV prevention and treatment efforts. Although recent data suggest an increase in condom use, in many places condom use is still limited, especially where commercial encounters take place in ‘risky’ locations with low police tolerance for this activity.
#5 Men Who Have Sex with Men (MSM)
Relatively little is known about the role of sex between men in India’s HIV epidemic, but the few studies that have examined this subject have found that a significant proportion of men in India do have sex with other men. As per recent data After Chattisgarh, Nagaland (13.58%) have the highest HIV prevalence among MSM. Poor knowledge of HIV has been found in groups of MSM. The extent and effectiveness of India’s efforts to increase safe sex practices between MSM (and their other sex partners) will play a significant role in determining the scale and development of India’s HIV epidemic.