Inter Press Service - December 15, 1999
Ranjit Dev Raj

At 21, Mukti is one of Bangladesh's better known HIV victims having been encouraged by a sympathetic professor who treats her at the medical college in Dhaka, to address public meetings on the disease and her plight.

Like Mukti, millions of young illiterate South Asian women are forced by dire poverty to leave home and look for work -- only to end up being sexually exploited and become exposed to HIV in the process.

Most of the 243 million poor women in South Asia have few choices in life including who their sexual partners would be.

The particular vulnerability of South Asian women to HIV was highlighted at the Fifth International Conference on AIDS in Asia and the Pacific (ICAPP) held in Kuala Lumpur late October.

According to Nay Htun, UN assistant secretary general and UNDP regional director for Asia and the Pacific, poor South Asian women are neither free nor adequately informed to secure safe passage to secure sources of job opportunities.

Trafficking in women greatly adds to the problem with the blurring of the edges between trafficking and legal migration making it difficult to ascertain numbers accurately, Nay Htun said at the conference.

According to non-government organisation (NGO) sources, cited by Nay Htun, there could be as many as 200,00 Nepali girls involved in the sex trade in India while hundreds of Bangladeshi women are illegally transported into Pakistan every day.

Recognising the seriousness of the situation, governments of the South Asian Association for Regional Cooperation (SAARC) have called for collaborative action to fight trafficking of women.

But what defeats such action is the fact that out of the 1.3 billion people in the world who live on an income of below one dollar a day, South Asia houses 515 million.

Widespread income and human poverty combined with illiteracy have served to deprive people in the region of the information and control over their lives necessary for protection against HIV.

According to Nay Htun, the huge and mobile population of the SAARC nations, especially in India, Pakistan, Nepal, Bhutan and Sri Lanka, is now becoming the epicentre of the HIV epidemic with five million people already infected.

To compound the problem, migrant workers have a negative image in the eyes of host communities and are often blamed for social problems including the importation of HIV as well as for bringing the infection back to their home countries.

According to Ashi Sangay Choden Wangchuk, the Queen of Bhutan and a prominent participant at the ICAPP, South Asia has the advantage of knowing what works and why.

"We know that discrimination and stigmatisation for people living with HIV/AIDS is counter productive. We have evidence that HIV is ten times more likely to be transmitted if STDs are left untreated in either partners," Wangchuk said.

She also emphasised the fact that social norms that reinforce promiscuity, irresponsibility, sexual violence and coercion not only threaten women but increase men's vulnerability to HIV/AIDS.

Bhutan, she said, had a limited number of HIV infections so far because the country has learnt that it is "important to take the window of opportunity that we talk about in prevention, care and support."

Wangchuk said she took to heart the message shared through the media by Bhutan's first AIDS patient who died in a local hospital three years ago, appreciating that he was neither stigmatised nor discriminated against.

Mukti was not so lucky. After the doctor in her village discovered her HIV status she was locked away in the local police station for a week before she was moved to Dhaka.

She still resents people staring at her "like a wild animal" or asking her to explain how she got infected.

According to a UNDP document, 'AIDS in South and Southwest Asia: A Development Challenge', many people in South Asia do not want to know or reveal their HIV status because of the "blame and shame" attached to AIDS.

Most of the countries in the region, with the exception of India, are considered to be in an early phase of the epidemic with low levels of HIV, according to the document.

The UNDP document places at the heart of the epidemic South Asia's women who, because of gender insensitivity, lack of basic rights and social status already suffer from poor access to resources, education, training and labour markets.

"Economic dependence, social expectations and fear of disrupting family life are powerful disincentives for wives to insist on the use of condoms," says Sonam Yangchen Rana at the UNDP's HIV/AIDS project here.

But this is especially true in environments such as that in the South Asian countries where sexual issues are not an acceptable topic for discussion even between husbands and wives, she said.

One consequence of the inability to discuss sex is the high prevalence of sexually transmitted diseases (STDs) in the region which combined with low levels of condom use greatly enhance the chances of HIV transmission.

According to Meenu Kapoor, a counsellor with the health NGO, Drishtikon (viewpoint) the average rate of STD infections among women living in the slum clusters of Delhi could average 30 percent or higher.

Drishtikon, which has been running workshops for young people and a laboratory with support from the World Health Organisation (WHO) has, curiously enough, not turned up a single instance of HIV infection.

A similar situation prevails in Dhaka where, according to Prof Nazrul Islam who teaches at the medical college, 60 percent of commercial sex workers are afflicted with STDs -- although less than one percent are yet testing positive for HIV.

Bangladesh has fewer than 150 cases of HIV infection and many of these were acquired and even first detected in West Asia -- as happened with Mukti," Prof Islam said. (END/IPS/rdr/an/99)
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