San Francisco Chronicle - Sunday, November 17, 2002
Siddharth Dhanvant Shanghvi, Chronicle Foreign Service

Hafeeza, a 32-year-old woman who lives in the slum of Tardeo near Bombay, was shocked when doctors told her that she had been infected with HIV by her taxi-driver husband.

"But what can I do?" said Hafeeza, who refused to give her last name. "Besides, the only thing I am interested in is saving the life of my baby."

Hafeeza is one the most vulnerable people in India's AIDS epidemic -- pregnant women.

Many of the women are monogamous housewives who acquired HIV from their husbands. They are also too poor to afford antiretroviral medicines, a sad irony in a nation that is one of the biggest producers of the drugs.

Dr. Vandana Bhatia, a clinical research associate at ARCON AIDS Research and Control Center -- a collaborative effort involving the University of Texas -- says the most troubling part of her job is breaking the news to women like Hafeeza that their husbands gave them the virus.

"Although most patients already know of their HIV status, many are clueless about how they got it, especially women," said Bhatia. "And as is often the case, the husband admits to relations outside the marriage. That's when her face crumples. It's as if she is thinking: 'What did I do to deserve this?' "

The World Bank estimates that women account for 1 of every 4 new HIV infections in India. In the state of Maharashtra, 2 percent of the 27 million pregnant women each year are said to have the human immunodeficiency virus.

In his book, "Sex, Lies and AIDS," Siddharth Dube writes that the major reasons for the spread of AIDS into the general population are poverty, illiteracy, a high rate of sexually transmitted diseases and government apathy.

But unlike Africa, where the substantial numbers of sufferers have spurred high-profile campaigns against the disease, the disquieting social stigma associated with AIDS has caused many Indians to accept the epidemic's devastation silently. In some villages, the discovery of a resident with AIDS has even led to death by lynching.

Aid workers say it is extremely difficult to teach infected men in conservative villages to wear condoms or to tell wives to demand that their husbands take precautions. As a result, the husbands pass HIV on to their wives and the wives pass it on to their babies.

Health activist Swatijha Manorama says the spread of AIDS can also be linked to the long-standing subordination of women and girls in Indian society, which takes on lethal dimensions when they don't even have the status to demand condom use.

Manorama points to Bombay prostitutes who have cut the infection rate by 14 percent in the past four years, after following the example of their Calcutta colleagues who unionized and insisted that their clients wear condoms.

"Sad as it sounds, married women don't have that bargaining power," she said.

"In a way, prostitutes are safer."

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