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March 9, 2000
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India, Bangladesh read warning signs for AIDs explosion
By Ranjit Dev Raj

NEW DELHI - The high levels of sexually transmitted diseases (STDs) prevalent in India and Bangladesh could signal an HIV/AIDS explosion in the South Asia region, says Peter Piot, executive director, UNAIDS.

Piot participated in a ceremony here Monday to formally launch the 2000 World AIDS Campaign which focuses on male attitudes and behavior and carries the theme ''Men can make a difference.'' Asked at a press conference after the launch why the over 30 percent prevalence of STDs among the general population in South Asia was not reflected in corresponding levels of HIV infections, Piot said it was still early days in the region.

India has the highest number of HIV infections in the world but the 3.7 million estimated victims form only a minuscule proportion of this country's billion-strong people.

A similar pattern of low HIV prevalence accompanied by warning signals indicate that rates could rise quickly in neighboring Bangladesh, said Salehuddin Ahmed, from the Bangladesh Rural Advancement Committee. Ahmed said his country had low levels of condom use while half of all commercial sex workers were infected with STDs greatly increasing the chances of HIV infection.

But Piot said South Asia could soon see an Uganda-like situation unless appropriate measures were taken to contain it early enough through awareness campaigns including the current ''gendered approach'' with its focus on boys and men. ''The time is ripe to start seeing men, not as some kind of problem but as part of the solution,'' Piot said adding that if women were at special risk of HIV infection it was because of their lack of power to determine when and how sex takes place.

All over the world, men tend to have more sex partners than women, including more extramarital partners thereby increasing their own and their primary partners' risk of contracting HIV. This risk, said Piot, was ''compounded by the secrecy, stigma and shame surrounding HIV,'' and had special meaning in South Asia where males exercise enormous control over women.

A example of what can happen to South Asian women was available in the person of Kausalya P who contracted HIV from her husband and was branded as a prostitute and thrown out of her home by her relatives. ''My marriage was decided by my father and my uncle, and I got to know what kind of man my husband was only after it was all too late,'' said Kausalya who now runs the Positive Women Network of South India which supports other women in a similar plight.

Kausalya said having worked with women victims of the epidemic she could vouch for the fact that where men and women supported each other they could cope better with the fallout of HIV infection than if they were left to fend for themselves.

A UNAIDS report, ''Men and AIDS - a gendered approach'', released at the launch challenges harmful concepts of masculinity and argues that changing the way adult men look on risk and sexuality and how boys are socialized may have crucial bearing on the future course of the AIDS epidemic.

Piot said male reluctance to offer care and support may be conditioned by traditional beliefs and expectations and influenced by divisive cultural beliefs and social norms in the same way that women are influenced by these forces.

The report listed several reasons for focusing the World AIDS campaign on men starting with their propensity towards high risk behavior such as using illegal substances and inject drugs. Men are less likely to pay attention to their sexual health and safety than women and can transmit the virus to both their drug partners and sex partners. Most sex between men is hidden and many men who have sex with men also have sex with women - their wives or regular or occasional girlfriends.

The report also emphasizes that all fathers and future fathers should be encouraged to consider the potential impact of their sexual behavior on their partners and children, including leaving children behind as orphans and introducing HIV into the family.

(Inter Press Service)

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