A situational analysis of HIV/AIDS-related discrimination in Kerala, India

Abstract

Due to its large population, India has a substantial proportion of the world's HIV infections. Recent evidence suggests that the virus is moving into the general population from high-risk groups. Despite this, a mentality of ‘us’ and ‘them’ continues to prevail, where PLWHA are marginalised from mainstream society. Focusing on the area of health care, this study, through an analysis of legislative policy, written regulations and interviews with key informants and direct witnesses aims to map the forms of structural discrimination that inform the lives of PLWHA. Study findings indicate that a lack of clearly enunciated and enforced legislation (which is in some instances clearly discriminatory), coupled with an absence of written internal policy, leaves room for selective interpretation, which in turn creates the opportunities for discriminatory behaviours to be perpetuated against PLWHA. The paper concludes with a call for better educational training of medical staff and the improvement of existing legislature.

Acknowledgments

This research was part of a grant made by Ford Foundation to Deakin University‘A situational analysis of HIV/AIDS-related stigma and discrimination in the Asia Pacific’. India was one of those countries. For their help and assistance I would like to thank Ms Geetha Venugopal, Dr A. K. Jayasree and Ms Bindu, for their invaluable assistance as part of the team, also Daniel Reidpath, Kit Yee Chan, Monica Barratt and Bianca Brijnath (Deakin University) and Lisa Messersmith (Ford Foundation). Anonymous reviewers contributed significantly to improving this paper.

Notes

1. The Hijras are a group culturally-specific to India, who participate in ritualised castration and consider themselves neither male nor female.

2. As much as possible, the translation of policy and legislation aimed to convey the sense and intent of the original, and may not represent a strict legal translation.

3. The de-linking of the testing of the blood from the individual donor has raised its own controversy, because it limits opportunities to use the blood donation process as an opportunity for identifying PLWHA and providing appropriate counselling, care and support.

4. This one was the earliest cases in Indian law that discriminated against PLWHA. Though it was overturned the following year and subsequent verdicts have barred isolation of HIV-positive peoples, it has been included here to illustrate that while discrimination has been institutionalised, agencies, such as the law, can and do change.