What You Pretend You Don’t Know Won’t Hurt You!?

Today I met an 11 year old boy who is HIV+. He was born positive, had no say in the matter and now lives his life knowing that one day his cd4 count will drop and he will either have to start taking Anti Retro Viral drugs (ARVs) or fall prey to opportunistic infections that will lead to his death. It is possible to reduce the chances of transmission of HIV from mother to child if it is known that the expectant mother is positive. However, convincing mothers to get tested and start the necessary medication if they turn out to be positive is a hard task because most women remain stubbornly in denial about the possibility that they could have contracted this virus. Denial is an act that has great destructive strength and is not confined to mothers in Zambia but exists in all sections of society all over the world.

While I have seen many in denial, I could not say to you that people in Zambia lack awareness about HIV/AIDS. I have found that the lay person’s knowledge about the disease, its transmission, methods of prevention and even treatment is far greater than that of people in the UK or India (having lived in both countries I speak of just these 2, though I am sure one could list many more). In fact, the level of ignorance and denial about HIV and other sexually transmitted diseases in the UK and India is frighteningly high. The consequences of this can be significant in both countries though the potential impact might be greater in India as AIDS is silently and surely creeping up on India’s youth.

With the decline of traditional values in Indian cities, young men and women have become increasingly promiscuous. I make no moral judgment on the issue but merely wish to point out the different implications that promiscuity has in the west and in India. While it is quite standard, across the globe, that young adults exercise their freedom to have premarital sex, many sexual partners (consecutively or at the same time) unprotected sex with multiple partners (again, this could be consecutively or at the same time), the difference that I have noticed between the youth in the west and that in India is this – empowerment! It is quite normal for youth in the west to be open about their sexual activity. This gives the advantage of being able to openly seek medical help and keep track of their sexual health. The situation is just not the same in India. The average sexually active Indian youth has never been tested for HIV or sexually transmitted infections. Even though they are aware of the possibility of having contracted something they will be hesitant to seek medical attention. This is a result of stigma or perceived stigma against sexual activity/promiscuity. Though it is still not OK for the Indian youth to engage in sexual intercourse outside of wedlock, it happens, and stigma persists. The issue that arises out of this partial rejection and partial preservation of traditional values is that the Indian youth remain in denial about their sexual health which should be a cause of great concern.

It will take ages for attitudes to change. I cannot even say with a great deal of confidence what these attitudes should be. Working so closely with people living with and affected by HIV/AIDS I feel there is strong case to be made for abstinence. But I do not think it very realistic to hope that young people will stay away from sex. Hoping that this will be the case and in fact assuming that it is might be the easy Indian way but it is extremely dangerous. The repercussions of such an attitude in the age of HIV can and possibly will be disastrous. We live in the 21^st century, everything we hear about it is not ‘out there’ but ‘right here’! So while we wait for things to change, my message is really quite simple – be strong, shake yourself out of denial, get tested and use a condom.