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2005-09-21-Indian women face peril of HIV
At the Vasavya Mahila Mandali home for vulnerable women and children in the city of Vijayavada in the southern Indian state of Andhra Pradesh, 23-year-old Nagmani clutches her five-year-old daughter in her lap.
Neither smiles. The doctors say both of them are traumatised.
In January Nagmani's husband died of Aids.
"After my husband died my parents in-law threw me out of their house," she says.
"My brother's wife didn't want me in my family's house either. I had no place to go, that's why my daughter and I came here."
Test results show Nagmani too is HIV-positive, but that's too much for her to cope with. She refuses to accept she is infected.
India already has over five million HIV-positive people.
Global progress towards the UN Millennium Development Goal of halting and reversing the spread of Aids by 2015 is minimal, and India is likely to find it particularly hard to fulfil.
Currently 39% of HIV-positive Indians are women.
The government here says it is trying to promote awareness.
But health workers fear unless there is a massive campaign to combat the widespread ignorance of HIV, especially among women, the situation will soon get much worse.
"Not only the illiterate women, but the so-called educated women also are not aware of HIV/Aids.
"That is the pity of the situation among women here," says Dr Deeksha, the medical director of Vasavya Mahila Mandali, which - in addition to running the home for vulnerable women - also works in HIV awareness and cares for women in Andhra Pradesh.
Sex is still largely a taboo subject in India, which makes education even more difficult, according to Dr Anbumani Ramadoss, the Indian health minister.
"We are trying to sensitise the husband in the first phase, saying don't do this and don't do that and try to be faithful and abstinent.
"It's a closely-knit community out there, and getting into the community, it takes a lot of work and energy," he says.
But the Indian government has come under fire from Aids activists, who accuse it of not doing enough to promote awareness or care.
"I think it's pretty much out of hand as far as I'm concerned," says Anjali Gopalan of the Naz Foundation.
"We're seeing a tremendous rise in numbers of people who are living with HIV," she says.
"We are seeing a rise in the number of orphans, so I think the window for opportunity that we did have even five years ago is not there any more."
Government prevention programmes have focused until very recently almost exclusively on high-risk groups such as sex workers, gay men and lorry drivers.
Consequently it is still largely seen as a disease confined to these groups by those Indians who are aware of HIV.
Accurate figures on HIV awareness are not available, but Dr Deeksha of Vasavya Mahila Mandali estimates at least 70% of women in the rural areas where she works have not heard of the virus.
The first time Lakshmi, 33, who lives in a slum just outside Vijayavada, learnt of HIV was when she received her positive test results.
"My husband is a truck driver and I got HIV through him. I had never heard of HIV or condoms before that and because I can't read, I couldn't understand any of the posters or banners."
Lakshmi's 12-year-old son died of Aids two years ago, which was when both she and her husband discovered they too were HIV-positive.
"I was very much afraid about my HIV status because no one wanted to touch us and people wouldn't let us into their houses.
"There's so much stigma," she says. "As a woman, I didn't want to go outside.
"Then I found a doctor who would touch me and he told me it's nothing to worry about and then I got the willpower to live."
Lakshmi has begun her own fight against ignorance by educating and counselling women in her area about HIV.
But it is only through people like her and the work of a handful of non-governmental organisations that HIV awareness is being spread amongst women in rural India.
According to Anjali Gopalan, the lack of services and awareness programmes is at a critical stage.
"We haven't really improved the services that exist at ground level and there seems to be such a tremendous resistance even now," she says.
Without a massive increase in awareness programmes - particularly aimed at women - India risks an epidemic which could cost millions of lives.