India's AIDS Control Programme

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IEC and awareness campaigns are a central element of India's AIDS control programme. Since the last decade that the programme has been in existence, the proportion of individuals in India who have 'ever heardof AIDS' has indeed significantly increased. However, as NACO's behavioural survey shows, awarenesslevels are low in rural areas, especially among women. Beyond awareness, accurate knowledge of HIV transmission, ways to protect one's self and perceived risk to self remain low, again especially so in rural areasand among women (NACO, 2001).

With some exceptions, the bulk of awareness programmes have focused on themes like: (a) 'AIDS kills' - a scare tactic that has not worked in motivating people to practice safe sex; (b) 'remain faithful to one partner' - a message that is irrelevant to the majority of Indian women who are monogamous; and (c) 'use condoms with sex workers' - which fails to address unsafe sex with regular, same sex or unpaid casual partners. More recently, prevention messages have evolved from fear based to more neutral themes - providing information on HIV transmission and methods of protection.

However emphasis of these awareness efforts has stopped at sterile delivery of information in a dogmatic fashion, rather than messages that would open up discussions on sexual pleasure, norms and health (e.g. concerns related to masturbation, semen loss) or alternate sexual identities. We know that sexualfulfillment and well-being are not only fundamental human needs but also a human right. We also know thatif HIV prevention messages are to contribute to sustained behaviour change, they must address sexuality,as it is essential to people's well-being. Most important, messages that impose the personal morality ofthe few on the sexual and reproductive rights of all are in fact counter-productive to behaviour change, riskreduction, and preventing HIV...

HIV/AIDS awareness messages in India either perpetuate stereotypes or at best remain neutral inaddressing negative gender and sexual norms that are fuelling this epidemic. For example, many awarenessprogrammes emphasize that men engaged in high risk behaviour use condoms with sex workers, but don'temphasize the same with wives who remain unaware, uninformed and unprotected. For Indian women, mostawareness programmes have not even begun to address their risk and need for prevention information. Thisneed goes well beyond the minimal knowledge of the virus and how it is transmitted, to include topics suchas reproductive anatomy and physiology or concepts such as virginity, masculinity, honour, shame, sexualdouble standards, and violence against women and girls. The analysis of the IEC and awareness component of India's AIDS control programme reveals that gender and sexuality have not been addressed in the design and delivery of prevention messages. The AIDS epidemic has tragically highlighted that gender inequality can be fatal. While changing unequal gender relationships is a long-term process and cannot be achieved through IEC and awareness programmes alone, gender-sensitive HIV/AIDS prevention mes-sages do play a critical role in promoting equitable norms and creating an enabling environment in whichindividuals can adopt behaviour change.

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