HIV
and Sexuality – Has India Missed the Bus?
HIV remains exceptional in that it carries the
seemingly immutable burden of being synonymous with immoral behaviour.
Open and safe conversations on sexual rights and
freedoms in the context of both disease and pleasure should have been the
method of decoupling HIV from prevailing notions of morality. India’s HIV
programme over the past 25 years chose not to do this.
In September
1998,
to the utter horror of HIV activists, the Supreme Court of India pronounced the
following in a judgement – “AIDS is the product of undisciplined sexual impulse.”
It was hearing the case of Mr. “X” v. Hospital “Z”.
The appellant Mr. “X” was a person living with HIV whose confidentiality had
been breached by hospital “Z”. The appellant sought damages for breach of
confidentiality, which had led to his marriage being cancelled, and ostracism
by his community.
This judgement, till it was revoked in 2003 after an
outcry from activists and lawyers, took away the right of a person living with
HIV to marry, found a family and procreate. This was the first time in judicial
history anywhere in the world that a court had suspended an individual’s right
to (heterosexual) marriage.
The body, a site of uncertainty, vulnerability,
connection, and fragile joys, became the site for reconciliation between
disgust and compassion, between pleasure and disease, between power and rights.
Even though this judgement was revoked, the idea that
the HIV infection was a result of sexual deviance remained firmly rooted in the
public imagination.
In May 2003, the then Information and Broadcasting
Minister Sushma Swaraj made the politically pragmatic decision
to impose a ban on condom advertising on Doordarshan
(India’s government founded public service broadcaster).
That HIV is primarily a sexually transmitted condition
amplified the existing draconian voices, which conflated ‘immorality’ with
condom promotion, and disease with sin.
Sex workers, drug users and persons belonging to
sexual minorities were at best considered marginal to mainstream society, and
at worst, those in need of reform and rehabilitation.
Only those who claimed to have been infected through
blood and blood products were considered ‘innocent victims’ – the rest, as it
were, ‘deserved’ the damnation. Men came under fire for ‘promiscuity’.
However negative the framing of this initial discourse
may have been, India was beginning to reveal that it was ready for a real
conversation on sexuality. Internet arrived in 1995, private media channels
started showing new kinds of content, and films such as Fire created a space
for debates
on sexuality. And when the HIV epidemic came upon us
thirty years ago, India, as it were, took her first baby steps out of the
closet.
In the midst of all this, the Government of India
played along with the US Global AIDS Strategy, which announced what the
conservative establishment of the day was most happy with – ‘Abstain, Be
faithful, use Condoms’– the famous ABC strategy. The assumptions of the ABC
strategy merit attention.
One, this strategy assumes that adolescents are either
sexually inactive and/or can be persuaded to abstain from sexual intercourse
till they are married. Of course, sexual minorities who don’t have the option
of marriage weren’t considered here. Two, this strategy assumes that partners
within a marriage choose to, or can be persuaded to, remain faithful to each
other. Three, and the most debilitating of these assumptions, was that women
and girls have full control of their abstinence and faithfulness despite the
epidemic of gender violence and disempowerment.
The C of the strategy, condoms, were therefore meant
for the ‘others’, the vectors of the disease – sex workers, men who have sex
with men and intravenous drug users.
And double quick, this bumped the condom out of the
lives of ‘normal’ people.
The condom was desecrated – it got labelled as a tool
in the hands of the sexually deviant, the thing that is used by the ‘outsider’,
to be used in hiding.
The twitter exchange below illustrates the issue
beyond any doubt.
[The response to Mona’s Tweet translates as, “To those
who cannot be faithful to their wife, AIDS is too little a punishment.”]
Remember, the three ‘high-risk groups’ mentioned above
(sex workers, men who have sex with men and intravenous drug users) continue to
be governed by laws which see them as indulging in criminal activity. Despite this, these groups rose to the
challenge, collectivised and empowered themselves to use the condom, and it is
all thanks to them that the spread of the virus has somewhat abated. Hundreds
of community-led interventions grew across the country, with peer educators
making safer behaviours acceptable, one person at a time. Nonetheless, they
continue to pay a heavy price for the absence of an inclusive mainstream
discourse on sex and sexuality – they live in daily fear of ridicule, violence,
neglect and marginalisation.
Condoms left the bedrooms of those who considered themselves
beyond risk. And that was the death knell of the discussion on sexuality that
the HIV response was mandated to have had among men and boys, women and girls.
In
As a result, some young people who are in the school
system get a few hours of this sort of sexuality education every year, quality
and content notwithstanding. Young people outside the formal school system just
fell off the radar.
In 2001, a writ
petition was filed in the Delhi High Court challenging
the constitutionality of Section 377 which criminalises same-sex sexual behaviour.
After many twists and turns, huge community mobilisation across the country,
media pressure and persuasion, the Delhi High Court read down Section 377 in
2009. This was a historic judgement. However, in 2013, the Supreme Court of
India set this judgement aside, observing that the High Court was anxious “to
protect the so-called rights of LGBT persons”.
It was no surprise, therefore, that a UNDP study
published as recently as in 2014 found that 61% of the respondents associated HIV
with shame, two-thirds blamed sex workers, drug users, sexual minorities and ‘promiscuous’ men for spreading HIV, and
most alarming of all, considered HIV to
be a punishment from God for their wrong behaviours.
This evidence proves beyond doubt that the HIV
programme did not get the fundamentals right. After 25 years of a high profile
and high investment HIV programme, we seem not to have moved much from that
September day in 1998 when the court blamed it all on “undisciplined sexual
impulse”.
As long as HIV infection is not decoupled from
prevalent notions of sexual deviance and immoral behaviour, the job will remain
half done. And this complex decoupling can still be done through conversations
on sex and sexuality.
Young people in India are more than ready for this
conversation, but can policy-makers rise to the occasion?
First published here https://www.tarshi.net/inplainspeak/issue-in-focus-decoupling-deviance-and-disease/
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