23 , 2002, Gazette)
by Chris HammondDr. Paul Sachdev
the end of 2002, it is estimated that the number of HIV-infected individuals
in India will have grown to approximately 35 million, outpacing the transmission
rate in any other country in the world. Of these cases, an increasingly
large number will be women.
According to Dr. Paul Sachdev, Social Work, this explosive growth rate
is due to a cultural gender bias, the focus of his survey, Sex, Lies,
and HIV/AIDS in India, conducted among 1,272 Indian graduate students
in social work, nursing/medicine and the humanities.
Dr. Sachdevs study is the first ever conducted in India on the attitudes
towards sex and HIV transmission. It was sparked by his desire to understand
how students attitudes can affect their ability to counsel clients
or treat patients.
This (gender bias) is very important when counsellors and social
workers go to work with women and men. The gender component is also important
for other reasons. If government officials dont support gender equality,
then government policy is going to be skewed in favor of men and neglect
women in terms of access to reproductive health care, education and counselling,
said Dr. Sachdev.
In 1994, eight years after the first AIDS case was diagnosed, the incumbent
health minister still publicly dismissed the problem of HIV transmission
in India: We are a traditional society and this western type of
sexual promiscuity does not exist in India and so it has no chance of
This attitude explains why married women who
showed up at clinics with symptoms of AIDS were not tested for the HIV
virus. Many doctors considered it impossible that such morally pure
women could contract the virus.
There was a massive denial among politicians and the medical community.
It was just a disease of the (female) sex workers. said Dr. Sachdev.
Because of this inaction, the virus spread from prostitutes to migrant
workers and into the bedrooms of girlfriends and wives.
Dr. Sachdevs study attacks a series of what he candidly refers to
as lies about sex and AIDS in India.
One such lie mens sexual needs are stronger than those of
women rationalizes the belief that men are, in fact, victims of
the HIV virus because their promiscuity is driven by a natural urge. Dr.
Sachdevs study refutes this notion, finding that women also have
a healthy sex drive. Nearly 70 per cent of women agreed it would be better
to express their sexual desires with as much initiative and aggressiveness
Further evidence of gender bias is evident in attitudes towards condoms:
48.2 per cent of men placed the responsibility for choosing a condom with
Dr. Sachdev points out that nearly all respondents exhibited good to excellent
understanding of HIV transmission, but that their behavior was not altered
correspondingly. Both men and women expressed a reluctance to use condoms
despite their awareness of the health risks of unprotected sex.
Education is not enough to change behaviour. We must also change
attitudes. Men need to be more sensitive and women need to be empowered,
said Dr. Sachdev. We have to infuse in them (men) the idea that
they have equal responsibility if they want to engage in mutual sexual
pleasure. Its not a one-way street.
Women need to learn the art of negotiating. A woman should be assertive
and secure enough in her relationship that she should be able to put this
very strongly. Look if you dont want to take responsibility,
if you dont want to use a condom. Then no sex. This is what
I call empowerment for women.
Dr. Sachdev recently conducted a seminar in India sponsored by the Delhi
State Aids Control Society. The seminar was attended by 300 people, including
the health minister, government officials, members of the medical community
and the general public. While there, he stressed that the attitudes and
behaviors studied in his survey reflect the best-case scenario as he had
surveyed a well educated cross-section of Indian society.
Its one thing to change attitudes among educated, literate
Indians, but how do you reach the poor, illiterate living in the villages?
Its an enormous task to educate these people. With its growing population
and inadequate health system, India is sitting on a time bomb.
Dr. Sachdev has been invited back to India in October to conduct another
seminar to students in various medical fields.