Comment

Welcome to indifference, mutated

SOME years ago, I was part of a panel discussion in Austin, Texas, on the Babri Masjid/Ram Janmabhoomi wrangle. I’m less concerned here with what the dispute is about – meaning the angry and intricate arguments, the stated and real motivations of the players – than that it has brought simmering Hindu-Muslim tensions into the open like never before in our 56 years. The riots in Bombay a decade ago and the orgy of killing in Gujarat in 2002 are only two fallouts. There are times when I can’t help thinking these tensions now threaten India’s very survival: I feel that sword hanging over my Indian head.

That said, that day in Austin we were all very civil and friendly. A graduate student friend from Orissa spelled out the Hindu viewpoint. A bright young Pakistani spoke for Muslims. And me? I was secularism’s spokesman – if a reluctant one, for reasons I hope will be clear by the end of this article – for the evening.

I hope I don’t need to tell you whom the audience showed the least interest in. Me. Oh, I went prepared with a raft of what I thought were powerful, appealing arguments to preserve secularism, to explain that it was the only hope for India. But while the audience reacted passionately to both my colleagues, I got a polite smattering of claps and not one question. Secularism, at least as I articulated and defended it that day, left everybody utterly indifferent.

Surely, you think, such indifference is the fate of the ‘fence-sitter’, the opinion that straddles the middle. Except for two things. One, I don’t believe secularism has any future if it is outlined as a fence-sitting idea. In fact, I think the seeds of its failure in India today lie right there. Two, in the years since that panel discussion, there seems to have been a definite evolution in the way secularism is viewed. Today, the object of the greatest venom from a champion on one side of the Babri Masjid tussle is not the champion on the other side, but the secularist who thinks he sits safely in between. While the champions almost feed off each other and grow, they positively hate the secularists. A once indifference has mutated into this hatred.

Why?

The second of those two things, first. When you are firmly in the saddle on one side of a tortured dispute, you know exactly where your opponents are: as firmly established on the other side. You don’t see eye-to-eye with them, you can’t stand what they say, but you have a certain understanding of exactly what their position is. Likewise with them. That understanding is good for you. It makes you clearer about your own position. It shores up your support.

Naturally, this is not some trenchant insight that nobody has had before. For example, leaders of Islamic parties in Pakistan frequently say that the rise to political strength in India of the party that claims to speak for Hindus, the BJP, is just the tonic for them. It serves to bring them more supporters in Pakistan, especially more fervent supporters. Which party would blink at that? The same applies in reverse. The stronger those Pakistani parties become, the more persuasively the BJP and its parivar can make their case for the great Islamic threat to Hinduism, to India itself.

And the man who sits in between, repulsed as much by rising Islamic fanaticism as he is by the rising thugs who seek to claim Hinduism? He finds he is seen as the real threat to both sides.

There was a spot-on illustration of this phenomenon three years ago, when the Syedna, spiritual head of the Bohras, boarded a plane for Bombay in Indore. Now the Syedna holds absolute sway over his sect. Every aspect of the lives of the faithful – births, marriages, deaths – is subject to his gaze and intervention. At least as seen from the outside, though no doubt Bohras will disagree, the Syedna and his followers are a model of the grip orthodox religion can exert.

Also on the flight that day was the well-known Bohra dissident and reformer, Asghar Ali Engineer. Innumerable times, Engineer has publicly criticised the Syedna for his practices. Naturally, his presence on the flight was an irritant to the Syedna’s travelling supporters. As he later revealed to Outlook magazine, two of them told him: ‘You shaitan, get down and see what happens to you!’

What happened to the ‘shaitan’ was that in the terminal at Bombay, three men assaulted him. One had been on the flight, the other two were from among the hordes who had turned up to greet the Syedna on arrival. The assault continued for several minutes. Engineer fell to the ground, bleeding. Eventually the police rescued him and took him to Nanavati hospital.

Meanwhile, more of the Syedna’s followers paid visits to Asghar Ali’s home and his poky office in Santa Cruz. These were not courtesy calls to express concern for his health. No, they ransacked both places, up to the fans on the ceiling. As Engineer wrote to me some days later: ‘My household things have been destroyed completely. Office computers were also destroyed.’

The assault apart: the Syedna represents, you would think, exactly the kind of obscurantism the BJP has always derided among Muslims. Therefore, you would think, they would support Engineer’s efforts to stand up to the Syedna. You would think. But doing so, you would overlook Engineer’s equally loud critique of the kind of obscurantism the BJP has been riding for years.

To the BJP, Engineer is the greater threat than the Syedna. For his arguments against the Syedna apply just as well – maybe better, and anyway Engineer certainly applies them just as diligently – to the BJP and its ideology. He sees perversion equally on both sides: in the grip the Syedna maintains on his flock, in the cynical politics of the BJP. To both, therefore, he is the enemy. After all, there’s an odd trust you can place in an opponent: that he will have his diametrically opposite views that sharpen your own. But the guy in the middle? If he finds your opponent’s views repugnant, he objects to yours too. How then can you trust him, pin him down?

So it was that the day after the flight, several of the Syedna’s supporters went to the police to make a complaint against Engineer. Far from them attacking him, they claimed, it was actually Engineer who had assaulted them and the Syedna. To anyone who knows Engineer – a gentle sixty year-old – this is a laughable accusation. But leave aside its doubtful merits to ask: Who accompanied this delegation to the police?

Answer: Two prominent Bombay politicians – ex-Housing Minister Raj Purohit and Atul Shah, MLA. Both belong to the BJP.

And that is the truth about the way secularists have come to be seen today: as the common enemy of obscurantists of every stripe. There was a time when Engineer would have been ignored as an irrelevance. But today it’s simple: He is hated. Whether the Syedna’s supporters or the BJP’s family members: their purest vitriol, always, is reserved for the secularist.

This has something to do, as I explained above, with the very nature of fence-sitting. But in India, it also has to do with the way we have treated secularism: the first of those two things I mentioned. As long as we define secularism as we have – as equal respect for all religions – it seems to me that we guarantee its failure. This is both related to and subtly different from the evolution of indifference to hatred that I have spent some paragraphs on.

Let me explain this with some thoughts about holidays.

Any number of people write me angry notes about public holidays in India. The lack of ‘Hindu’ holidays, they say, is another way Hinduism is ‘being denigrated’ – an actual quote – in this country. (Not that it doesn’t happen outside this country. ‘The Indian Consulate in New York,’ I heard from an always sarcastic correspondent recently, ‘will be closed this year for four American holidays, two Christian holidays, one Jain holiday, one national holiday, one Buddhist holiday and four Muslim holidays. No wonder the BJP government is very pro-Hindu!’).

Such holiday-counters rattle off various ‘Hindu’ occasions that should be holidays but are not. They calculate the ‘percentage’ of Christian holidays, say, and compare that to the percentage of Christians in the population. The mismatch in favour of the holiday percentage, they pronounce, is even more evidence of the ‘anti-Hindu’ propensities of Indian governments. Yes, there are actually people doing these arcane calculations. (Allow me my share as well. If there was just one Christian holiday, there would have to have a minimum of fifty all told. Any less, and the percentage of Christian holidays is higher than that of Christians in India – two per cent. We have Christmas, but never have we had close to fifty public holidays. Therefore, our governments are anti-Hindu and pro-Christian. QED).

Calculations aside, you might note that the Indian calendar is already crowded with holidays for Hindu festivals like Holi, Diwali, Janmashtami, Dassehra, Navratri and Ganesh Chaturthi, with many regional variations. But if you’re inclined to see ‘denigration’ and ‘anti-Hindu’-ness under every stone, that argument doesn’t convince. If every single day of the year was a holiday, you would still unearth insults.

So instead, I wonder how giving people opportunities to laze about at home – or agitating for yet more opportunities to do so – amounts to respect for religion. For anything. Do you ‘respect’ a religion by declaring yet one more holiday?

And when I wonder like that, my thoughts lead inexorably to one conclusion: ‘equal respect’ for all religions – which is how we came to have our long list of religious holidays – is a myth. Or, since we are discussing secularism, let me put it this way: secularism, defined as equal respect for all faiths, is a myth. It cannot work. To me, a firm agnostic – which is why I was unhappy defending our notions of secularism on that Austin panel – it makes no sense, and I can see why it makes no sense to religious-minded folks.

The pursuit of ‘equal respect’ will necessarily produce disgruntled souls digging wherever they can for ‘denigration’. Here we’re told that an article that pokes gentle fun at Catholics in Bombay insults their faith; there a comment about Mohammed by a disreputable Christian evangelist abuses Islam; over in that corner sit the fellows totting up denigration in the calendar.

Why all this? Because the idea of respecting all faiths equally is a close cousin to the idea of pleasing everybody. Some genius saw fit to give us the aphorism that warns against that second idea: ‘You cannot please everybody.’ We’ve all heard that, and no four words are truer. Unfortunately, nobody warned us against attempts to give equal respect to all religions. So we try, and try again with well-intentioned, if muddle-headed, purpose – and manage only to annoy ever more people. To the extent that we all begin to suspect the good intentions themselves.

Time for a change, I suspect. And perhaps for this radical thought: the only way the state can truly respect all religions is by offering them none.

Let me quickly say that I am not advocating mass conversions to atheism or agnosticism. (Though frankly, we agnostics don’t care one way or another). What I am questioning is the idea, sold to us in India by giants like Nehru and Gandhi, that secularism must mean equal respect for all religions; more, that a state can actually achieve that equal respect.

‘Sarva dharma samabhava’ – we heard it from those giants and from successors who aren’t half the men they were anyway. But today, as the secularism they wished for us crumbles into failure and hatred, when ‘Nehruvian secularism’ itself is an insult, when Nehru and Gandhi themselves are ridiculed, we can only conclude: it was an exercise in futility.

Or let me put it this way: to the state, secularism must mean an equal indifference to all religions. Or it means nothing. Where indifference was once how secularists were treated, I’m suggesting today that indifference must be the foundation of a new secularism. A true secularism.

Just two implications of such indifference here.

One, leaders will refrain from pious statements about our ‘vaunted’ secularism every time we spit on it as we did in Gujarat in 2002, or in Bombay in 1992-93, or in Delhi in 1984. Our leaders clutch at such straws because the rest of us are so profoundly disillusioned with what passes for secularism. But changing the way we look at it might spur us to something more than empty words from empty leaders. We might learn to actually punish rioters and hate-mongers, whoever they are, instead of hiding injustice behind meaningless words like ‘vaunted’. That, in turn, can only work to give secularism new meaning.

Two, the state shuns anything to do with any religion. No Satyanarayana pujas in public sector offices; no interference in religious institutions; no observances of any kind at the start of government sponsored functions. And not one religious holiday on the calendar. You are welcome to do these things, but do them on your own time. Those who want to observe their Good Fridays or Ids, Patetis or Diwalis, can do so by using one or more of, say, fifteen optional holidays employees are entitled to take through the year. The state will recognize just one holiday, August 15. (Though I have reservations about even that one).

This way, we undermine the whiners combing the calendar for insults. When nobody gets official holidays, nobody can claim disrespect. (At least from the calendar).

That hints at the true benefit of such a view of secularism. You don’t foster respect by trying to cater to every faith. As we have learned with tragic effect (or maybe we haven’t learned), that breeds streams of moaners and hatred, demagogues and Indian blood shed. No, respect comes instead, and only, from being firm and fair. It comes from single-mindedly, in an almost Machiavellian sense, slicing away every chance to claim disrespect.

And to me, the only way to do that, where religions are concerned, is for the state to stay away from every single one.

People balk at separating church and state so explicitly. They think it negates some deeply felt human need for religion, or maybe – awful thought! – it amounts to godlessness. Wrong. It means neither. Such separation, maintained strictly in a wildly diverse country, is the clear-eyed view of secularism we have never had. It is a break from secularism’s fence-sitting past, the way to a precisely articulated and diligently pursued future. It is the only way this greatly reviled idea can regain meaning and relevance.

Now that’s worth some respect.

Dilip D’Souza

 

India’s AIDS control programme

CONVENTIONAL wisdom suggests that a combination of HIV prevention interventions that include behaviour change communication, STI control, voluntary counselling and testing (VCT) and prevention of mother to child transmission (PMTCT) – focusing on the most vulnerable populations are hallmark best practices for AIDS control programmes and policies (Global HIV Prevention Working Group, 2003). Accordingly, as highlighted in the December 2002 issue of Seminar (520), India’s National AIDS Control Organization (NACO) has implemented awareness campaigns, STI control efforts, targeted interventions for high-risk groups, VCT centres, and is scaling up the PMTCT programme. Nonetheless, critical gaps remain in India’s current National AIDS Control Programme (NACP-Phase 2). These gaps are likely to undermine the effectiveness of the AIDS control programme in failing to address four underlying realities that are the hallmark of the HIV/AIDS pandemic and the responses to it, both globally and in India.

The first is that this epidemic is fuelled by inequities: gender, economic and social. Second, a majority of HIV infections are sexually transmitted, whereas in most societies sexual behaviour and sexuality are issues cloaked in shame, secrecy and moral posturing. Third, the epidemic poses an additional burden on government health infrastructures that are already crumbling due to a history of neglect and poor allocation of resources. And last, the defining characteristic of this epidemic has been stigma and discrimination, which has resulted in denial and violation of human rights of individuals and communities affected by HIV/AIDS. In this note, I examine three key components of India’s AIDS prevention strategies – the IEC and awareness programme, STI control, and targeted interventions through the lens of the four realities articulated above.

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 heard of AIDS’ has indeed significantly increased. However, as NACO’s behavioural survey shows, awareness levels 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 areas and 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 sexual fulfillment and well-being are not only fundamental human needs but also a human right. We also know that if 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 of the few on the sexual and reproductive rights of all are in fact counter-productive to behaviour change, risk reduction, and preventing HIV.

Globally as the epidemic enters the third decade, our understanding of prevention strategies that work reveals that knowledge and awareness of HIV transmission is insufficient to bring about behaviour change. This is especially the case for women who, in most societies, including India, are unable to negotiate safe sex due to unequal gender relations. For example, cultural and social norms (legitimized as ‘traditions’) overlook men having multiple sexual partners as an expression of ‘manhood’, while denying women even the most basic information about their bodies to protect their virginity and honour. Such norms make it difficult for women to even initiate conversation about sex and contraception with their partners.

HIV/AIDS awareness messages in India either perpetuate stereotypes or at best remain neutral in addressing negative gender and sexual norms that are fuelling this epidemic. For example, many awareness programmes emphasize that men engaged in high-risk behaviour use condoms with sex workers, but don’t emphasize the same with wives who remain unaware, uninformed and unprotected. For Indian women, most awareness programmes have not even begun to address their risk and need for prevention information. This need goes well beyond the minimal knowledge of the virus and how it is transmitted, to include topics such as reproductive anatomy and physiology or concepts such as virginity, masculinity, honour, shame, sexual double 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 messages do play a critical role in promoting equitable norms and creating an enabling environment in which individuals can adopt behaviour change.

STI control is another key HIV prevention strategy that India’s AIDS programme has adopted. The importance of STI control was determined in the early ’90s when the role of STI in facilitating HIV transmission was established. In resource poor settings, the WHO recommends syndromic management as the standard of care for STI treatment. Accordingly, strengthening STI clinics in district hospitals and training medical providers at the primary care level in syndromic management is the strategy of choice in India’s AIDS programme. Examining this strategy from a health systems perspective reveals the following. At present, strengthening STI clinics, setting guidelines, and training in district hospitals is the mandate of NACO as part of the AIDS control programme. Whereas, strengthening services for Reproductive Tract Infections (RTI) including STI in primary and secondary health facilities is the mandate of the Ministry of Health and Family Welfare at the central level as part of the Reproductive and Child Health (RCH) programme.¹ 

Evidence points to a lack of a uniform, coordinated strategy in the implementation of STI control efforts at the different levels of the government health system resulting from a fragmented and vertical implementation of the AIDS control and the RCH programmes. For example, a report by the Task Force on Health and Family Welfare in Karnataka (2001) identifies that efforts to respond to the HIV epidemic in the state have remained inadequate in light of the rapidly increasing infection rates in the general population. The report describes one reason for this as the vertical implementation of the HIV/AIDS programme from the state’s Ministry of Health and Family Welfare activities, resulting in the latter not responding to the HIV/AIDS problem. Furthermore, at the primary care level, under the RCH programme mandate, STI control efforts compete with child survival and maternal health, resulting in a low priority given to STI services by Karnataka state’s Ministry of Health and Family Welfare.

In addition, inadequate investment in health services by state governments has resulted in poor health care infrastructure in terms of inadequate staffing, training, drugs, referrals, monitoring, and supervision at all service delivery levels. This provides the backdrop in which STI control and HIV prevention efforts are being undermined within the government health system. According to the Karnataka Task Force report (2001), without linkages among HIV/AIDS, RTI/ STI and TB programmes, and given low allocation of resources, primary, secondary and even tertiary health facilities lack simple diagnostics and drugs.

Surveys of healthcare providers in Andhra Pradesh and Maharashtra reveal that basic laboratory facilities including working microscopes, diagnostics for syphilis, incubators and gram stain reagents are missing in a substantial proportion of facilities. Many STI providers do not ask about sexual risk, or conduct physical examinations, or counsel the patient about condom use facilities (FHI a & b, 2001). Therefore, India’s AIDS control programme needs to (a) strengthen clinical management with training in-patient counselling and behavioural risk assessment; (b) strengthen services with laboratory facilities; and (c) ensure a regular supply of STI drugs.

Data on STI recognition, healthcare utilization and treatment-seeking behaviour from India demonstrate additional gaps in the STI control strategy adopted in the AIDS programme. For example, NACO’s (2001) behavioural surveillance indicates that awareness and recognition of STI symptoms is much lower compared to HIV. Access to district level hospital facilities as the first point of contact with the healthcare system is often limited to urban and peri-urban populations. Furthermore, studies on healthcare seeking from India show that women are less likely than men to seek treatment for numerous reasons, such as a perception that STI symptoms are normal, feelings of shame, and a lack of resources and mobility. Where treatment is sought for STI, it is mainly in the private sector or in primary and secondary health facilities, where in any case the referral system and the quality of care are often poor (Amin, 2000).

Analysis of the STI control efforts highlights that the AIDS control programme needs to place a greater emphasis on recognition of STI symptoms and appropriate treatment seeking. Furthermore, there needs to be some level of integration of the AIDS control with the RCH programme, as they both have the mandate to address RTI/STI. Without coordination between these programmes and health services in terms of setting guidelines, resource sharing, training, and support, the effectiveness of STI control through the government health system is likely to be limited. Likewise, without HIV/AIDS advocacy efforts also focusing on strengthening and improving the deteriorating government health system, effective implementation of HIV/AIDS control strategies through the government health system is likely to be undermined.

Last, looking at the ‘targeted interventions’ approach as another cornerstone strategy of India’s AIDS control programme, several issues emerge. The targeted intervention approach has translated the concept of ‘targets’ narrowly into ‘high-risk groups’ defined as sex workers, truck drivers, migrant workers, injection drug users (IDU) and men having sex with men (MSM). This approach derived from the epidemiological standpoint of prioritizing allocation of scarce resources where they are most needed makes sense. However, from a human rights perspective, defining ‘high-risk groups’ or ‘core transmitters’ in official parlance and awareness campaigns as members of groups that are already seen as social outcasts has contributed to a circle of blame, stigmatization and hence, further marginalization of those who are most vulnerable to infection.

For example, let us take the case of sex workers in India. Despite prostitution being technically legal under the Immoral Traffic in Persons Prevention Act of 1986 (PITA), sex workers have long been stigmatized and subjected to frequent police harassment. With the advent of the AIDS epidemic, sex workers were both targeted as core transmitters and recruited as peer educators. As it happened with the gay community in the 1980s in the U.S., where the epidemic was perceived as a problem of homosexuals, the ‘risk group’ approach in India has contributed to the perception that HIV/AIDS is a problem of sex workers and truckers. A recent report of the Human Rights Watch (2002) reveals that police abuse of sex workers has remained unabated and in fact expanded to target NGOs, outreach workers, and peer educators who are providing life-saving HIV/AIDS information and condoms to sex workers.

From a behaviour change perspective, the construction of ‘risk’ as a problem of the ‘other’ results in individuals not perceiving risk to themselves as they may not identify themselves with such ‘risk groups’. And indeed, behavioural surveillance data indicate that perceiving risk of HIV to one’s self is abysmally low in almost all groups that have been surveyed (FHI c, 2001). Instead, people perceive that sex workers and their clients are vulnerable, but not themselves. Finally, the targeted intervention approach also fails to reach other populations at risk, such as married women and adolescents. This when prevalence rates among married women attending antenatal clinics are reaching as high as 4-5% in some districts (U.S. Census Bureau, 2000). As the epidemic inexorably becomes generalized – as is the case in Andhra Pradesh, Manipur, Maharashtra and Karnataka – the need to find ways to reach populations such as married women and adolescents becomes imperative.

Increasingly it is being realized that AIDS control programmes must be based on a foundation of strategies that (a) promote gender equity; (b) protect human, sexual and reproductive rights and freedoms of all; (c) strengthen healthcare systems to ensure delivery of quality services; and (d) address stigma and discrimination. I have argued here that at present India’s AIDS programme does not address any of these underlying premises and realities. Awareness programmes focus either on technical information or fear inducing themes. Neither is sufficient to bring about behaviour change, which at minimum requires efforts to bring about normative changes in how society views sexual and gender relationships.

STI control strategies at the district hospital level are not sufficient, if treatment is primarily being sought either in the private sector or primary and secondary care facilities, and the quality of services in the government health facilities at all levels is poor. Therefore, tackling HIV/AIDS prevention, especially at scale, will simultaneously require improvements in the government health system. The targeted intervention approach has been narrowly construed, contributing to the further stigmatization of groups that are already marginalized, and neglect of populations like married women that are increasingly at risk. Therefore, the concept of ‘risk’ needs to be delinked to specific ‘groups’ and instead defined in terms of ‘vulnerability’. As India moves to prepare for the Phase 3 of the AIDS programme in the coming year, it is perhaps the right moment for policy-makers and donors to take a stock of these realities and address them more concretely.

Avni Amin

 

Footnote:

1. The HIV/AIDS and Reproductive and Child Health (RCH) are centrally designed and funded programmes. While the AIDS control programme is being administered through autonomous State AIDS Control Societies (SACS) established in each state, the RCH programme is being administered and implemented through the Ministry of Health and Family Welfare in each state.

 

References:

A. Amin, Gender, Empowerment and Women’s Health in India: Perceived Morbidity and Treatment-Seeking Behaviour for Symptoms of Reproductive Tract Infections among Women of Rural Gujarat. Baltimore, MD: Doctoral Dissertation Thesis Submitted to the Bloomberg School of Hygiene and Public Health, Johns Hopkins University. 2000.

Family Health International (FHI a). Health Care Provider Survey in Maharashtra. Mumbai: AVERT Society. 2001.

Family Health International (FHI b). Summary Report: Health Care Provider Survey in Andhra Pradesh, India. Hyderabad: Andhra Pradesh State AIDS Control Society. 2001.

Family Health International (FHI c). Communication Needs Assessment in Maharashtra. Mumbai: AVERT Society. 2001.

Global HIV Prevention Working Group. Access to HIV Prevention – Closing the Gap. http://www.unaids.org/publications/Prevention130503_en.pdf. May 2003.

Human Rights Watch. Epidemic of Abuse: Police Harassment of HIV/AIDS Outreach Workers in India. Vol. 14, No 5. http://www.hrw.org/reports/2002/india2/india0602.pdf. July 2002.

National AIDS Control Organization (NACO). National Baseline General Population Behavioural Surveillance Survey (BSS). New Delhi: Ministry of Health and Family Welfare, Government of India. http://www.naco.nic.in/nacp/bss5.pdf. 2001.

Task Force on Health and Family Welfare, Karnataka: Towards Equity, Quality and Integrity in Health, Final Report. Bangalore: Government of Karnataka. April 2001.

U.S. Census Bureau. HIV/AIDS Surveillance Database. International Programmes Centre: Population Division. http://www.census.gov/ipc/hiv/india.pdf. June 2000.