January/February #169 : Till Death Do Us Part - by Isabell Zipfel

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Till Death Do Us Part

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January / February 2011


Till Death Do Us Part

by Isabell Zipfel

How marriage puts women in India—and around the world—at risk of contracting HIV

 

Click here to read a digital edition of this article.

India is ranked third in the world in terms of the number of people living with HIV, but because the country has such a large population (an estimated 1.15 billion), its prevalence rate of HIV remains relatively low overall. Nonetheless, some communities do face elevated risk of exposure to the virus. One such group is married women—they have little or no power to protect themselves from husbands who have sex and/or use injection drugs beyond the marriage. This phenomenon is true in many other countries as well, including the United States.


When HIV enters a marriage in India, often the wife is cast aside. With high levels of HIV-related stigma, low general awareness about the virus, and a patriarchal society that prevents women from advocating for their health, India is a prime example of how marriage can be a barrier to preventing, and surviving, HIV/AIDS. Eighty percent of infections in India occur through heterosexual sex, and women account for 39 percent of adult infections.

Here, photojournalist Isabell Zipfel comments on the state of AIDS in India and shows—through the stories of three women living with HIV—how greater rights for women could mean fewer cases of HIV/AIDS not just in India but all over the world.


In India, HIV evokes more than just an infection; the term is more a repository for all sorts of fears, prejudices and rumors. For many people with HIV/AIDS, the social ostracism and exclusion are almost worse than the infection itself. Many try therefore to keep their HIV status quiet.

The criminalization and social exclusion of so-called “risk groups” (men who have sex with men—MSM—sex workers, injecting drug users) further contribute to the fact that many cases of new HIV infection are not reported.

Thus the paradox arises that in spite of a growing infection rate, the HIV status of people in India remains largely hidden. According to the 2010 Global Report from the Joint United Nations Programme on HIV/AIDS (UNAIDS), the country has an estimated 2.4 million people living with HIV/AIDS—but that figure could be significantly higher, as many people do not get tested. 



India’s health system further ensures the discrimination and stigmatization of people with HIV/AIDS. The medical records of those affected are often insensitively handled, and people living with HIV frequently receive worse service than other patients. In some cases, they are completely denied any sort of medical treatment.

Together, these factors seriously hinder efforts to adequately treat people with HIV. They also undermine prevention and education programs.

India’s patriarchal structure and the systematic way it places women in positions of weakness heighten women’s vulnerability to HIV/AIDS. In India, many women have no right to sexual self-determination. And because of India’s age-old traditions, most do not choose whom to marry or when. Today, it’s estimated that 90 percent of all marriages in the country are arranged marriages.

If women become HIV positive, they experience further discrimination, particularly since wives are frequently held responsible for their husbands’ HIV status. Even though it is often the men who bring HIV into the marriage, it is the women who will be socially ostracized and banished from the marital home.

Because women mostly do not have their own income, there is often nothing else they can do other than to return to their parents’ house—if they are even allowed to come home. Many are not as this amounts to an admission of their failure as a wife and daughter. The result for many is that a positive status brings drastic and immediate restrictions in economic, social and interpersonal resources.

People with HIV/AIDS in India feel compelled to live outside the usual traditions and norms, in a world in which rules of caste and religious membership are no longer valid. People living with HIV have to find a new place for themselves in the rigid and hierarchical Indian society. In short, they have to reinvent themselves—and their lives.

The following three stories showcase that truth. They were told to me by three Indian women who contracted HIV while married. Their names are concealed to protect their privacy and safety.

I carried out the photo reportage and life history interviews mainly in Delhi. DPWN (Delhi Positive Women Network) provided me with valuable help in making contacts locally.

Pages: 1 | 2 | 3

Search: marriage, India, arranged marriages, Isabell Zipfel, Delhi Positive Women Network, infidelity, prostitution, injection drug use


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