Reducing HIV among India's Most Marginalized

Arupa Shukla - India

Nov. 30, 2007—Like people the world over, Arupa Shukla got her image of the country’s brothels from Bollywood. Lights! Music! Glamour!

Then she went to see one of Mumbai’s commercial sex districts.

“When you go there, you see it’s a very small room with a bed sheet, partitions, a narrow bed. It’s stinking, dirty, with no light,” Arupa says of the disturbing scene she first witnessed about a decade ago. Most of the women have been trafficked from rural areas and forced into prostitution, often by their own husbands. Seeing the place without the romantic filter of a movie camera, she says, “changed my perception and made me think I need to do something here.”

“Here” is the world’s largest demarcated red light district.

Soft-spoken, petite and armed with a master’s degree in sociology but no experience dealing with AIDS, Arupa set her sights on fighting the soaring rate of HIV infection among India’s commercial sex workers. At the time, as many as 65 percent of the prostitutes were HIV positive; nine years later, the infection rate is down significantly, though still unacceptable at 45 percent, Arupa says.

Working for a global nonprofit organization, Arupa oversees strategic planning, communications, worker training and implementation of a number of innovative projects that strive to reduce the occurrence of HIV and AIDS among commercial sex workers and their clients, trucking community, migrants and prisoners. Along with a team of 425 outreach workers, Arupa has helped design cutting-edge programs intended to prevent and treat infections in Mumbai’s most vulnerable populations.

She is particularly proud of the creation two years ago of a women’s collective, called Sangamitra, which has empowered commercial sex workers to speak out on their own behalf—to gain basic rights, to combat the trafficking of children into red light districts and to report atrocities committed by the police. The collective also provides services such as banking, groceries, household items and health insurance. “We have plans to take this to the next level, to make women more self-reliant,” Arupa says.

It is critical, she says, to educate and empower women in order to reduce the vulnerability of women to HIV in India. It’s not an easy task, she concedes, because the vast majority of Mumbai’s commercial sex workers are illiterate. But by teaching them about condom use and by giving them tools toward self-sufficiency, her organization is chipping away at the problem.

“Women are the ones who are carrying the burden,” Arupa says. “The woman is taking care of the children, parents, property. It makes it more important for the focus to be on women so that they can take care of the family.” She would like to make sure that programs for men consider implications to women as well. For instance, she says, many of the clients of commercial sex workers live in rural areas and travel to Mumbai and other cities for work. They have sex, become infected and go home to their wives. If their wives become infected, they have to go to cities to seek treatment. If they get pregnant, they expose their infants to the disease.

And so, Arupa has spent time at truck stops, educating drivers about how HIV is spread and explaining the importance of using condoms. Truck drivers are particularly vulnerable to infection, she says, since they are away from home for long periods of time and often engage in casual sex or visit brothels. Her organization counsels thousands of drivers a month, meeting them at India’s largest truck terminal.

Attending the Advancing Women’s Leadership and Advocacy for AIDS Action workshop in the summer of 2007 opened her eyes to the power of advocacy and of the further need to empower women living with HIV and AIDS, Arupa says.

“I’m compelled to see things differently. I’ve never worked with advocacy before,” she says. “Here [at the workshop], when I see these women, they’re so powerful. These experiences are so powerful. It compels you to think differently.”

Many of her classmates at the workshop were not only working to reduce the spread of AIDS, but also living with HIV themselves. Arupa says she found these women to be especially courageous and inspiring.

“It is amazing to see the strength they have to go on with life,” she says. “It’s unbelievable to see the strength women have.”

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Arupa participated in Advancing Women’s Leadership and Advocacy for AIDS Action, an initiative to equip and empower a cadre of women from around the world with the knowledge and skills to strengthen and lead the global response to AIDS.

You can read more about the initiative here.

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