I arrived in India late last night and was greeted by thick, muggy air, the blaring horns of 10,000 taxis, stray, hungry dogs, and an overwhelming sense of gratitude for the journey that I am embarking on. I am here to visit the YouthAIDS programs that have been established in Mumbai, Delhi, and Jaipur. YouthAIDS actually has programs set up in 22 states throughout India, but we are only visiting the areas that are at the highest risk. The purpose of this trip is two-fold. First to raise awareness about HIV among those most at risk including commercial sex workers, their clients, MSM's (men who have sex with men), and IDU's (intravenous drug user's). We are also here to engage the corporate sector, U.S. and Indian companies that have Indian interests, to continue educating them about raising awareness within their industries about social responsibility, taking a stronger role in communicating the crisis to their employees (especially the migrant workers), and to continue raising money to support organizations like YouthAIDS. Each day we will be traveling around these various cities observing and participating in the different programs. These programs will include visiting HIV prevention and client intervention programs, wellness clinics for sex workers, rural birthing centers, public hospitals, peer education and brothel programs, as well as, voluntary counseling and testing centers. We will also be seeing street theatre geared towards the illiterate, meeting the traveling physicians that are permitted to see women in brothels whom are not allowed to leave (sex slaves), and experience the social marketing of condoms, behavior change communications and help lines.

To prepare for this trip, it was important for me to understand how the HIV/AIDS crisis has affected the Indian culture. Considering the countrywide poverty, I wasn't at all surprised to know that the statistics are staggering, especially for young women. Kate Roberts, the founder of YouthAIDS, explained that the "Inequities, driven by overwhelming poverty in India, affect both male and female children. Yet cultural traditions, scant economic resources, and limited opportunities marginalize young girls. Young boys have better access to health care, nutrition and education. Gender bias is reinforced throughout adulthood as men retain economic and political power."

It is common knowledge that the women in India are often a disenfranchised group, without status or rights. When marriage or work opportunities are not available, some women turn to prostitution to avoid starvation. Because of my background working with prostitutes, I'm excited that we will be engaging directly with commercial sex workers and their clients. The "trucker route" is one of the fastest ways that HIV/AIDS is spreading throughout India, and women, on a global scale, are at a much greater risk for infection. Considering that 60 percent of the population that contracts AIDS will be women, it is important that we make them aware that there are measures to be taken to protect themselves and prevent further infection.

Here are some of the facts that I gathered to give you a better understanding of the crisis as it is affecting India and her people:

• 1,080,264,388: Population of India (July 2005 est.).


• 5.7 million: Estimated number of people living with HIV by the end of 2005.


• 0.9 percent: Estimated percentage of adults living with HIV/AIDS by the end of 2003.


• 1.6 million: Estimated number of women (ages 15-49) living with HIV/AIDS by the end of 2005


• 270,000-680,000: Estimated number of deaths due to AIDS during 2005

India has among the highest number of persons living with HIV/AIDS in the world today, although the overall prevalence remains low. Some states experience a generalized epidemic with the virus transmitted from high-risk groups into the general population. A major challenge is to strengthen and decentralize the program to the state and district levels to enhance commitment, coverage and effectiveness.

Risk and Vulnerability

Several factors put India in danger of experiencing a rapid spread if effective prevention and control measures are not scaled up and expanded throughout the country. These risk factors include:

Unsafe Sex and Low Condom Use: In India, sexual transmission is responsible for 84 percent of reported AIDS cases. HIV-prevalence rates are highest among sex workers and their clients, injecting drug users, and men who have sex with men (many of whom are married). When surveyed, 70 percent of commercial sex workers in India reported that their main reason for not using of condoms was because their customers objected.

Migration and Mobility: Migration for work for extended periods of time takes migrants away from the social environment provided by their families and community. This can place them outside the usual normative constraints and thus more likely to engage in risky behavior. Concerted efforts are needed to address the vulnerabilities of the large migrant population.

Injecting Drug Use (IDU): Studies indicate that many drug users are switching from inhaling to injecting drugs. This phenomenon is more localized in the Northeastern states of India, and injecting drug users show sharp increases in HIV prevalence. Forty-one percent of IDUs in a national survey reported injecting with used needles or syringes. Of those who cleaned their needles and syringes, only three percent used an effective method such as alcohol, bleach, or boiling water. Appropriate strategies are also needed to address the double impact of drug use and unsafe sexual practices.

Low Status of Women: Infection rates have been on the increase among women and infants in some states. As in many other countries, unequal power relations and the low status of women, as expressed by limited access to human, financial, and economic assets, weakens the ability of women to protect themselves and negotiate safer sex, thereby increasing vulnerability.

Widespread Stigma: Stigma towards people infected with HIV/AIDS is widespread. The misconception that AIDS only affects men who have sex with men, sex workers, and injecting drug users strengthens and perpetuates existing discrimination. The most affected groups, often marginalized, have little or no access to legal protection of their basic human rights. Addressing the issue of human rights violations and creating an enabling environment that increases knowledge and encourages behavior change are thus extremely important to the fight against AIDS.

After reading these sobering statistics perhaps you have a better understanding of the gratitude I'm feeling at being able to participate and serve this culture. My own life was transformed by the gift of yoga. Everything that I am and intend to be is directly influenced by some of the great Indian teachers and philosophers including Pantanjali, Gandhi, Sri BKS Iyengar, Sri Pattabhi Jois, Sri Aurobindo and the Mother, Amritanadamayi (Ammaji) and Neem Baba Karoli, to name only a few. Their words and the actions they've taken in their lives have impacted me as a humanist. Through their teachings I am committed to manifesting positive thoughts into global action, and to try to make a difference in the world and to the people whom inhabit it. It is the traditions of the Indian culture that taught me worship and devotion, and the words of these great beings that taught me to respect and celebrate God, life, and other human beings. The yogic philosophy, "we are all one" is the understanding I choose to live by, and to be able to practice this belief in the culture that inspired it is a privilege. It is this opportunity to be of service to these men and women, the indirect decedents of my teachers, that I am entirely grateful for and I intend to do whatever I can to make a difference.