‘AIDS has exited our consciousness. But it’s here’

The first time we saw Rupa who requests that we identify her by her first name only she is dressed in a bright green saree with gold trimmings She has matched it with goldgreen jhumkas and stands with her back turned to us We tap her on the shoulder and she spins furrowed brows sitting above a pair of bright hazel eyes ldquoNamasterdquo she says ldquowhat exactly do you want to knowrdquoWe have interrupted her during her chat with the staff at the AIDS Healthcare Foundation AHF personnel in Kalamboli Navi Mumbai She is answering their questions about her weight whether she had a fever since her last visit has she stuck to safe sex and does she have medicine in stock It was nine years ago that the trans woman now 32 was diagnosed with HIVldquoI had been unwell for a couple of years in and out of the general physicianrsquos clinic I was a commercial sex worker at the time and one doctor told me to get testedrdquo says the Bihar native ldquoAIDS is very common in the Kinner communityrdquo she says of her transgender brethren ldquoMany of us get into commercial sex work early because we know nothing else to surviverdquoDr V Sam Prasad country program manager for AIDS Healthcare FoundationThe Panvel resident knew it was too late for her but she is doing her bit to educate young trans persons about the use of condoms ldquoWe talk about condom negotiation and how to cajole customers to use one Most of these kids are under 18 and have been in the trade since they were thrown out of their homes or are runawaysrdquoRupa exited commercial sex work after the diagnosis and has followed safe sex and the single partner rule since ldquoI usually roam the Kalamboli highway signal to collect money And I am faithful to my partner I am happyrdquo she says excusing herself she must head to the local shop owner who will convert her coin collection from the previous night to notesSecond from left counselor Dhanushri Deodhar Sister Jancy Joseph from sisers for the Destitute and Dr Divya Mithel with the centrersquos staff PicAishwarya DeodharAHF has a head office in Delhi while the Kalamboli centre operates from a space provided by the Sisters of the Destitute a SyroMalabar Catholic womenrsquos religious institute Its chief medical officer Dr Divya Mithel has been working with the women of this centre since its inception in 1991 when the area was nothing more than a truck stop and a den to acquire drugs and paid sex Dr Mithel says that the centre was initially run with government aid but in 2013 funding was stopped and the AHF stepped in ldquoWith every passing year the age of those getting tested and seeking treatment is dropping We now see a lot of young people five to 18 years old A large chunk of these belong to the queer community and identify as gayrdquoWorryingly this comes at a time when the Bombay High Court said that India must consider lowering the age of consent for sex because after the enactment of the Protection of Children from Sexual Offences POCSO Act 2012 adolescents were being prosecuted for consensual relationships with minor girlsMihir Maher and Bismaya Kumar RauloIn 2015 a survey conducted by online healthcare portal MediAngelscom found that among the 15000 teenagers in six major metros the first sexual contact for boys was at the age 1372 years and for girls at 1409 yearsThis is particularly rampant in the queer community Dr V Sam Prasad country programme manager for AHF explains ldquoWhile the decriminalisation of Section 377 in 2018 came as a big relief to the LGBTQiA community it meant that you could not be jailed for having sex with a person of the same gender The community would now gather without fear Underage queer persons and in particular Men who have Sex with Men MSM and bisexual persons also began to attend these celebratory events and gatherings with fake identityrdquo AHF staff say that a spike in HIV cases in the queer community is being reported in centres in both Mumbai and Delhi ldquoSymptoms begin to show typically six months after unprotected indiscriminate sex The minors then used the same fake identity cards to visit our centres We ensure that they are tested counselled and handed medication If we insist that they come with a guardian they will never return Our experience has also revealed that they are using social media to connect with adult men from the community There is no way to verify age online you are as old as you say you arerdquoA major deterrent for minors to get tested and opt for antiretroviral therapy ART which suppresses the HIV virus and prevents it from thriving is the need for them to be accompanied by an adult This believes Prasad is a big reason why medical help isnrsquot being sought ldquoThe stigma of being an HIV infected person coupled with the shame of being queer makes matters worserdquoAHF has tied up with Impulse a volunteerbased organisation that works with members of the queer community on HIV and Sexually Transmitted Infections STI drug prevention and mental health to host awareness and communal events Mihir Maher president Impulse Mumbai says that no minors are allowed here ldquoWe only connect with them online In metros like Mumbai we see that underage persons have easy access to information and multiple dating apps Simply entering on inaccurate birth year allows you to use Grindr Bumble and Tinder Many users are minors who do not know enough about safe sexual practices and end up with HIV and STIrdquoAccording to the Mumbai District Aids Control MDACS Mumbai has registered 1616 HIV cases Of these approximately 50 are under 18 says an official The total number of positive cases stood at 1245 last year and was 1158 for 202021Bismaya Kumar Raulo Impulse India program manager has been living with HIV since a few years ago They are particular he says about screening minors at their events that are held three times a week across Mumbai and Delhi ldquoWe must stop encouraging condom negotiation with those who are not in commercial sex work The queer community must go with the nocondomnosex rulerdquo says Raulo over the phone from Delhi ldquoOne Saturday we decided to place an HIV testing booth at one of our events in DelhiOf the 96 visitors who got tested that day 125 per cent were HIV reactive We cannot deny that the community is in fact at serious riskrdquo An HIV reactive result could be a sign of an HIV infection but itrsquos not the same as a positive result ldquoWe are trying to work with members of the queer community who tend refuse to seek help from an NGO or government organisation because of the stigma of being called out as MSM and HIV infectedrdquoAt the Kalamboli centre counsellor Dhanashri Salunke is talking to a young man who tested HIV the previous day He is accompanied by a friend who whispers to him ldquoEverything will be alrightrdquo When we ask the friend where they are from ldquoGujaratrdquo he saysThe centre gets a large number of patients from Bihar Rajasthan and Gujarat ldquoThey donrsquot want to go to centres in their villages since they fear being outed as both gay and infected AIDS may not be the looming monster it was in our minds some time ago but itrsquos very much hererdquo says Salunke