November 30th 2025.
Jyoti Dhawale's early adulthood was filled with struggles and hardships that constantly left her with new wounds before the previous ones had a chance to heal. Coming from a military family that frequently moved around, she was already dealing with partial deafness and the challenges of growing up with a stepmother when she was diagnosed with HIV in 2005. This led to violence, loss of custody of her only son, and ultimately, homelessness.
Despite all the obstacles she faced, Dhawale managed to turn her pain into a purpose and became an HIV changemaker and a global ambassador. Her journey is often compared to the rise of a phoenix, but she acknowledges that the stigma surrounding HIV still exists. "Even though the current environment offers better tools, community support, and understanding, the emotional and social battle remains," she says.
Over the past two decades, a lot has changed for people like Dhawale who are living with HIV. "Medical care, awareness, and access to therapy have greatly improved," she says. "People like me can now live long and healthy lives. While a cure is still far away, our daily medication gives us hope for a better future." Her story reflects the progress that India has made in its fight against HIV.
India's Response to HIV
When the Human Immunodeficiency Virus was first detected in India in 1986 among female sex workers in Chennai, the country was still learning about public health. Due to the strong taboo surrounding HIV and the misconception that it only affected "high-risk" groups, the threat was largely ignored and did not receive the necessary attention, even as infections among sex workers, truck drivers, and the general population continued to rise. By 1996, HIV had become a major health crisis in India, making it one of the world's fastest-growing HIV hotspots.
However, India's response to the virus has been remarkable. The country's National AIDS Control Organisation has been leading the efforts since 1992 through various programs and initiatives that focus on early detection, intervention, and surveillance, particularly among heterosexuals, men who have sex with men, trans-people, and other sexual and gender minorities. As a result, the prevalence of HIV among adults has decreased to 0.2%, and there has been a significant decline in new infections and AIDS-related deaths.
Today, over 95% of people who test positive for HIV are quickly connected to medical care. The goal is to reduce new infections and AIDS-related deaths by 80% by 2030. However, as India enters its 40th year of fighting against HIV, it is evident that there is still work to be done. Despite the progress in faster testing, better treatment, and effective prevention, the country's social attitudes and behaviors have not kept pace with its health systems.
Challenges and Concerns
"Although India has the third-largest number of people living with HIV globally, the low prevalence rate of 0.2% makes it difficult to identify and connect with those who need care," says Dr. Sunil Solomon, a professor at Johns Hopkins University and chairman of YRGCARE. "There is still a lot to be done among people who inject or use drugs, as they are at a much higher risk of HIV infection."
Dr. Nilesh Gawde, an assistant professor at Tata Institute of Social Sciences, agrees and emphasizes the impact of social determinants on the HIV epidemic, such as gender inequalities and drug trafficking. He points out that states like Punjab, which are hubs for drug trafficking, have been struggling to curb new infections.
Dr. V. Sam Prasad, the Country Programme Director for India Cares, warns that despite the declining infection rates, the fight against HIV is far from over. He notes that new hotspots are emerging, and there has been an increase in other sexually transmitted infections and drug use.
Changing Dynamics
The epidemiological landscape of HIV is changing in India. "We are seeing old problems resurface in new areas, such as the growing use of drugs in central India and other northeastern states," explains Dr. Solomon. "Moreover, people are now seeking sexual partners online, making it difficult for traditional outreach programs to reach them. There is also an increase in overlapping behaviors, such as men who have sex with men and also use drugs." He believes that more comprehensive and innovative interventions are needed to address these changing dynamics.
Overcoming Barriers
The affordability of HIV treatment is a major concern, with high prices making it difficult for many to access life-saving medications. Dr. Sam emphasizes the need for pharmaceutical companies to prioritize people over profits and make innovative treatments accessible to all. Dr. Solomon adds that meeting the growing demand for HIV treatment within a limited budget is a major challenge and calls for more significant investments to save costs in the long run.
Moving Forward
"We still have a long way to go to achieve the 95-95-95 targets of diagnosis, treatment, and viral suppression," says Dr. Gawde. He believes that addressing broader social issues, such as gender inequalities and drug trafficking, is crucial in the fight against HIV.
Dr. Sam stresses the need to revamp prevention efforts and make them more relevant to contemporary times. He also advocates for comprehensive sexuality education for the younger generation, who are particularly vulnerable to HIV. "We must adapt to the changing times and destigmatize the use of condoms, making them easily accessible through online platforms," he says.
Dr. Solomon highlights the importance of utilizing data science and AI to improve the efficiency of HIV programs and reduce dependence on physical facilities. He also emphasizes the need to understand the underlying reasons for certain behaviors, such as drug use, and address them holistically by collaborating with different ministries.
As India's HIV map shows more hope than red, the country must continue to adapt and evolve in its fight against the virus. Stronger science must be coupled with effective execution to address the changing social nuances and challenges.
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