Manorama Bakshi
When India diagnosed its first case of HIV in 1987, it was met with silence, fear, and judgment. The virus was poorly understood, and those living with it were often treated as outcasts -denied care, employment, or even the dignity of empathy. Hospitals hesitated to admit them, schools refused their children, and neighbours withdrew in fear. It was a time when HIV was not just a virus — it was a social sentence.
Nearly four decades later, as the world observes World AIDS Day 2025, India’s journey stands as a remarkable story of transformation. We have moved from fear to awareness, from discrimination to inclusion, and from despair to determination. Yet this progress, though hard-won, remains fragile -and demands that our response stay as human as it is scientific.
A Journey of Progress and Resilience
At the turn of the millennium, India was confronting one of the fastest-growing HIV epidemics in the world. More than five million people were living with HIV. Awareness was low, treatment scarce, and stigma all-pervasive. Families were often torn apart – not by the infection, but by discrimination, rejection and shame.
Two and a half decades later, the picture has changed profoundly. According to the National AIDS Control Organisation (NACO), new HIV infections have declined by 46% since 2010, and AIDS-related deaths have fallen by over 76% since 2004. Today, more than 1.78 million people in India are receiving free, life-saving antiretroviral therapy (ART).
This transformation did not happen by chance. It was built on sustained public health efforts, multi-sector collaboration, and the courage of people living with HIV — many of whom, once shunned, are now leading the very programmes that changed their lives.
The Numbers Tell a Story — of Progress and Persistence
Before understanding where we stand, it helps to know how progress is measured. Globally, UNAIDS uses what is known as the 95–95–95 target — meaning:
- 95% of people living with HIV should know their status,
- 95% of those diagnosed should be on treatment, and
- 95% of those on treatment should have viral suppression (meaning the virus is undetectable and cannot be transmitted).
India’s current standing — 87–77–73 — comes from the India HIV Estimates 2022 report. It means:
- 87% of people living with HIV in India know their status,
- 77% of those diagnosed are receiving ART, and
- 73% of those on treatment have achieved viral suppression.
These numbers show remarkable progress — but also remind us that the last mile is always the hardest. Each gap in this chain represents a life that could be healthier, longer, and stigma-free.
Globally, 40.8 million people are living with HIV, including 1.4 million children. Of them, 77% receive treatment, and 73% have achieved viral suppression — an unimaginable reality just two decades ago. The numbers tell us where we are; the people behind them tell us how far we’ve come.
The Jammu & Kashmir Lens — Local Realities, Shared Hope
In Jammu & Kashmir, HIV prevalence stands at 0.06% — the lowest in the country, far below the national average of 0.21% (India HIV Estimates 2021). The Jammu & Kashmir AIDS Control Society (JKACS) has played a central role in achieving and sustaining this progress through its focused, community-based interventions.
Since its inception in 1998, JKACS has registered 6,305 HIV-positive cases, with more than 4,000 people currently on lifelong ART. The region’s achievements include expanded Integrated Counselling and Testing Centres (ICTCs), greater awareness in schools and colleges, and strengthened linkages to free treatment and care.
Yet, challenges persist. Difficult terrain, migration, and stigma still hinder early testing and adherence. Many women in remote areas continue to hide their diagnosis out of fear of discrimination. But the tide is changing. Through its partnerships with NGOs, community workers, and peer educators, JKACS is promoting inclusion, awareness, and compassion — showing that progress is not only possible but sustainable when people are placed at the centre.
Science Offers Hope — But Access Defines Justice
The science of HIV prevention has never been more promising. New long-acting injectables such as Lenacapavir, which provide protection for up to six months in a single shot, could redefine HIV prevention and treatment. For people struggling with adherence or stigma linked to daily medication, this could be life-changing.
India has begun introducing long-acting injectables in six states — a hopeful start. But access must be equitable. These innovations should reach not only patients but also frontline healthcare workers who face occupational risks. As the “world’s pharmacy,” India has both the moral and practical responsibility to ensure that affordability does not become a new form of exclusion.
ART: Treatment, Prevention, Empowerment
It bears repeating: ART is not just treatment — it is prevention, protection, and empowerment. When a person achieves viral suppression, they cannot transmit HIV. Each person on ART is one less possible transmission — and one more life lived with dignity. Ensuring universal ART access is not merely a medical goal; it is a moral one.
The Social Side of the Epidemic
Science alone cannot end AIDS. Stigma still deters people from testing. Gender inequality still limits access to care. Transgender persons, sex workers, and other key populations continue to face systemic barriers.
That’s why we must continue to emphasise the ABCD of prevention — Abstinence, Behaviour change, Condom use, and “Don’t do drugs.” These are not moral dictates but health principles rooted in empowerment and respect.
Communities at the Centre
This year’s World AIDS Day theme, “Overcoming Disruption, Transforming the AIDS Response,” reminds us that our greatest strength lies in communities. During the pandemic, when clinics were closed, community networks ensured the uninterrupted supply of ART medicines and psychosocial support. Their dedication reaffirmed a timeless truth: the power to end AIDS lies not only in science, but in solidarity.
The Road Ahead – Policy, Compassion, and Courage
To sustain this progress, India must:
• Expand access to long-acting injectables under NACO’s national plan.
• Integrate HIV care with mental health, gender-based violence, and reproductive health services.
• Strengthen the response to HIV-TB co-infection, which remains one of the leading causes of death among people living with HIV. Integrated screening, early diagnosis, and joint treatment under a “One Health” approach are essential to breaking this deadly synergy.
• Ensure routine screening and timely management of sexually transmitted infections (STIs), which increase both the risk of HIV transmission and disease progression. Sexual health clinics must move from stigma to service — offering testing, counselling, and care without judgment.
• Invest in community-led programmes that build trust, reduce stigma, and ensure retention in care.
• Champion equitable funding across regions, so no one is left behind because of geography or gender.
And above all, we must never return to silence. Silence was the epidemic’s first ally. Dialogue, empathy, and inclusion remain our strongest vaccines.
The Human Heart of Public Health
Public health is not about numbers or targetsit is about people, dignity, and hope.
As PLHIV community member once told me, “Madam, medicine helps us live — but dignity helps us live fully.”
Ending AIDS is not just a biomedical challenge; it is a social promise – a commitment to compassion and courage. Because the fight against HIV is, at its heart, a fight for equality – and a promise that no one, anywhere, will ever be left behind again.
Dr Manorama Bakshi, Director and Head Healthcare ConsociaAdvisory and Visiting Senior Fellow, IMPRI
Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation
The author is : Public Health Professional & Policy Advocate
The post Beyond the Red Ribbon: Why India’s Fight Against HIV Must Stay Human appeared first on Daily Excelsior.