Gujarat with a population of 50.6 million lies on the west coast of India. The state shares international boundary with Pakistan at the north-western periphery and national boundary with Rajasthan in the northeast, Madhya Pradesh in the east, Maharashtra and Dadar and Nagar Haveli in the southeast and Arabian Sea in the west and southwest. Gujarat represents about 6% of the total area of the country with 25 districts and 226 talukas. Gujarat’s unique geographical and socio-economic characteristics have made the state highly vulnerable to the spread of HIV. Some of the factors that contribute to the vulnerability of Gujarat to HIV include:
• busy trucking routes
• high degree of industrialization resulting in influx of migrant labourers from various parts of the country
• high mobility of population between Gujarat and Mumbai in particular for trade and commerce
• renowned educational institutions attracting youth from various parts of the country and abroad
• longest coastline with many ports
• exposure to extensive commercialization
• traditional festivals like Navratri providing ample opportunities for youth to socialize.
The 2006 estimates suggest national adult HIV prevalence in India as approximately 0.36 percent, amounting to between 2 and 3.1 million people (NACO 2007). The HIV epidemic has begun to take devastating toll in the state. Though no separate estimates are made for states, from the data of HIV sentinel surveillance of ANC clinic attendees, a gross estimate suggests that in Gujarat, the number of people living with HIV may vary from 75,000 to 15,00,000 (GSACS, PIP 2007). About 3000 AIDS patients were treated in government hospitals in Gujarat and the commonest opportunistic infections were tuberculosis and oro-pharyngeal candidiasis. With every passing year, number of PLHIV is increasing and with the advent of ART, life expectancy has increased. State spends millions of Indian Rupees on STD/HIV prevention and awareness activities, treatment for STIs, condom promotion and distribution and assisting people living with HIV. Further, gender inequities, low literacy, and poverty have added to the prevalence of HIV. These circumstances have also made People Living with HIV susceptible to stigma and discrimination when they are identified as being HIV-positive. Empirical evidence suggests that many men and especially the women are often stereotyped as having contracted HIV through immoral sexual behaviour. HIV-related stigma and discrimination together have long been recognized as one of the main obstacles to the prevention, care, and treatment of HIV and AIDS. Yet little has been done on a large scale to combat them.