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Feature HIV/AIDS

Mass economic migration: the greatest threat to HIV control in India

BMJ 2013; 346 doi: (Published 29 January 2013) Cite this as: BMJ 2013;346:f474

Re: Mass economic migration: the greatest threat to HIV control in India

This is a very sad but true scenario. The group of people who leave their home in search of work outside their states are mostly without any formal education and are manual labourers who spend months, sometimes years, out of home earning money. Talking about sex is a taboo for them, so it's very difficult to educate them about sex and use of condoms.

The government is doing its bit by advertising on television and radio and organising camps. There are separate STD clinics at primary health centre level, but this doesn't seem to be enough. The 'epidemic' of AIDS is spreading fast and is a big threat as tuberculosis is also common in india.

Another problem comes when these patients present with surgical complications. Primary health centers are not equipped well to handle these patients because operating on HIV positive patients involves cost of using everything disposable and running an exclusive theatre which should be fumigated post operatively. Primary health centres are not equipped to handle that, there is a lack of both funds and manpower.

The burden of HIV positive cases is far greater than what is apparent in the reports.
Targeting the migrated labourers, truck drivers at railway stations and their routes might be benefit but the system will have to break the taboo of the group about sex and associated diseases.

Competing interests: No competing interests

31 January 2013
Mandeep Kaur
general surgeon
Apollo Hospital
679/sector 7b/ faridabad, haryana, India