How common is HIV/AIDS in India's Red Light Areas?

by Sarah Symons, Founder & Director, and Richa Gupta, Research Fellow

One survivor who inspired the founding of Her Future was Anita, who I met at a shelter in Nepal in 2004.  Anita had been trafficked from Nepal to India at age 12, soon after the death of her father.  A friend invited her to see a movie in a nearby town.  At the bus stop, a local woman gave the girls a Coke.  They woke up two days later in a brothel in Mumbai.  Anita was raped by 6 men for 3 days in a horrific ‘breaking in’ process.  She was enslaved for 4 years during which time she contracted HIV.  At that time, life-saving treatment was not available, so Anita eventually died of AIDS, but not before she became an activist inspiring hundreds of people, including me. 

Every morning, Anita would travel to the border of Nepal and India, where she worked alongside the police, stopping every car and looking for trafficking in progress.  She knew all the signs, and saved many lives before losing her own.


  • India has the third highest prevalence of HIV in the world, with an estimated 2.1 million people in 2017 living with the illness. Unprotected sex is a key factor behind the spread of the disease, as well as infected syringes and drug use via injections.
  • There exists a severe stigma surrounding HIV-AIDS in Indian society, with infected individuals often facing workplace discrimination, ostracism, and poor access to treatment facilities, basic amenities, and proper nutrition. Expulsion from school is a common occurrence among children suffering from HIV, along with instances of physical violence and abuse.
  • HIV directly compromises the immune system, leaving patients extremely vulnerable to infections—including, but not limited to, pneumonia, influenza, and encephalitis. Furthermore, it takes a toll on the mental health of patients—leading to a higher likelihood of suffering from depression, post-traumatic stress disorder (PTSD), and other forms of emotional trauma.

HIV and Sex Workers

  • In 2017, it was estimated that 1.6% of Indian, female sex workers were living with HIV, although this number varies between states (for instance, the prevalence of HIV among sex workers in Maharashtra was approximately 7.4%). Indeed, sex workers have been deemed among the highest risk groups for HIV.
  • Indeed, these rates would vary widely among the red light districts in India, with some of the prominent locations being: Sonagachi (Kolkata), Kamathipura (Mumbai), Budhwar Peth (Pune), Meergunj (Allahabad), and G.B. Road (Delhi) – all of which are far more likely to be epicenters of this infection
  • On average, sex workers are 13 times more likely to be infected with HIV, compared to adults not engaged in this industry
  • Data suggests that women forced into prostitution are nearly 3 times more likely to test HIV-positive: primarily due to economic vulnerability, an inability to strike a negotiation regarding condom use (or other forms of birth control), and societal marginalization. Having multiple partners is another significant factor accounting for this distressing statistic, and it isn’t uncommon for clients to refuse to pay if they have to use a condom. Moreover, clients may also offer sex workers substantially more money for unprotected sex.
  • Drug use through shared syringes places sex workers at a significant risk for contracting HIV; there was the recent news case of hundreds of Pakistani children being infected with HIV due to unsterile syringes in medical facilities. Indeed, infected needles can be a deadly trigger for the spread of HIV.
  • Most female victims of human trafficking in India are controlled and manipulated through fear—and are often trapped into years, or even decades, of servitude. In the words of a former victim, “our lives are like of animals”; and once their ability to earn money goes down, they are typically left to fend for themselves

Reducing the Prevalence of HIV

  • Integrating condom usage and distribution into the work of these women can be key—as well as increasing their access to HIV services, family planning capabilities, and gynecological resources. These steps could play into the empowerment of these communities—even though their dignity and freedom have been stripped away.
  • Pre-exposure prophylaxis (PrEP) refers to the use of antiviral drugs to reduce their susceptibility to the virus. However, while the drug can be highly effective, its accessibility to victims of human trafficking and sex work remains painfully limited.
  • Greater political and legal pressure on the judicial system: despite the passage of the Immoral Trafficking Prevention Act (ITPA) back in 1956, the actual prosecution and confinement of human traffickers is extremely rare. Hence, increased pressure on law enforcement officers to uphold the mandates of this act could help reduce the prevalence of this phenomenon—and by extension, of HIV.

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