India: Drastic shortage in condom supplies makes sex workers have 'unsafe sex'

A funding crunch and procurement delays in the state government-run HIV/AIDS programme have disrupted supplies of free condoms to sex workers of New Delhi.

India provides free condoms under its community-based AIDS prevention programme that targets high-risk groups like sex workers. The World Bank estimated that the strategy has helped avert 30 lakh HIV infections between 1995 and 2015.

However, government data released last week showed nearly two-thirds of India's 31 state AIDS units had less than a month's supply of condoms. Some states only have enough for a few days.

"I am more scared of HIV now," said Shaalu, 32, a sex-worker who is using fewer condoms these days when she meets her clients.

She is hard-pressed for funds to repay a debt of about Rs 3 lakh.

Experts fear that the shortage of condoms could lead to more unsafe sex and increased infections, especially among the poor.

The human immunodeficiency virus (HIV) that causes AIDS can be transmitted via blood, breast milk or unprotected sex. The incurable infection killed 1.3 lakh people in India and 15 lakh globally in 2013, said the World Health Organisation (WHO).

Mona Mishra, an activist who runs the nationwide AIDS Momentum campaign, said: "Not having the only barrier at the doors of those who need it is catastrophic."

The shortages have come after Prime Minister Narendra Modi slashed AIDS funding in February by one-fifth. Modi hoped states would fill the gap, but the cut came as regional AIDS units faced bureaucratic payment delays.

An official at the National AIDS Control Organisation (NACO), which runs the programme, blamed the condom shortage on the cuts and a delayed procurement tender that was recalled due to technical discrepancies.

Although condoms are cheap in the open market, women sex workers often hesitate to buy them from a medical store due to social taboos.

Kusum, head of the All India Network of Sex Workers, which represents 2 lakh women, revealed that the sex workers, who mostly come from poor families, are forced to have unsafe sex with their clients if the latter don't carry their own condoms.

In Maharashtra, on 17 October, the stock of free condoms was one-eighth of its monthly requirement of 33 lakh condoms.

Despite these hiccups, India's AIDS programme has ironically achieved praise globally as HIV prevalence among women sex workers almost halved to 2.67% during the 2007-2011 period, and new infections have also fallen in recent years.

The NACO official in New Delhi said free condom supplies should improve in the next 15-20 days.

But for Shaalu, who only gave her working name, AIDS budget cuts and condom shortages are a double shock. She last received her Rs 3,000 monthly salary for promoting safe sex as a "peer educator" in April.

"The government should at least give us condoms so we can earn money," she said. "If we get infected, we will die."