Fatal Ignorance

 The sexual wisdom of schoolboys derived from garage gossip? Prissy reactions of puritanical prudes? You'd be surprised. These are the informed opinions of 25 general practitioners registered with the Indian Medical Council, practising in Delhi for the last 10 to 20 years. They were responding to a pre-programme questionnaire at a workshop of the Rajiv Gandhi Foundation (RGF), concerned at the rising numbers of HIV positive Indians: 1.8 million as per WHO estimates, organised in January together with the AIIMS-affiliated NGO AIDS Cell, Delhi. The aim: to raise a 90-doctor RGF AIDS workforce that would work in tandem with NGOs for AIDS prevention, control and management.

The medicos' responses revealed an appalling ignorance about the disease among the community. Six out of 25 doctors did not know what the acronym AIDS (Acquired Immuno Deficiency Syndrome) stood for. Awareness of the clinical aspects of the disease was abysmally low. Nine doctors subscribed to the CIA theory of AIDS: that it was invented in a laboratory and was accidentally spread into the community. Eight were convinced that AIDS was a problem of promiscuous, not "ordinary, moral, people". Eighteen were unaware that the transmission mode of HIV was akin to that of the hepatitis B virus. Twelve were unaware that HIV-infected people would test negative in the first three months after being infected and that they would develop symptoms of full-blown AIDS only after 10 years. Ten did not know the name of even one drug used to treat the disease, while three said aspirin was an effective medication for AIDS.

Many subscribed to fantastic theories on modes of AIDS transmission. Three believed mosquito bites could transmit the HIV virus. Eight doctors felt a patient's saliva contained enough of the virus to infect them, three felt an infected person's tears too were infectious. Sixteen doctors felt they could catch the virus if they swam in the same pool as an HIV carrier, 12 thought handling a patient's laundry exposed them to risk, while seven felt even sharing a cup or glass with such a person would put them in mortal danger.

Fear psychosis, uninformed dread seemed to be the underpinning to other wild contentions. Sample this: three doctors felt they could catch AIDS if they hugged an HIV-positive person, one felt a handshake was enough to do that, another felt mutual masturbation was dangerous, four believed sharing an office or a telephone would jeopardise their lives, while six believed sharing a toilet seat guaranteed death sentence.

Many respondents revealed acute homophobia. Two believed 75 to 85 per cent HIV infection resulted from anal (read homosexual) intercourse as against the valid 5-10 per cent figure. Eight were convinced that eating at a restaurant that had a homosexual cook exposed them to the risk of infection. Three were categorical about their bias: "Avoiding social contact with homosexuals," they said, "wouldhelp in the avoidance and spread of AIDS."

Sexual prejudice is one thing, sexual ignorance quite another. Nine respondents were convinced you were safe from infection if you had sex only with your spouse, seven saw no danger in having sex that involved exchange of blood, semen or genital excretions, four believed the "withdrawal method" guaranteed HIV immunity, while three did not know what schoolboys do: that you never test a condom for leakage before use.

Double standards often surfaced. All doctors favoured mandatory blood testing for patients prior to surgery but reacted indignantly to suggestions that they be subjected to the same. Five respondents suggested that a child should be prevented from attending school if he tested HIV positive. One stated that "AIDS sufferers are responsible for their own misery", and it would be "better not to spend resources on them".

Dr Shankar Choudhary, co-ordinator of the NGO AIDS Cell, which conducted the workshop, is unfazed by the responses: "Sure they smack of prejudice but so does the society to which they belong." For him the gains of the workshop were more important. "We managed to clear misconceptions. Hopefully we will change their attitude towards the disease and the high-risk groups affected by it," he said. If the appalling findings are any indication, the doctor has an uphill task ahead of him.