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Forbidden Pleasures

Mohan Rao

Edited by Ravi K. Varma , Pertti J.Pelto, Stephen L.Schensul and Archana Joshi 
Sage Publications, New Delhi, 2004, pp. 431, Rs. 450.00


The onset of the AIDS pandemic came as a profound shock to the developed world. Believing as they did, that having completed their epidemiological transitions, infectious diseases were a thing of the past in their societies, the reactions when the disease was recognized was fear, shock, anger, disbelief—and stigmatization of the victims. Was this divine vengeance for their sexual revolutions? Indeed could it be the revenge of the dark continent, whence they had taken light through slavery, colonial loot and plunder? As Rosenberg remarks: (AIDS reminds us), we have not freed ourselves from the constraints and indeterminacy of living in a web of biological relationships – not all of which we can control or predict. Viruses, like bacteria, have for countless millennia shared our planet and our bodies (Rosenberg 1992: 287).1   Its initial association primarily with gays and drug addicts, and the huge clustering among blacks trapped in poverty and hopelessness, seemed to suggest that it was a disease of the dregs of society, reinforcing existing prejudices of class, race and sexual orientation. But when the enormous costs of the disease to society, its seeming ability to cross barriers of class, and its mutability came to the fore, efforts were on to take stock of the disease, and to control its spread in the general population. Since not very much was known about the epidemiology of the disease, one primary method of prevention was obviously sexual continence and the use of condoms. But when the association of AIDS with other reproductive infections became apparent – evidence strongly suggests the facilitating role of genital ulcerative diseases (chancroid, syphilis, or herpes) in HIV-1 transmission (de Schryver and Meheus 1990)2 – it was evident that the ambit of intervention had to be broadened to reproductive health as a whole. Thus the impetus for improved management and control of STIs, and the resultant shift in focus from special treatment centers, was primarily due to the advent of HIV infection and AIDS (Chen et al 1991).3 What was also done in the process—and that is another story of global politics, was to undermine efforts at primary health care—without which of course even reproduc- tive health programmes cannot be implemented.   It is not surprising that AIDS acquired some urgency in developing countries, especially since it was seen to devastate parts of Africa. This very urgency, however, meant that in many countries—as in India—efforts were not made to obtain ...

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