Prathmesh Patil

Aadhaar

Avinash Jadhav

General Hospital

Maharashtra State AIDS Control Society

Seema Waghmode

While one of the many objectives ofhas been a genuine effort to efficiently disburse government schemes, patients living with the Human Immunodeficiency Virus or HIV have raised a unique concern — they fear that the mandate to submit a photocopy of their Aadhaar card to avail of anti-retroviral therapy (ART) is encroaching on their medical privacy.With the deadline to accomplish all Aadhaar linkages looming, the recent government push in this direction has raised doubts among a swathe of activists — especially those working with sex workers — saying that vulnerable patients may be avoiding treatment out of fear of social stigma.Decades of counselling, awareness and education have ushered in a new perspective on HIV, which is still often mistaken for being the same as AIDS, a much more advanced and fatal stage of the ailment. HIV, however, can be kept at bay using ART, which slows down the rate at which the virus replicates., a counsellor at an Integrated Counselling and Testing Center (ICTC) at Cantonment, explained, “We counsel and screen patients at ICTCs, from where we link them to ART centres under the(MSACS). There, patients get treatment, counselling and medicines free of cost.”Elaborating on the current situation, Vrushali Gore, a project manager with NGO Kayakalp, said, “Since October this year, ART centres have started asking for Aadhaar card photocopies while registering for therapy. If not provided, they repeatedly ask for it when patients come for regular checkups or medicines.” This, say activists and counsellors, has made many patients averse to treatment. “Sex workers, for instance, already face exclusion from society due to their profession; being infected with the virus makes things worse. Now, they are feeling burdened by the necessity of handing over full identity details to ART centres,” added, founder of Kayakalp.One such patient, 50-year-old Anitya (name changed) — who has been a sex worker for more than 16 years and is HIV positive — shared, “I was taking ART at Sassoon General Hospital, when they began asking for Aadhaar details. I felt very scared that they would stop my treatment. I don’t want anyone to know I am undergoing it. People back in our villages could shame us if they find out about our lives. It is important to us that we do not reveal our identity. I have been taking ART for 2.5 years now, to keep myself alive for my son. I help others like me to take their medicine regularly, by being an example to them, and making them register for the process.”Sassoon dean Dr Ajay Chandanwale informed, “We register patients anyway when they come for treatment. Linking it to Aadhaar is actually going to prove beneficial for them, as it would help us maintain their profiles and track if they are taking medicines on time.”Echoed Gopal Bari, a counsellor at the Armed Forces Medical College’s ART centre, “When a patient is taking ART, it is crucial to take medicines for his/her whole life — especially since in India, we implement ART-1 treatment, and if it is not fully followed, a drugresistant strain of the bacteria may develop, forcing us to push for ART-2 medicines. This is why keeping track of patients and their medicine dosages is extremely important. But often, migrants leave the city or do not have stable addresses. Now, in such cases, Aadhaar would immeasurably help us identify, register and track them.”Waghmode countered, “We understand issues involved in treatment, as we work with almost 2,300 commercial sex workers and have a floating population of more than 700. We know it is crucial for these women to take therapy, but using Aadhaar to enforce it will just be counter-productive. We will fight the government on this if needed and refuse any attempt to put these women’s privacy and identity at risk.”Bari added, “Organisations like NMP Plus register patients and take responsibility to keep therapy going. That is one option for those concerned with privacy. But, we never refuse anyone medicines for the lack of Aadhaar either. It is only better that we find a permanent solution to all this.”█ We know it is crucial for some CSWs to take ART, but using Aadhaar to enforce it will just be counter-productive. We refuse any attempt to put their privacy and identity at risk