‘HIV and Women in the Northeast’ explores the feminization of the HIV/AIDS epidemic in the northeastern states of India. Shyamala Shiveshwarkar illustrates the reason behind the growing epidemic in the Northeast—that the virus has been extending its reach with high-risk sub populations like injected drug users (IDUs) as well as making inroads with the general population—and focuses on how it is impacting women detrimentally. The region has seen the HIV/AIDS epidemic primarily driven by IDUs; states are combating the double dilemma of drugs and AIDS. Transmission of the virus from IDUs to spouses, sexual partners and children has also been established, which has led to statistical increases in sero-positivity. Given that the “Northeast” is a homogenizing misnomer, the author uses tracking mechanisms to outline how differences in socio-economic and anthropological dynamics contribute to different prevalence rates and changes in infected populations over time.
Shiveshwarkar establishes and elaborates on the critical linkages between drugs, violence, and gender inequalities at the individual, family, and societal levels to establish women’s increasing vulnerability to HIV/AIDS. She asserts that regardless of whether they are affected or infected, women are being forced to take on a greater share of the socio-economic and psychological burdens of stigma and discrimination, violence, caring for the sick and providing for their families. Many women, including young girls who are forced to drop out of school, are made to work to cover the medical expenses of sick spouses or to repay debts. The author takes care to outline the intersection of these vulnerabilities with the political insurgency in these states and explores the problems with existing treatment and care of HIV/AIDS—focusing primarily on its inadequacy and male-centricism, which severely limits women’s access to prevention and care
In her conclusion, Shiveshwarkar, insists on the need to recognize that accessibility is a web of socio-economic, cultural and physical geographical factors: for women, the presence of services alone is insufficient. The author argues that what is needed is holistic reform which includes addressing the drug problem in these states, demanding state-sponsored medical interventions and gender sensitive medical environments.