INTRODUCTION
1.1. HIV/AIDS - A Historical Perspective
Acquired Immune Deficiency Syndrome (AIDS) is known to be a leading cause of adult deaths in the
world (Narain, 2004). The first cases of AIDS were noticed in homosexual men in the United States
in 1981. The causal agent, Human Immunodeficiency Virus (HIV) was identified in 1983 (Fahey &
Flemmig, 1996). HIV appears to have started spreading rapidly in the late 1970s or early 1980s in
America, Australia and Western Europe. In 1982, the Center for Disease Control (CDC) in the USA
formally defined the epidemic as 'Acquired Immune Deficiency Syndrome' (AIDS) (Alcorn, 1999).
As is well known, HIV transmission occurs mainly through contact with bodily fluids. Unprotected
sex and injecting drug use where needles are shared are the main routes of transmission (Alcorn,
l 999; Fahey & Flemmig, 1996). AIDS is the end-stage outcome of the HIV infection (Fahey & Flemmig,
1996). A decrease in the CD4+T helper cells is, in fact, a bona fide marker of overall disease
progression (Smith, 1998).
HIV infection and AIDS disease have been a global concern for almost three decades now. Although
the epidemic was first identified in United States most of the new infections now occur in
developing countries (Narain, 2004). These countries are least equipped to respond to the challenge
effectively (Alemnji, Nkengasong, & Parekh, 2011; Grant & De Cock, 1998). Even after 30 years of
its arrival AIDS still continues to be a life-threatening disease and those infected by HIV
continue to be stigmatised and ostracised. It still continues to be the concern of millions of
people. The UNAIDS Joint
United Nations Programme on HIV/AIDS states that in 2002 a total of 3.1 million people worldwide
died of AIDS, which is the highest number of deaths registered in any year since the epidemic
started (UNAIDS Joint United Nations Programme on HIV/AIDS [UNAIDS], (2002).
1.2.HIV/AIDS Epidemic in India
HIV epidemic has really become a huge challenge in the country since the first case was detected in
Tamil Nadu in 1986 (Sharma, 2009). Based on the available data, the number of HIV infected persons
went up from 3.5 million in 1998 to over 5.2 million,
