As India continues its march toward becoming a global leader in health innovation and public health, the fight against HIV remains a critical challenge. The country has the third highest burden of HIV in the world with an estimated 2.3 million people living with HIV (PLHIV) in 2021. With young people aged 15-29 years comprising 25% of the population but accounting for 31% of the AIDS burden (National AIDS Control Organisation—NACO– Annual Report 2022-23), their active engagement in HIV prevention strategies can create a lasting impact in public health outcomes.
The intersection of social, cultural, and economic factors creates a complex landscape of HIV risk. Traditional societal taboos surrounding sexuality, early marriage practices, and economic dependency form multi-layered barriers to effective prevention. Gender disparities particularly amplify risk for young women, who face limited autonomy in sexual health decisions, restricted access to resources, and heightened exposure to sexual violence.
Young people represent both our most vulnerable group and our most powerful agents of change. Despite living in an information age, many harbour misconceptions about HIV transmission. The National Family Health Survey-5 (NFHS-5) underscores this challenge with only 25.80% of the respondents (in a sample of 2,02,052 participants) demonstrating comprehensive HIV knowledge. Also, evidence suggests people aged 15–29 years demonstrated reduced knowledge of HIV/AIDS compared to respondents aged 30–39 years. Consequently, adolescent and youth represent a vulnerable age group due to their propensity for engagement in high-risk sexual behaviour and reduced knowledge of HIV/AIDS that precludes risk mitigation through adoption of adequate protection and safe behaviour.
Gender disparity stems from multiple factors, including physiological vulnerabilities, societal norms, and limited autonomy in sexual health decisions. Lack of access to education, resources, income, political agency, coupled with incidences of sexual violence, coercion and social dislocation in conflict situations like war, or owing to migration for work, serve to increase the risk of HIV infection to women through unprotected sexual intercourse.
India has made substantial strides in responding to HIV. The establishment of Red Ribbon Clubs in educational institutions is a major step. These clubs help youth become more conscious and conscience about HIV/AIDS and related issues to further act as change agents, in HIV/AIDS programmes.
The path forward is clear: we must intensify youth-focused interventions. This includes expanding comprehensive sexuality education, empowering peer networks, engaging communities, and leveraging digital platforms for information dissemination. Most importantly, we must break the silence surrounding HIV/AIDS and create an environment where young people feel empowered to seek information and services without fear of judgment.
The dream of an HIV-free India is not a distant aspiration but an achievable reality. By equipping young Indians with knowledge, resources, and agency, we can transform the narrative of HIV from a story of vulnerability to one of resilience and empowerment.
(This article is authored by Dr Vivek Yadav, senior vice president, IPE Global and project director, Young Adults for Accessible, Respectful, and Inclusive Reproductive Health Initiatives (YAARI)).
