Vast Distances a Barrier to Combating HIV/AIDS in India

India has 147 antiretroviral therapy (ART) centers providing free treatment to HIV/AIDS patients. But many of those infected with the virus live in rural areas that are hours or days away from such facilities.

Sambit, a 30-year-old former tailor, must board a crowded and frequently filthy train three days a month for a three-hour journey to Delhi to receive HIV treatment. "There’s no seat and I am very weak," he said. Sambit, who asked that his full name not be revealed, cannot afford lodging in Delhi so he endures the travel.

Many patients in a similar situation simply stop their treatment, which can lead to drug resistance. These patients may then need more powerful second-line drugs, which are not freely accessible in India. "Travel can affect drug compliance," said a New Delhi doctor who spoke on the condition of anonymity. "Patients who don’t get family support, women who may not like to travel alone will just give up."

Delhi has nine ART centers, more than most Indian states. Approximately 6,000 patients receive treatment in Delhi, with nearly half residing outside the capital.

In a bid to help rural patients, the government plans to build 500 "link centers," smaller clinics that will be set up throughout India. "They just come to pick up the drugs if they have no side effects and they go home ... that saves transport and other costs," said Sujatha Rao, director-general of the National AIDS Control Organization.

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