In a two-part series, Onmanorama looks into a rise in HIV cases among youths and the reasons behind the surge.

Kasaragod: A year ago, a teenager from Kasaragod left home for NEET coaching in Kozhikode, carrying the hopes of becoming a doctor. During his time away from home, he had unprotected sex with multiple male partners he met online. Concerned that he might have been exposed to HIV, he later walked into a testing centre in Kasaragod and sought help. The result came back positive.

Around the same time, another student from Kasaragod who had been studying in Bengaluru tested positive. A cable television technician in his twenties with partners in Palakkad and Kozhikode. A software engineer from Ernakulam. A young priest from Thrissur. Counsellors and caregivers working with HIV-positive people across Kerala say these cases are part of a pattern they have increasingly encountered over the past two years.

While HIV incidence among female sex workers has fallen to negligible levels, health workers say a growing number of young men are arriving at testing centres after unprotected sexual encounters with multiple male partners, many of whom they met through social media platforms and dating apps.

The trend, they say, is reflected in Kerala's HIV numbers. In January, then Health Minister Veena George said HIV infections among Kerala's youth were rising at an "alarming rate". The share of new HIV cases among people aged 15 to 24 increased from 9% in 2022 to 14.2% in 2024. Between April and October 2025, she said, it rose further to 15.4%. Counsellors working in the field say a growing share of those infections is being reported among young men who have sex with men (MSM), particularly those who engage in unprotected sex with multiple partners.

A detailed questionnaire sent by Onmanorama to the Kerala State AIDS Control Society seeking data on recent infection trends remains unanswered. However, its Deputy Director, K Sreekumar, acknowledged the changing profile of new infections.

Data compiled by Onmanorama from 11 districts show that 29% of new HIV-positive individuals enrolled at Care and Support Centres (CSCs) in 2025-2026 were MSM. In the first quarter of the current financial year, the proportion increased further to 31%. People who test positive for HIV are referred to Antiretroviral Therapy (ART) centres, known as Ushas, for treatment. Those requiring counselling, social support and assistance in accessing government welfare schemes are referred to CSCs.

Several counsellors said the CSC figures may understate the scale of the trend, as a significant number of MSM, particularly migrant workers and married men, do not register with care centres even after being diagnosed with HIV. "The 30% share of MSM in new infections is something we have started seeing over the past two years," said a Thiruvananthapuram-based counsellor involved in HIV care. "Most of them are in their twenties."

Partners remain anonymous
Finding partners is much easier now because of mobile applications and social media, said a counsellor from Palakkad. "They meet, engage in a one-night stand, delete the account and move on. Many of them have multiple partners."

The challenge begins when one of them tests positive. "Many are reluctant to reveal their partners. Sometimes we discover they have had seven or eight partners. We spend weeks counselling them and convincing them that informing partners is important," said the counsellor.

Health workers insist that young people must be better informed about HIV and encouraged to practise safe sex. "Sex is a basic human right. We cannot tell people not to have sex," said the Palakkad counsellor. "What we want is protected sex. We want people to know their status, seek treatment and be honest with their partners."

Modern antiretroviral therapy can suppress the viral load to 99%, allowing people living with HIV to lead normal lives and dramatically reducing the risk of transmission. The concern, counsellors say, is not sexuality but unsafe sex.

The district-level picture
The numbers emerging from different districts tell a similar story. In Kasaragod, 52 new HIV cases were registered at CSC during the 2025-2026 financial year. Only two of them were MSM. But in the first three months of the current financial year, seven of the 10 new cases were MSM. Two of them were students.

"The rise among young people is worrying because many are unaware of the risks involved," said an official associated with the district programme. "That is why we are seeing infections among 22-year-olds."

Palakkad CSC saw 120 new cases during 2025-2026. Of them, 38 were MSM, accounting for nearly one-third of the total.

Among those who tested positive were young IT professionals, hostel residents, a male masseur and hotel employee, according to counsellors. Most were in their twenties. "The partners of many hostel residents are not their classmates or fellow hostellers, but people they meet online and often know very little about," he said.

In Kollam and Thiruvananthapuram, 426 new cases were reported to CSCs in 2025-2026. Of them, 155 were MSM. Significantly, 115 of those 155 were aged 24 years or below.

In Ernakulam and Thrissur, 417 new cases were reported at Thrissur CSC during the same period. Of them, 116 were MSM, and 29 were injection drug users. Officials there pointed to the growing use of dating applications as one reason for the rise in infections among MSM.

Kozhikode CSC, which caters to Kozhikode, Wayanad and Malappuram districts, recorded 17 new HIV-positive MSM registrations in 2025-2026. In just the first three months of the current financial year, the centre has already registered seven such cases.