No funds for awareness as HIV cases soar among youth in Kerala | Part 2

In a two-part series, Onmanorama looks into the rise in HIV cases among youths and the reasons behind the surge.
Read Part 1 here

Dwindling investment in awareness programmes has impeded preventive measures to check the soaring HIV incidence among the youth.

The Global Fund, an international financing mechanism that supports HIV, tuberculosis and malaria programmes worldwide, has reduced its allocation to India from $500 million to $300 million for the 2026-2028 cycle.

Although the Union government has marginally increased domestic allocations for HIV programmes, counsellors say awareness campaigns have become less frequent and less sustained. "We need continuous programmes from Class XI onwards, right through college," said a senior counsellor in Ernakulam. "Young people need repeated exposure to information about HIV, safe sex and testing. One-off programmes are not enough."

Another concern is the gradual shrinking of Kerala's support infrastructure for people living with HIV. Care and Support Centres (CSCs) provide counselling, help patients access welfare schemes, assist with partner notification and monitor treatment adherence.

According to officials, Kerala once had 14 CSCs or help desks. The Pinarayi Vijayan-led government reduced it to seven, and there are now discussions about bringing it down further to four by October, they said.

Social workers said the government is also planning to do away with Antiretroviral Therapy (ART) centres and provide treatment to people living with HIV through regular hospital counters. “If that happens, more people may drop out of care because of privacy concerns,” said the Palakkad counsellor.

Karnataka has asked all government, aided and private engineering and degree colleges to conduct Integrated Health Camps offering HIV screening, testing and counselling services. While testing remains voluntary, the initiative aims to improve early detection and awareness among students.

Officials also pointed to delays in the monthly financial assistance provided to HIV-positive individuals to cover travel expenses for treatment. The ₹ 1,000-a-month benefit has reportedly not been disbursed for the past 22 months. "For many HIV-positive people, that money makes a real difference. The government should convert it into a pension so that it is released every month without interruption," said the Kochi-based counsellor. "At present, if a beneficiary dies before the dues are cleared, the pending amount is not paid to the family." Beneficiaries say they hope the pending dues will be cleared before Onam, as many rely on the support for travel and treatment-related expenses.

The migrant factor
Health workers identified migrant workers as another growing challenge in HIV care. Those who test positive are usually linked to ART centres and monitored regularly until treatment becomes part of their routine. Migrant workers, however, are often lost to follow-up after a few visits.

A migrant worker from Odisha employed at a plywood factory in Perumbavoor stopped attending treatment three months after enrolling. Another worker from Assam disappeared before health workers could test his wife and two children. “Both men had acquired the infection through unprotected sex with male partners,” said a Kochi-based counsellor.

In Palakkad alone, counsellors said, 32 migrant workers who had started treatment later moved away without leaving behind contact details or addresses, making follow-up nearly impossible.

Health workers said the government should maintain a register of migrant workers entering and moving within the state, with updated contact details, to ensure continuity of care.

A warning from the frontlines
Kerala currently has around 23,000 registered HIV-positive persons. Yet counsellors believe many more remain outside the treatment system.

The UN's goal is to reduce new HIV infections to near zero by 2030 to end AIDS as a public health threat. Those working on the frontlines fear Kerala is moving in the opposite direction. "Every year we used to see around a thousand new cases," said a counsellor. "If the current trend continues, we may cross 1,500 or even approach 2,000," said the Thiruvananthapuram-based counsellor.