Women and AIDS: medico-social stigmas in rural Kumaun.

The subjugation of women prevalent throughout most of India is compounded in the mountainous areas of rural Kumaun by a lack of access to female education and reproductive health care. Kumaun women believe that their health problems especially abdominal pain result from a curse associated with giving birth and are thus untreatable. Until a child can eat independently Kumaun culture dictates that mothers severely curtail their fluid intake and abstain from salt and fat--a tradition that produces severe iodine deficiency and other morbidity. Although no cases of human immunodeficiency virus (HIV) have been reported to date in this population this reflects the lack of an HIV testing facility. When the acquired immunodeficiency syndrome (AIDS) epidemic emerges in Kumaun women are likely to be blamed as they are for producing a female child. Moreover the high prevalence of tuberculosis in Kumaun women significantly increases their risk of HIV infection. Recommended to challenge the conservative dogmas that place Kumaun women at risk of HIV are the following measures: 1) provision of at least a primary education to girls; 2) health education on the basic principles of hygiene disease causation and nutrition; 3) availability of primary health care and maternity centers; 4) use of audiovisual aids in local dialect to eliminate health-impeding superstitions; 5) a mass media campaign to address medico-social misperceptions about AIDS; and 6) modification of womens fatalism about their health.