The government’s move to link citizens’ Aadhaar card information to social and healthcare schemes may face resistance in the National Aids Control Programme, which has already started the process of linking the information, although not mandatory yet, to existing patients enrolled for HIV treatment. In Mumbai, of the 41,038 patients diagnosed with HIV, 42 per cent (17,392 patients) have provided their Aadhaar information, linking their personal details — such as biometrics, full name and address — to the National Aids Control Organisation (NACO). There still remains a 58 per cent gap in registration of Aadhaar information.
Health workers believe that social stigma attached to the disease may be an impediment for patients not willing to disclose their identity, specially sex workers, transgenders, and men who sex with men (MSM).
The city has 703 sex workers and 232 MSM diagnosed as HIV positive. According to Rekha Kulkarni, attached to NGO Aditi, several sex workers get treatment under a different name to conceal their identity. “A sex worker may work under a different name and get treated under that name. Her Aadhaar details are linked with her original name that she does not want to disclose,” Kulkarni said.
NGO Aditi works in Bhandup and Vile Parle area with 2,500 sex workers to identify, screen, diagnose and treat them for HIV in collaboration with the Mumbai District Aids Control Society (MDACS).
In Bhandup, a 37-year-old mother of four girls was diagnosed with HIV four years ago. Much before that, her husband’s death forced her to enter the sex trade to earn a living. Now, her 19-year-old daughter is a sex worker and HIV positive. Both undergo anti-retroviral treatment (ART) under a different names. “She fears that her neighbours will come to know if after linking the Aadhaar card some health worker turns up at their door,” said Pooja Walawalkar, project manager for Aditi.
In 2016, NACO had issued a circular asking all centres to start linking Aadhaar information of patients with their database. Unlike social welfare schemes where Aadhaar linkage has been made compulsory, NACO has kept it optional. Officials claim that the move will reduce duplication of patients registered with multiple ART clinics and help track those who drop out of treatment.
“Often, HIV infected patients provide no contact details. If they stop visiting ART clinics, locating them becomes impossible,” a NACO official said. According to the official, linkage to Aadhaar may also help widows and children of deceased HIV patients to avail of social schemes. In Mumbai, the process to link patients to Aadhaar card began few months ago. The Committed Communities Development Trust, an NGO that looks after 91 HIV-affected children in the city, has already initiated the procedure to register each child for an Aadhaar card to be able to avail of the benefits. “Most of these kids are slum dwellers with no identity proof. We have created Aadhaar cards for 84 kids till now and linked it with NACO,” said project director Poonam Patkar.
Similarly, Desire NGO in Goregaon has 33 HIV affected children in their shelter home. “A lot of government schemes require Aadhaar linkage. We have started the process of registering our children. Most of them are orphans who lost their parents to AIDS infection. We have no problem in linking them,” said project manager Bhushan Pondre.
At Humsafar Trust that provides HIV treatment support to transgenders and MSM, officials, however, claimed that 100 per cent linkage to Aadhaar card may face difficulties as not all transgenders have Aadhaar and not all of them are willing to link Aadhaar information to NACO.
“We come across several HIV-infected transgenders who don’t even have a basic ID proof. There is also the question of their personal choice,” said Tinesh Chopade, assistant programme manager.
Another coordinator, Santosh Korambe, said based on NACO guidelines, HIV-infected transgenders and MSM are counselled if they initially refuse to link their Aadhaar information. “After our counselling, they usually agree to give their Aadhaar details,” Korambe said.
A lot of men who have contracted HIV after having sex with men also wish to hide it from their families. Providing Aadhaar for AIDS treatment may reveal their identity.