‘Need for Non-Judgemental Care to Combat HIV in the LGBTQIA+ Community’: Dr. Divya Mithel

Dealing with a lot of stigma and challenges in society already, the LGBTQIA+ community lands into isolation even more when diagnosed with HIV or when they fear it. However, they have started finding shelter in Navi Mumbai’s care centre for HIV and AIDS that operates free of cost for the patients.

Dr. Divya Tarin Mithel, who has been running the AFH-JCC clinic in Kalamboli has also observed the changes in the demographics of the people coming to her centre and shares that it has been a recent development that persons belonging to the LGBTQIA+ community have been coming to the centre for assistance over the HIV AIDS and the potential of getting it.

As per the recent 'India HIV Estimations 2023' report, over 2.5 million people are living with HIV in India. However, New annual HIV infections have also reportedly decreased by 44 per cent since 2010. While there is no official data on the number of infected LGBTQIA+ members, experts, over time, have spoken about the substantial numbers being infected.

“They are mostly abandoned by their families and are in distress when they come here,” Dr. Mithel, the director of the AFH-JCC clinic, says in an online interaction. The care that houses a team of counsellors, doctors, phlebotomists, nurses, sisters and even an outreach worker helps people with the process of counselling before taking them for a test for HIV. Moreover, they also refer patients to psychiatrists for support in dealing with trauma, stigma, and suicidal thoughts.

India offers comprehensive HIV and syphilis testing to all pregnant women, with more than 30 million free HIV tests being conducted annually. In total, more than 1.7 million people are receiving free antiretroviral therapy (ART) through public healthcare systems.

However, other than what is written on paper, people diagnosed with HIV have to battle much more in the sociocultural dynamics that often go unnoticed. Highlighting the pop culture references, Dr. Mithel says, “There are people who meet each other on online dating apps and hardly know their sexual partners or where they might have got infected,” Dr. Mithel says.

While the care unit tests for HIV,  and has a facility of 30 beds for the patients, it aims to foster an environment of dialogues over sex, sexual health and the after-effects of it, for which they deem the partner's presence with the patient of utmost importance, only to no avail. “A lot of times, people party, use drugs and even indulge in activities like group sex. I have been made aware of this recent culture through them while talking to them,” says the 62-year-old Dr. Mithel.

However, those already in guilt find solace when not being judged for any records like these and provided treatment for it. “The LGBTQIA+ community is opening up about their problems, and we must make them feel safe,” Dr. Mithel says.

Time changes while stigma remains

In the past twenty-six years of operations, Dr. Mithel has observed that the patients are sceptical about bringing their partners to the centre. Started in 1999, the centre aims to include both treatment and counselling together for which, on the condition of anonymity, they ask the patients to come with their partners.

“Initially, men above forty would come to us and would be reluctant to get their wives here. After a lot of forcing, they would,” Dr. Mithel recounts, adding that the culture has been shifted to more young individuals coming to the centre. “Young people above fourteen years of age are coming in the past few years, while their partners’ age would also be around 15-16,” she adds.

While demographics might have changed, the reluctance towards bringing the partners remains the same. “Many also believe that their lives are over once they are diagnosed with HIV,” says Dr. Mithel. On the other hand, the myth about spreading HIV is prevalent even now, she says.

HIV-AIDS has long been encircled by the myth of getting spread while coming in contact with an HIV patient, and one of the missions for Dr. Mithel is to debunk this myth. “I explain to people that it is only through sexual contacts or intravenous drug use or infected blood like that that the disease can infect others,” she says.

The other sexually transmitted infections, in Dr. Mithel’s understanding, like chlamydia, gonorrhoea, and syphilis, have increased “In the last three to four years, we have seen a 35% increase in the sexually transmitted infections,” she says.

What the LGBTQIA+ community, along with the young coming to the clinic, are also relieved about is the fact that the centre does not reach out to their families without their consent, which might not necessarily be the case in the government facilities.

Many a time, in the absence of the patients, enrolled with the government schemes, if fail to show up, the officials call the alternative numbers for reminders. However, such is an intervention to privacy, observes Dr. Mithel. “They (the queer community) already deal with a lot of challenges related to safety and privacy, there should not be an addition,” she says.

A warrior for the HIV-infected patients

Started as a Jyoti terminal care centre, Dr. Mithel joined it as a volunteer; however, he completed a specialisation course in HIV fellowship and even contacted Christian Medical College,  Vellore, for a one-year training. Later, the National AIDS Control Organisation, which supplies medicines and takes care of HIV-infected people in India, recognised 350 centres all over India as community care centres in 2025, and this was one of them.

To her dismay, the programme was wrapped in 2013, after which the centre fell short of funds, while the patients kept coming in, making Dr. Mithel reach out for funds. “While a few public hospitals in Mumbai like KEM and JJ hospital were already giving the antiretroviral therapy, which is required as a treatment, even though there is no cure to it and hence, we had to get our centre running too,” Dr. Mithel reminisces adding that she got in touch with the US-based AIDS Health Foundation that helped them further and also helped in setting up the Navi Mumbai’s branch of the same organisation.

Dr. Mithel and her team, thus, have been over the bumpy ride and have made sure that the patient does not get any additional opportunistic infections like tuberculosis, loss of motion and weight loss.

The care centre observed at least 15 patients in a month, not just in the adjoining areas of Mumbai but also from places like Goa, and even Bengaluru. For the expecting mothers, the centre enrols them with the Prevention of Parent to Child Transmission (PPCT) programme run by the government of India, available in all the government hospitals.