Damned Heretics

Condemned by the established, but very often right

I am Nicolaus Copernicus, and I approve of this blog

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Qualified outsiders and maverick insiders are often right about the need to replace received wisdom in science and society, as the history of the Nobel prize shows. This blog exists to back the best of them in their uphill assault on the massively entrenched edifice of resistance to and prejudice against reviewing, let alone revising, ruling ideas. In support of such qualified dissenters and courageous heretics we search for scientific paradigms and other established beliefs which may be maintained only by the power and politics of the status quo, comparing them with academic research and the published experimental and investigative record.

We especially defend and support the funding of honest, accomplished, independent minded and often heroic scientists, inventors and other original thinkers and their right to free speech and publication against the censorship, mudslinging, false arguments, ad hominem propaganda, overwhelming crowd prejudice and internal science politics of the paradigm wars of cancer, AIDS, evolution, global warming, cosmology, particle physics, macroeconomics, health and medicine, diet and nutrition.

HONOR ROLL OF SCIENTIFIC TRUTHSEEKERS

Henry Bauer, Peter Breggin , Harvey Bialy, Giordano Bruno, Erwin Chargaff, Nicolaus Copernicus, Francis Crick, Paul Crutzen, Marie Curie, Rebecca Culshaw, Freeman Dyson, Peter Duesberg, Albert Einstein, Richard Feynman, John Fewster, Galileo Galilei, Alec Gordon, James Hansen, Edward Jenner, Benjamin Jesty, Michio Kaku, Adrian Kent, Ernst Krebs, Thomas Kuhn, Serge Lang, John Lauritsen, Mark Leggett, Richard Lindzen, Lynn Margulis, Barbara McClintock, George Miklos, Marco Mamone Capria, Peter Medawar, Kary Mullis, Linus Pauling, Eric Penrose, Max Planck, Rainer Plaga, David Rasnick, Sherwood Rowland, Carl Sagan, Otto Rossler, Fred Singer, Thomas Szasz, Alfred Wegener, Edward O. Wilson, James Watson.
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Many people would die rather than think – in fact, they do so. – Bertrand Russell.

Skepticism is dangerous. That’s exactly its function, in my view. It is the business of skepticism to be dangerous. And that’s why there is a great reluctance to teach it in schools. That’s why you don’t find a general fluency in skepticism in the media. On the other hand, how will we negotiate a very perilous future if we don’t have the elementary intellectual tools to ask searching questions of those nominally in charge, especially in a democracy? – Carl Sagan (The Burden of Skepticism, keynote address to CSICOP Annual Conference, Pasadena, April 3/4, 1982).

It is really important to underscore that everything we’re talking about tonight could be utter nonsense. – Brian Greene (NYU panel on Hidden Dimensions June 5 2010, World Science Festival)

I am Albert Einstein, and I heartily approve of this blog, insofar as it seems to believe both in science and the importance of intellectual imagination, uncompromised by out of date emotions such as the impulse toward conventional religious beliefs, national aggression as a part of patriotism, and so on.   As I once remarked, the further the spiritual evolution of mankind advances, the more certain it seems to me that the path to genuine religiosity does not lie through the fear of life, and the fear of death, and blind faith, but through striving after rational knowledge.   Certainly the application of the impulse toward blind faith in science whereby authority is treated as some kind of church is to be deplored.  As I have also said, the only thing ever interfered with my learning was my education. My name as you already perceive without a doubt is George Bernard Shaw, and I certainly approve of this blog, in that its guiding spirit appears to be blasphemous in regard to the High Church doctrines of science, and it flouts the censorship of the powers that be, and as I have famously remarked, all great truths begin as blasphemy, and the first duty of the truthteller is to fight censorship, and while I notice that its seriousness of purpose is often alleviated by a satirical irony which sometimes borders on the facetious, this is all to the good, for as I have also famously remarked, if you wish to be a dissenter, make certain that you frame your ideas in jest, otherwise they will seek to kill you.  My own method was always to take the utmost trouble to find the right thing to say, and then to say it with the utmost levity. (Photo by Alfred Eisenstaedt for Life magazine) One should as a rule respect public opinion in so far as is necessary to avoid starvation and to keep out of prison, but anything that goes beyond this is voluntary submission to an unnecessary tyranny, and is likely to interfere with happiness in all kinds of ways. – Bertrand Russell, Conquest of Happiness (1930) ch. 9

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India ravaged by virus transmitted by sex contrary to all scientific studies

Times reports above the Sunday fold: Indian AIDS spread by truckers and other clients of paid sex

As pointed out earlier the HIV virus is not transmitted effectively in heterosexual sex (takes 1000 bouts on average). That is what 20 recent mainstream studies say.

Why then is the Times publishing a typically sensational report today (Tue Dec 6) on India Accelerating: An Epidemic Spreads On India’s Roads: Cargo and a Deadly Passenger

by Amy Waldman, explaining that the country is in an uproar because truckers, taxi drivers and other clients of paid sex are transmitting AIDS up and down the country along the new super highways, including to their wives?

Amy quotes a taxi driver dying of AIDS without access to any antiretrovirals – how can that be explained? Obviously there is another disease rampant – tuberculosis is mentioned. Are the Indians failing to treat for TB now that the AIDS narrative is taking over their land?

Why doesn’t the Times employ someone educated in science to the extent of familiarity at least with the mainstream AIDS story, let alone the challenge to it from the Duesberg papers and other dissident scientists, who can help to demand a litle more informed reporting from their apparently totally scientifically illiterate correspondents and editors?

That this is not a misplaced insult is clear from Nicholas Kristof’s Op Ed piece The Hubris of the Humanities, also today, lamenting the state of ignorance of science among some of the nation’s “cleverest” people, ie those like himself educated in the humanities. Kristof admits he is a “math ninny” and that he found it impossible to find anyone in the Times newsroom outside the science section to check an equation he wanted to include in a piece.


A year ago, I wanted to ornament a column with a complex equation, so, as a math ninny myself, I looked around the Times newsroom for anyone who could verify that it was correct. Now, you can’t turn around in the Times newsroom without bumping into polyglots who come and go talking of Michelangelo. But it took forever to turn up someone confident in his calculus – in the science section.

Does Kristof realize that his columns on AIDS suffer from the very ignorance he is concerned about? Perhaps we should send him our earlier post on his performance, with some of the disrespectful adjectives removed.

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The New York Times

December 6, 2005

Op-Ed Columnist

The Hubris of the Humanities

By NICHOLAS D. KRISTOF

The best argument against “intelligent design” has always been humanity itself. At a time when only 40 percent of Americans believe in evolution, and only 13 percent know what a molecule is, we’re an argument at best for “mediocre design.”

But put aside the evolution debate for a moment. It’s only a symptom of something much deeper and more serious: a profound illiteracy about science and math as a whole.

One-fifth of Americans still believe that the Sun goes around the Earth, instead of the other way around. And only about half know that humans did not live at the same time as dinosaurs.

The problem isn’t just inadequate science (and math) teaching in the schools, however. A larger problem is the arrogance of the liberal arts, the cultural snootiness of, of … well, of people like me – and probably you.

What do I mean by that? In the U.S. and most of the Western world, it’s considered barbaric in educated circles to be unfamiliar with Plato or Monet or Dickens, but quite natural to be oblivious of quarks and chi-squares. A century ago, Einstein published his first paper on relativity – making 1905 as important a milestone for world history as 1066 or 1789 – but relativity has yet to filter into the consciousness of otherwise educated people.

“The great edifice of modern physics goes up, and the majority of the cleverest people in the Western world have about as much insight into it as their neolithic ancestors would have had,” C. P. Snow wrote in his classic essay, “The Two Cultures.”

The counterargument is that we can always hire technicians in Bangalore, while it’s Shakespeare and Goethe who teach us the values we need to harness science for humanity. There’s something to that. If President Bush were about to attack Iraq all over again, he would be better off reading Sophocles – to appreciate the dangers of hubris – than studying the science of explosives.

But don’t pin too much faith on the civilizing influence of a liberal education: the officers of the Third Reich were steeped in Kant and Goethe. And similar arguments were used in past centuries to assert that all a student needed was Greek, Latin and familiarity with the Bible – or, in China, to argue that all the elites needed were the Confucian classics.

Without some fluency in science and math, we’ll simply be left behind in the same way that Ming Dynasty Chinese scholars were. Increasingly, we face public policy issues – avian flu, stem cells – that require some knowledge of scientific methods, yet the present Congress contains 218 lawyers, and just 12 doctors and 3 biologists. In terms of the skills we need for the 21st century, we’re Shakespeare-quoting Philistines.

A year ago, I wanted to ornament a column with a complex equation, so, as a math ninny myself, I looked around the Times newsroom for anyone who could verify that it was correct. Now, you can’t turn around in the Times newsroom without bumping into polyglots who come and go talking of Michelangelo. But it took forever to turn up someone confident in his calculus – in the science section.

So Pogo was right.

This disregard for science already hurts us. The U.S. has bungled research on stem cells, perhaps partly because Mr. Bush didn’t realize how restrictive his curb on research funds would be. And we’re risking our planet’s future because our leaders are frozen in the headlights of climate change.

In this century, one of the most complex choices we will make will be what tinkering to allow with human genes, to “improve” the human species. How can our leaders decide that issue if they barely know what DNA is?

Intellectuals have focused on the challenge from the right, which has led to a drop in the public acceptance of evolution in the U.S. over the last 20 years, to 40 percent from 45 percent. Jon Miller, a professor at the Northwestern University medical school who has tracked attitudes toward evolution in 34 countries, says Turkey is the only one with less support for evolution than the U.S.

It’s true that antagonism to science seems peculiarly American. The European right, for example, frets about taxes and immigration, but not about evolution.

But there’s an even larger challenge than anti-intellectualism. And that’s the skewed intellectualism of those who believe that a person can become sophisticated on a diet of poetry, philosophy and history, unleavened by statistics or chromosomes. That’s the hubris of the humanities.

* Copyright 2005 The New York Times Company

In other words, the Times is typical in its ignorance of science aside from those who work in the area, so God help us if they report on AIDS in the International section as a topic which rests on scientific premises, since no one there has a clue as to the mainstream AIDS literature, let alone the controversy over whether it is valid, if they have heard of the issue at all.

Is it not time for the newspaper of record to report a little more responsibly in this area of US global policy? Their current performance as exemplified by this front page story is merely sensational pandering to readers’ prejudice against poor Indians and in support of a medical hypothesis which is the most questioned by scientists of any health scare extant.

This huge piece detailing the spread of AIDS down India’s new superhighways is the second most popular article to be emailed today, so it amounts to spreading the virus of a scientific fiction along the interstate and global highways of the Net in the most infectious way possible.

Yet mainstream AIDS papers say it is impossible.

Perhaps the New York Times’ Amy knows better that the scientists and their research. just as Larry Altman knows better than HIV?AIDS critic Peter Duesberg, his peer reviewers and the editors of Cancer Research and the Proceedings of the National Academy, not to mention a slew of other top journals.

But is this surprising, when, as reporters with hands on experience of the day to day events of HIV?AIDS in the real world, they are clearly better informed than scientists who carry out peer reviewed research, who are probably just sitting in their ivory towers mapping at second hand statistics supplied by medical workers in the hospitals and clinics of faraway continents?

Who would you rather put your money on, Amy Waldman’s unerring eye trained on an Indian prostitute she has just met whose story she takes down first hand right then and there, or an ivory tower researcher dealing with a bunch of statistics?

Contemplating this obvious choice, it seems to us that rather than the Times going hat in hand to the NIH to beg that self serving institution for guidance via press release or Anthony Fauci as to what is going on in AIDS, the NIH should humbly refer to the reporters of the Times when it wishes to conduct research in this field of study.

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The New York Times

December 6, 2005

India Accelerating | An Epidemic Spreads

On India’s Roads, Cargo and a Deadly Passenger

By AMY WALDMAN

NELAMANGALA, India – Hot water: 10 rupees. Cold water: 8 rupees. Toilet: 5 rupees.

Sex: no price specified on the bathhouse wall, but, as the condom painted there suggests, safe.

Sangeetha Hamam, a bathhouse, sits on the national highway near this gritty truck stop about nine miles north of Bangalore. Its mistress is Ranjeetha, a 28-year-old eunuch who lives as a woman. Her lipstick and black dress provide a touch of glamour in the small dark shack.

Her clients are not only truckers, but also Bangalore college students and other city residents. They know to look for sex at highway establishments geared toward truckers. Her customers – as many as 100 on Sundays for her and five other eunuchs – come for a “massage” and the anal sex that follows, but also for the anonymity the location confers.

Ranjeetha knows men will pay more for unprotected sex, but she calculates that the extra money is not worth the risk to her livelihood and life. She knows they can go elsewhere; there are some 45 bathhouses doubling as brothels near this truck stop. She also knows several eunuchs who have died of AIDS.

India has at least 5.1 million people living with H.I.V., the second highest number after South Africa. It is, by all accounts, at a critical stage: it can either prevent the further spread of infection, or watch a more generalized epidemic take hold. Global experts worry that India is both underspending on AIDS and undercounting its H.I.V. cases.

Its national highways are a conduit for the virus, passed by prostitutes and the truckers, migrants and locals who pay them, and brought home to unsuspecting wives in towns or villages. In its largest infrastructure project since independence, India is in the process of widening and upgrading those highways into a true interstate system. The effort will allow the roads to carry more traffic and freight than ever before. But some things are better left uncarried.

The national highways between New Delhi, Calcutta, Chennai, formerly Madras, and Mumbai run through at least six districts where H.I.V. prevalence is above 2.5 percent. Earlier this year, a New York Times reporter and a photographer drove the route, which has been nicknamed the Golden Quadrilateral.

To drive it is to peel back a nation’s secret, or not so secret, sex life, and the potent mix of desire, denial and stigma that is helping spread the disease.

India’s entry into the global economy over the past 15 years may also be furthering the spread of AIDS. With rising incomes, men have more money for sex; poor women see selling sex as their only access to the new prosperity. Cities are drawing more migrants and prostitutes, and Western influences are liberalizing Indian sexual mores. In response, cultural protectionists are refusing to allow even the national conversation about AIDS to reflect this changing reality.

The notion of a sexually chaste India is a “complete myth,” said Ashok Alexander, the director of Avahan, the India AIDS Initiative of the Bill and Melinda Gates Foundation. Its preservation hurts prevention: “You say it’s not a big problem, only ‘those people’ are doing that.”

Driving the highway also shows the complications in reaching the various constituencies along it. India’s AIDS epidemic is as variegated as the country itself, with a multiplicity of high-risk groups. Intravenous drug users concentrate in northeastern states. Devadasis – poor, lower-caste women consecrated to gods as young girls and then consigned to prostitution – live in the south.

Many of the groups are deeply fragmented and in perpetual motion, making them difficult for educators to reach: the man who owns a single truck; the woman who works at night out of a thatched hut; the lone migrant who shuttles back and forth between his village and urban work.

But a number of AIDS prevention groups have come to see working along the highway as the best hope for targeted interventions.

Avahan is pouring much of its $200 million into efforts along the highway. Another group, Project Concern International, sent young men to walk the Golden Quadrilateral – 3,625 miles long – over the course of a year to raise awareness about AIDS.

They met truckers, villagers, road workers and migrants, and in some places were cheered as heroes. In others, they were chased out for daring to discuss condoms and H.I.V., accused of spreading promiscuity and disease.

Sometimes, construction on the highway blocked the workers’ way. But the deeper obstacles were culture, politics and history. The puritanical values of British colonialists repressed sexual expression in this country – essentially criminalizing homosexuality – and stigmatized it in many Indians’ eyes as well. Some of the socially conservative Hindu nationalists who governed until 2004 tried to pretend no one was having sex, at least outside marriage.

In truth, sex work has flourished in independent India. Red-light districts operate openly in cities like Mumbai, formerly Bombay, and in its new suburbs and industrial areas. Hundreds of girls and women parade the streets at night near “pharmacies” where quacks peddle fake AIDS remedies.

And advocates battling the spread of AIDS say they have learned that men having sex with men, then with their wives, is surprisingly common, but veiled by stigma.

Ranjeetha, the bathhouse mistress, believes the real danger is not open eunuchs like her, but the men in denial, who work in offices by day and dress in saris at night. “People who lead double lives don’t use condoms,” she said.

Awareness and Denial

At least 1,000 trucks a day pass through Nelamangala’s trans-shipment point, often waiting hours or days for a new load. In the interim, drivers and their helpers patronize bathhouses like Sangeetha, although many of the sex establishments do not paint condoms on the outside, and use none inside.

There are three million to four million trucks on India’s roads, at least one million of them traveling long distances. If truckers cannot find sex at trans-shipment points, they can buy it on the roadside, where women signal potential clients with flashlights.

As many as 11 percent of truckers may be H.I.V. positive. In some parts of the country, like Tamil Nadu, the stigma around truckers has grown so strong that fathers forbid their daughters to marry them.

Yet no one has figured out a comprehensive system for education or testing. There are perhaps 3,000 to 4,000 regional transport companies, but most trucks are owner-driven or run by small companies.

The major stopping points, or trans-shipment yards, see so many truckers each day that even if truckers take an AIDS test, there is no way to follow up – an “amnesiac system” in one advocate’s words.

In a dusty parking lot at this truck trans-shipment point, an AIDS educator wielded a black dildo and a condom, encircled by truckers who stifled mirth and curiosity.

“Why are you targeting us?” a trucker asked the educator.

Truckers asked if AIDS could be transmitted by mosquito bites. They made ribald jokes about their sex lives, and boasted about not using condoms.

One trucker interrupted to say he knew people who used condoms and still got AIDS.

“Check the expiration date,” the educator said.

“We are illiterate, we can’t read,” the trucker replied.

In the country’s north, some drivers say they have never heard of AIDS, although their facial expressions may suggest otherwise. In the south, where AIDS is much more common, denial is trickier. Truckers have heard of AIDS, and often know someone who died from it, and word is starting to travel along with the virus.

But awareness does not always translate to protection. Bhagwan Singh, 47, a trucker who was halting at the Gujarat-Rajasthan border, said he did not use condoms, because he had paid for sex only a few times.

“What happens if I just go once, twice, thrice?” he said. “Only if I’m a regular fellow I might contract such things.”

Bringing H.I.V. Home

Once, twice, thrice or more often, whatever the truckers do on the road, or migrants do in cities, is coming home to oblivious wives. Here, the danger of a culture that is simultaneously licentious and conservative, of seasoned husbands and sheltered wives, becomes clear.

This has become especially apparent in India’s southern states, which are prospering economically, but have been hit the hardest by AIDS, along with pockets of the isolated northeast.

The states the highway runs through in the south all have H.I.V. infection rates of 1 percent or higher.

In the government hospital in Guntur, a district with a 2.5 percent H.I.V. infection rate, Sambra Ja Lakshmi, 27, a mother of two, was being counseled.

Her husband, a 33-year-old trucker, had done “thousands of kilometers on the national highway,” as she put it. Where he got H.I.V. is unknown, but he was so sick he could no longer move. She, a homemaker and mother who barely left her village about 15 miles off the highway, was H.I.V. positive, too.

The counselor, Sunita Murugudu, had heard it before, and knew she would hear it again.

Some 80 percent of truckers’ wives who came in for voluntary testing and counseling tested positive, she said, usually because by the time they came in their husbands were on their deathbeds, and denial could no longer be sustained.

G. Karuna, 24, was another woman who fell prey to the peregrinations of her husband, a long-distance driver from a family of truckers. When they both sought treatment for tuberculosis or opportunistic infections at hospitals, they hid his occupation, since many private hospitals now turn truckers away.

After her husband died, his family blamed her, a cruel vengeance some in-laws inflict on the widows. They have made treatment and prevention that much harder.

She was forced to sleep on the path outside; the family refused to share even a loaf of bread that she had touched. Soon their whole village had ostracized her.

Ms. Karuna cried as she told her story, but that story also conveyed an uncommon strength. She had left her husband’s family and her village to start a new life on her own. She became an activist with the Social Educational and Economic Development Society, an advocacy group in Guntur, trying to save other truckers’ wives.

She showed women pictures of her handsome husband before he sickened, and after.

She told the wives to know what their husbands were doing outside the home, to negotiate the use of condoms with them, to get treated for sexually transmitted diseases. Her husband’s relatives still teased her: “Why are you working so hard? You also will die.”

Morality and Stigma

In the town of Nippani, outside Lafayette Hospital, a sign warned against unprotected sex, showing a blue demon on a horse slaying a healthy man.

But those who fell prey to that demon were not welcomed, explained a doctor, Sunil Sase. AIDS carried a stigma like leprosy, he said, “so we are not exactly treating the AIDS cases.” They were sent to another hospital 50 miles away.

A group working to raise AIDS awareness among prostitutes had been chased from Nippani after being accused of promoting sex. Most of the devadasis and prostitutes, who had been working in the town on the highway for 50 years, had been chased out in a morality crusade. Now they were scattered along the road, impossible to reach with education or condoms.

A mob had pulled one prostitute, Reshma Sheikh, and her 7-year-old son out of her house to try to force them from town. “We have a right to live and work there, we never hurt the sentiments of the people around,” she said. She had stayed, only because she had nowhere else to go.

The main group leading the crusade was the Shiv Sena, a Hindu nationalist political party. Sunil Sadashir Dalavi, 32, the local leader, boasted about their success. But he said the women were not the only cause for the spread of AIDS.

“Educated boys don’t get jobs, they have extra time, they don’t know what to do,” he said. “They can’t marry till they get a job, they have very strong desires, so they go to these women.”

Once the men were married they would not do “these things,” he insisted, despite government surveys showing otherwise. The answer to controlling sex was controlling the culture, he said. A lot of local men went to two nearby cinemas that screened sex movies, he said, and then to brothels. “We want to close the ‘talkies’ down,” he said, “so people will not do this.”

A Fragmented Industry

In almost every doorway in the red-light district of Chilakaluripet, in Andhra Pradesh, women drape, wearing bright clothes, garish makeup and come-hither expressions that have served to lure both men and disease.

For half a century, the town has been a center of sex work, combining its location on the national highway with women from its Domara community, which has come to specialize in prostitution. Truckers passing through know where to stop; if they do not, there are hotel boys, rickshaw pullers and others willing to guide them.

In recent years, the town and surrounding area have also become a center of H.I.V. infection, and, given the number of long-distance truckers tarrying here, a likely source for its spread elsewhere.

The sex industry has been organized in some cities, like Calcutta, but mostly it is as fragmented as the trucking industry. Chilakaluripet features brothel-based and home-based prostitutes, secret prostitutes and women who sell sex along the highway. A police crackdown on brothels in recent years has further dispersed the women.

Venkaimah, a 25-year-old widow, is part of a “highway brothel” – a small moving coterie of women who work in bushes or fields or restaurants along the road. Her workday starts when the light is gone and the truck traffic heavy. She leaves her two daughters, 10 and 2, behind, and on a good night may get 8 to 10 customers who pay 50 cents to a dollar each.

Some prostitutes now use condoms, but the disease continues to spread. One local organization, Needs Serving Society, estimated that 1,000 people had tested positive for H.I.V. in the town and nearby villages, most of them not prostitutes, but locals who may have patronized them. No one, though, had any real idea of the true number. On one narrow lane alone, 20 prostitutes were infected, said one of them, Konda, 38.

Venkaimah’s children motivated her to use condoms – if she did not, she knew that sooner or later they would be orphaned. But loneliness can loosen defenses: like many prostitutes, she had “temporary husbands” – longtime boyfriends – with whom she did not use a condom at all.

Chilakaluripet, known for sex, was now marked by death.

In a courtyard, Venkateswarmma, a mother of two, as thin and brittle as a doll, sat on a cot, unable to move. Her husband, a brothel owner’s son, had died 10 days before, infected after sleeping with its employees. She was near death herself, unable to walk for her husband’s death ceremony. Her 2-year-old son had already died from AIDS; she would leave behind an 11-year-old boy.

A Mobile Society

For 15 years, Vilas Jaganath Kamkar had been taking the bus from his village in Maharashtra state to Mumbai, its capital, where he worked as a taxicab driver. In 1994, he had taken a wife, Manisha, but he kept working in Mumbai, with monthly visits home.

In this migrant nation, his life was not unique. Nor, in this age of AIDS, was his fate. Migrants may be the hardest group for AIDS educators to reach. As Indian society becomes more mobile, people are leaving villages for urban work at increasing rates.

In Maharashtra, new plants and factories are springing up along the revamped highway. As rural migrants come to work in the factories, poor women follow to sexually service the men. Newly rich locals patronize the abundant supply of women, spawning H.I.V. “hot spots” along the highways.

In cities, the migrants live in slums, three or more to a room, and may move often. Away from their families for months at a time, they seek the companionship not just of prostitutes but of girlfriends, with whom safe sex is often ignored.

Migrants leave home to work, but go home to die. At the hospital in Satara, a prospering city on the highway south of Mumbai, Mr. Kamkar, the taxi driver, now 32, lay breathless on a hospital bed. His luck had run out, and not just because he had contracted H.I.V. Only 25 hospitals and health centers were prescribing antiretroviral drugs. They were available in Guntur, but not 12 miles south in Chilakaluripet. They could be had in Mumbai – but not in Satara.

All Mrs. Kamkar, 25, a mother of two, could do was take her husband back to their village, try to ease his pain and nurse him until the end.

“It’s a matter of his destiny,” she said.

* Copyright 2005 The New York Times Company

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