In a small house tucked inside the crowded lanes of Harsh Vihar in East Delhi, the sound of sewing machines mixes with the aroma of homemade vermicelli and papad. Here, Mahua (name changed), a woman living with HIV, starts her day early. She cooks, sews, and works hard, just like many others in her neighbourhood, trying to provide for her family and live with dignity.

Across India, more than 2.5 million people are living with HIV, according to a 2024 report by the Ministry of Health and Family Welfare. In Delhi alone, close to 39,000 people received treatment last year. Yet, the real struggle goes far beyond the illness itself. Many people living with HIV face judgment, isolation, and fear, especially in poor urban communities. They worry that if their condition becomes known, they will be rejected by society, even by their own families. This fear stops many from going to hospitals or health centers.

For Mahua and many others, the HIV diagnosis was only the beginning of the hardship. It wasn’t just the medicine. It was the shame. She was afraid to even visit the hospital. For women in urban slums, most of whom are migrants from across the country, the burden of illness often comes with the fear of social exclusion and the collapse of livelihood.

And there’s always the money. Living with HIV means more than managing an illness. It comes with the constant pressure to afford medicines, maintain regular nutrition, and pay for basic healthcare. For many, these essential needs remain out of reach.

But something is changing.

Since 2021, Caritas India’s Gram Nirman program, supported by Caritas Australia, has quietly been scripting a different story. Working across 18 slums and 65 sub-slums in East Delhi, the program is helping women living with or affected by HIV reclaim their dignity through care, community, and most importantly, economic independence.

Understanding the severe financial pressure faced by people living with HIV, especially women, the Gram Nirman team began encouraging and promoting small, collective enterprises. They motivated women to come together, build trust, and start group-based income generation activities right from their homes and neighbourhoods.

Mahua now leads Ekta Mahila Samuh, a group of 15 women, most of whom have either tested HIV-positive or have family members who have. Their enterprise, a blend of home-based food production and tailoring, has become a beacon in Harsh Vihar. Every morning, the women roll vermicelli and shape papads; by afternoon, they switch to stitching salwar suits and blouses for local customers.

Each woman earns around ₹300 a day, translating to a monthly income of nearly ₹9,000 per household. It’s not just money. It’s hope. It’s pride. It’s a reason to wake up and work.
Across East Delhi, in the dense lanes of Ashok Nagar, another group is thriving. Under the leadership of Aanandi (name changed), Suraj Mahila Samuh has found its niche by making cloth bags and selling them at weekly haats (local market). Festival seasons bring additional business with home-made sweets and snacks. Every woman here earns up to ₹2,000 a week. For families that once lived hand-to-mouth, this is nothing short of transformational.

But it hasn’t been easy.

The idea of collective enterprise was foreign. Yet, through months of meetings, training, and tireless encouragement from Gram Nirman facilitators, a bond was formed. Groups that once hesitated now meet regularly, discuss profits, plan inventories, and even dream of expansion.

The reality of HIV in urban slums is stark. Stigma runs deep. Many women are abandoned or forced into commercial sex work, with little access to healthcare or nutrition. Caritas India’s approach is holistic, identifying and supporting people through counselling, linking them with health services, providing nutrition advice, helping them access government schemes, and encouraging home-based care.

The income-generation part is only one piece of the puzzle, but it’s the one that empowers. With the support of Gram Nirman and their own inner courage, these women have found a way to earn their livelihood with dignity.

There is a different energy now. These women no longer see themselves as victims. They are entrepreneurs.

To date, the program has mobilized seven women’s groups across East Delhi, with over 75 women involved. Three groups are already profitably running ventures; others are in various stages of planning and capacity building.

Plans are underway to scale up their tailoring work by introducing advanced machines. The women are eager, confident, and ready.

In communities where HIV still whispers like a curse, Gram Nirman is helping people speak out, not in protest, but in pride. With locally rooted, low-cost solutions like microenterprises, the program is reintegrating the most marginalized into the development fold.