For five years shopkeeper Dilawar Jain, 35, had intermittent fever and diarrhea, but doctors in his remote rural area of Rajasthan state could find nothing wrong with him. Then he developed symptoms of tuberculosis, which are recognized throughout India, and ended up in a nursing home in the nearest big city, Bombay. There doctors found he had AIDS. Jain, his wife and elder brother were given the news, although the rest of the family was kept in the dark. Feeling stronger after TB treatment, but with only a few months to live, Jain wants nothing more than to return to his village in the countryside.

For years health experts have known that HIV, the virus that causes AIDS, could bring a devastating scourge to a country like India, with a poor, largely illiterate population of 940 million. Initially much attention was paid to the brothels of India's big cities, where the sexually transmitted disease first appeared. But the main apprehension was that HIV would someday run rampant through the vastly populated but undeveloped countryside. Patients like Jain, trickling back to the cities for treatment of mysterious ailments, show that the fears are being realized: India's bout with AIDS is becoming a plague.

At the World AIDS Conference in Vancouver this month, Dr. Peter Piot, the head of the Joint United Nations Program on HIV/AIDS, estimated that India has 3 million HIV-infected citizens, the largest number of any country. In comparison, South Africa has 1.8 million, Uganda 1.4 million and Nigeria 1.2 million, although considerably higher percentages of the population are infected in those countries. India may catch up in that category too. The India Health Organization, a voluntary group active in AIDS research and awareness campaigns, offers a horrific prognosis: under the likely assumption that the number of infections will double every 18 months, in four years there will be 20 million to 50 million HIV-positive Indians--as much as 5% of the population--and the death toll could be 6,000 to 12,500 a day. "In many parts of the country, no one has told people they are vulnerable," says the organization's secretary-general, Dr. I.S. Gilada. "Many rural people have never heard of AIDS."

And no wonder. Officially, India admits to only 2,800 deaths caused by AIDS, but the government agrees that most cases have gone unreported. The unofficial toll exceeds 125,000. India has received plenty of aid and loans for HIV education since 1992, including $85 million from the World Bank and $10 million from the U.S. Agency for International Development. Less than half of that money has been spent. "What we are talking about is a campaign that reaches every corner of India," says Dr. Cornelia Davis, who heads the country's UNAIDS office in New Delhi. "And that has not been done." The most terrible form of instruction--friends and family who fall sick or die--has also failed: in the great majority of cases of Indians who succumb to AIDS, the disease is never diagnosed and the cause of death is instead attributed to a secondary infection that thrives because the victims' immune systems are weakened. In the Indian context, that is usually tuberculosis. Five years ago, the TB ward of the J.J. Hospital in Bombay saw only an occasional HIV-positive patient. Today nearly a third of those admitted have AIDS, although doctors don't always tell them for fear they will commit suicide. In rural areas, where 74% of India's population lives, the tubercular patient wouldn't even be tested for an underlying disease.

India's impending status as the AIDS capital of the world will come as a national shock. During the 1980s many Indians considered AIDS a scourge of the libertine West that posed no threat to a relatively isolated land with a conservative society based on monogamous marriages. But India has hundreds of thousands of sailors, construction laborers and clerks who work abroad for a time, and a continual tide of students and businessmen returning from overseas. Marriage is indeed the bedrock of Indian sociology--the divorce rate is almost negligible--but a third of the customers visiting brothels in cities such as Bombay, which has 70,000 sex workers, are students just a few years short of marriage. Indian villages are not, in fact, the bastions of sexual probity they are quaintly imagined to be, and the country has a huge population of migrant workers moving through cities in pursuit of farming or industrial jobs. Research is showing that Indian society is more footloose and sexually free than is commonly admitted. As a result of that mobility, HIV is no longer confined to the red-light zones of big cities and the roadside brothels that service long-distance truckers. "Now you will find it all over India, "says Dr. K.C. Mohanty of the J.J. Hospital. "The disease is spreading much faster."

The problem with HIV in India's countryside is that awareness of the disease is often nonexistent--literacy is less than 50% in rural areas, and there are fewer than five TV sets for every 100 Indians--and medical care is scattered, primitive and dependent on diagnosis through symptoms. Yet HIV doesn't normally produce symptoms until it triggers full-blown AIDS, a process that can take years.

Educational campaigns among urban prostitutes since the late 1980s have yielded encouraging results. Sex workers in cities like Bombay and Pune, for example, are starting to insist that customers use prophylactics. "The dustbins are filled with condoms, and you can see them on the roads," says Seema Rajan, an Indian Health Organization activist in Pune. "That is a positive indicator." Infection rates have stabilized among prostitutes, although at a worryingly high 60%. But no publicity campaign has penetrated the countryside, where customers return after a spree--or a job--in the big city. Mala (a pseudonym) was forced into prostitution in the western city of Pune at age 14. She started feeling ill in 1991 but wasn't tested for HIV for three years. In the meantime, she had unprotected sex with some 3,000 customers. Mala still plies her trade, although she now insists that a condom be used. "No one ever told me there is such a disease," she says.

India clearly has to begin telling its millions that AIDS exists and that the disease can be avoided. But that task has overwhelmed the bureaucrats. Within the past year the government has finally admitted that outside estimates of the number of HIV infections nationwide are correct, and 3 million is now the official figure. Some educational efforts have been made in the countryside, using puppet shows and street theater intelligible to the illiterate masses. "But everything has been done in a limited scope," says UNAIDS' Davis, "and that effort has to be multiplied." Recent encouraging news from the West about new combinations of treatments for HIV could be largely irrelevant in India, where the drugs involved are so expensive that they might be available only to the wealthy.

Added to the HIV problem is a related medical disaster that is already worsening. Tuberculosis is prevalent in India; nearly half the population has a latent TB infection. Normally only 3% to 4% of those cases develop into active TB. But a person who is HIV positive, with a weakened immune system, is prone to the disease and in conventionally crowded Indian living conditions could, on average, spread it to 20 others. Although older strains of tuberculosis are successfully treated and cured with government-subsidized drugs, TB remains the largest killer of adults in the country. And that's before the full effect of the HIV problem has been felt. The two diseases combined, according to the National AIDS Control Organization, are "an epidemic within an epidemic."

Manohar, a farmer who visited a Bombay brothel a few years ago, is back in the big city with a double diagnosis of AIDS and TB. He is too ill to sit up and shakes his head when asked if he has heard of a disease called AIDS. Manohar's wife and three-month-old son are back on the farm: they're unlikely to be tested unless they end up in a city hospital in a condition close to death. India may have millions of unfortunates like Manohar, terminally ill and fatally ignorant of the disease that has infected them.

--Reported by Meenakshi Ganguly/Bombay