Thangzual’s (name changed) life seemed perfectly normal until he began experiencing persistent fever, diarrhea and infections late last year. A 24-year-old man, concerned about rapid weight loss, entered his symptoms into the phone.
When HIV came up as the likely cause, he froze. Clinics, helplines and next steps were also listed in the search results. But he wasn’t sure where to begin—or indeed, whether to begin at all. “How could this happen to me,” he remembers asking himself. “To me, HIV was a disease of prostitutes and drug users. I was afraid of being labeled immoral.”
He was toying with the idea of visiting a testing center when he came across an Instagram post by the Mizoram State AIDS Control Society (MSACS) about a new health and outreach center called SPOT, or “Safe Place for Open Conversation.” The liberating sound of its name, along with the promise of free HIV services, immediately attracted him, but what caught his eye more were the accompanying visuals: the place didn’t look like a clinic at all.
The next day, Thangzuala found himself in the basement of the Mizoram Upa Pawl (MUP) headquarters in Aizawl, where he discovered a vibrant cafe that offered not only drinks and snacks, but also free HIV and STI testing, condoms, counseling and support.
It wasn’t long before Thangzuala was answering the kindly questions of the unhurried advisor. For the first time since his turmoil began, he relaxed without averting attention. Finally, he was ready to visit the testing center, encouraged by the counselor’s offer to accompany him.
At SPOT Cafe in Aizawl. | Photo credit: MSACS
Anticlinic
SPOT, which opened on February 9 this year, is rewriting the rules of engaging young people about sexual health. In a relaxed, intimate setting – complete with a graffiti wall, television, karaoke and fun games – young people can feel at home among the condom dispensers and counselors.
Mizoram’s postcard landscapes have long resisted the overwhelming challenge of public health. One of India’s smallest states – second smallest by population and fifth smallest by area – Mizoram has the highest HIV prevalence in the country, currently 2.75% of the population, and the highest incidence with new cases around 0.9%, according to the India HIV Estimate 2025 technical report.
Between April 2025 and January 2026, Mizoram recorded 1,478 new cases — 955 males and 523 females, including 86 pregnant women. “What’s particularly concerning is that most people who test positive are in their prime years,” says Dr. Jane Rinsangi Ralte, Project Director, MSACS.
“We can’t force people to take certain actions, but we can certainly give them safer options.”Dr. Jane Rinsangi RalteProject Director, Mizoram State AIDS Control Society
The situation has been compounded by the influx of cheap drugs from the porous border with Myanmar, part of Southeast Asia’s drug-producing Golden Triangle; abysmally low condom use; and “serial monogamy,” where multiple monogamous relationships over a lifetime increase the risk of HIV transmission.
The epidemic was once controlled almost entirely by intravenous drug use. This has now fallen to around 27%. Almost 70% of new cases are attributed to sexual transmission.
Shadows out, people in
It is against this grim backdrop that SPOT emerged as a first-of-its-kind, people-focused health initiative created through a partnership between MSACS and AHF India Cares, the India program of the AIDS Healthcare Foundation, a US-based non-profit organization. SPOT is not a clinic that tries to imitate a coffee shop, but a social center designed to normalize conversations and care about sexual health and sexually transmitted infections (STIs).
“In a state where HIV prevalence among adults is almost 13 times the national average, we need to look beyond incrementalism,” says Lalrinpuii, Mizoram’s Health and Family Welfare Minister. She revived the NACO-mandated AIDS Legislative Forum in Mizoram and raised ₹20 lakhs through contributions from legislators to help those who cannot afford to travel to ART (anti-retroviral therapy) centres. “Unfortunately, the most affected age group is also the most reluctant to seek help,” she says.
For services to overcome stigma, the minister believes innovation must become a cornerstone of public health. “New models like SPOT, in line with national and international rights-based principles and frameworks, are bridging the gaps left by conventional systems,” he says. “The initial response to SPOT indicates a great opportunity for us to institutionalize new approaches to deliver clinical outcomes with dignity and convenience. We aim to scale up such cafes in Mizoram. They can also be replicated across India in accordance with the local culture.”
“In a state where adult HIV prevalence is nearly 13 times the national average, we need to look beyond incrementalism.”LalrinpuiiHealth and Family Welfare Minister of Mizoram
Prevention can only work if young people do not feel reduced to statistics. “It’s unrealistic to expect them to go to conventional health care facilities where they will feel judged,” says Dr. V. Sam Prasad, Country Program Director, AHF India Cares. “SPOT meets young people where they already belong – socially, emotionally, culturally – and helps them own their health with confidence and dignity. For young adults in Mizoram, this can mean the difference between meaningful engagement and being left behind.”
The cafe thus becomes more than just a backdrop. “Coming out is essential to replace stigma with empathy. This is where SPOT can play a vital role,” says Henry Zodinliana Pachuau, professor of social work at Mizoram University and co-author of several national and global studies on HIV/AIDS and STIs in Mizoram. “Amidst the state’s thriving coffee shop culture, SPOT provides the perfect incentive for young people to not only talk freely about STDs, but also benefit from vital behavioral health counseling and harm reduction services such as syringe distribution and opioid substitution therapy.”
The name SPOT was intentional. “In the Mizo language, ‘spot’ is slang for illegal places where people go to drink or use drugs,” explains Dr. Ralta. “We wanted to change that negative connotation.”
Counseling in the cafe SPOT | Photo credit: MSACS
Within weeks of its opening, SPOT has welcomed dozens of young people, one as young as 10, who come after school or college, between work shifts, on dates or to meet friends. They’re looking for vital answers, mental health support, relationship advice and free condoms – all over the cup in a discreet environment, unencumbered by tedious meetings and explanations.
Just like in real life, curiosity often starts. For example, a ten-year-old girl visiting her parents wanted to understand how SPOT could help children her age cope with stress and confusion.
Whole heart, no judgement
“For me, SPOT is like a safe space that I didn’t have when I first found out I was HIV positive,” says Vanlalruati Colney, activist and founder of Positive Women’s Network of Mizoram. She was one of the first Mizo women to publicly disclose her HIV positive status in 2003. “I experienced the brutal reign of fear and shame that comes with HIV and can break people to the point where they lose the will to even seek help,” she adds. “SPOT humanizes the challenges that ignorance and suffering throw at young people. This is what the fight against HIV/AIDS needs – compassion, courage and care without judgement.”
Within a few weeks of its opening, SPOT welcomed dozens of young people. | Photo credit: MSACS
SPOT has good company in town devising new ways to break through the cloak of restraint like the massive 30ft. a condom billboard – Aizawl’s first – and a unique ‘Love Brigade 2.0’ campaign where two-wheeler taxi drivers wearing condom jackets distribute free protection. Still, says Dr. Ralt, it was hard to find a spot for SPOT. “We wanted a central location, but most people were hesitant to rent the space to us. Finally, Laltanpuia, the owner of Aizawl Art Gallery, offered us a space of almost 400 square feet below the gallery and the project became a reality with the support of MUP.”
SPOT will soon begin testing for HIV and syphilis in two kits, says Dr. Ralta. “There is already growing demand for blood tests to start.”
SPOT wants a positive diagnosis to be the beginning of care, not the end of hope. “We can’t force people to take certain actions, but we can certainly give them safer options,” concludes Dr. Ralta.
The author is an independent journalist and commentator.
