Children affected by AIDS in India suffer from abuse and discrimination, a problem that undermines efforts to fight a growing epidemic and places millions of lives in danger, according to a report issued Thursday by Human Rights Watch.

The New York-based organization urged the Indian government to ensure that children affected by HIV and AIDS are not denied access to education and medical care.

Such children face discrimination in schools and hospitals, are denied care by orphanages, and are forced onto the streets and into the worst forms of labor, said the report, "Future Forsaken: Abuses Against Children Affected by HIV/AIDS in India." It was based on interviews and field research in five Indian states.

At least 5.1 million people are living with HIV/AIDS in India, a figure second only to South Africa's, according to Indian government estimates. Although the government has not determined the number of children affected by AIDS, some experts say that more than 1 million children under 15 have lost one or both parents to the epidemic and that more than 200,000 children are HIV-positive. HIV is the virus that causes AIDS.

"There is a sense of denial by the Indian government that HIV-affected children face widespread abuse, and their concerns are invisible in government's policy response," said Zama Coursen-Neff, author of the 209-page report. "We hope our report would bring the children into the government's radar screen."

The government's National AIDS Control Organization declined to comment on the report. The agency, in collaboration with UNICEF, runs an AIDS education program for high school students in states with a high prevalence of infection. The program provides basic facts about the epidemic and virus transmission, said a UNICEF spokeswoman. But the challenge remains in reaching millions of students who never reach high school, she added.

The Human Rights Watch report, which includes testimony from children, says: "Doctors have refused to treat and sometimes even touch HIV positive children. Schools have expelled or segregated children because they or their parents are HIV positive."

It quotes Sharmila A, 10, an AIDS orphan living with HIV, recounting the attitude of her teachers when they found out she was infected.

"When I went to school, I sat separately from the other children, in the last mat. I sat alone," the report quotes her as saying. "The other children wanted to be with me, but the teacher would tell them not to play with me. She said, 'This disease will spread to you also, so do not play with her.' "

In a major policy initiative in April, India began distributing free anti-retroviral drugs to about 100,000 poor AIDS patients. In a symbolic gesture as she announced the program, Sushma Swaraj, then health minister, hugged two AIDS-affected children who had been denied access to school.

Three Indian states have policies addressing discrimination against AIDS-affected people in education and health. The Lawyers Collective (HIV/AIDS), an advocacy group that has been working with the government since 2001 on draft legislation to protect the rights of AIDS-affected people, said a bill would be introduced in parliament this year.