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Vulnerability of Women & Children to HIV/AIDS. DR. KANUPRIYA CHATURVEDI DR. S.K. CHATURVEDI. What is Vulnerability ?. “that may be wounded” “Susceptible of injury” “Exposed to damage” (lit. or fig.). Who Are Now the People Infected & Affected by HIV/AIDS in India?.
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Vulnerability of Women & Children to HIV/AIDS DR. KANUPRIYA CHATURVEDI DR. S.K. CHATURVEDI
What is Vulnerability? “that may be wounded” “Susceptible of injury” “Exposed to damage” (lit. or fig.)
Who Are Now the People Infected & Affected by HIV/AIDS in India? • 25% of all HIV infection fall in women, with an accompany increase in vertical transmission and pediatric HIV • Reported median of HIV prevalence among pregnant women exceed 2%in most high prevalence states • Already about 660,000 young women and 345,000 young men aged between 15-24 years are living with HIV/AIDS • Over 50% of all new infections occurring among young people aged below 25 • 120,000 AIDS orphan children and 160,000 AIDS children living in the country
Vulnerability Factors of Women • Overall Status • Illiteracy • Low Control on • Reproductive Rights • Low Access to Health • Care • Lack of Knowledge • Violence Against • Women
Vulnerability Factors of Women • Sex ratio: 933/1000 (~ 25 million missing)
Women & Education • Close to 245 million women lack the basic capability to read and write (over 50% of women in India) • Women’s literacy lower than men • Gross school enrolment rate is 65% for boys and 49% for girls, ages 11-14 • Drop out rates: 60% for girls, 54% for boys (middle school) • Gender gap in literacy is increasing in some states(Rajasthan – girl enrolment 33.3%, boys 83%)
Women & Reproductive Rights • 26% married by the age of 15 and 54% by 18 • 36% of married adolescents between 13 and 16, and 64% between 17and 19, are already mothers or pregnant with first child • 52% of women have never used contraception (condom use < 3%) • Little control over fertility and reproductive rights
Women & Access to Health Care • Annual Pregnancies 27 million • % ANC Coverage (1/3+) 65.4/38 • % Institutional Deliveries 33.6 • % Deliveries attended by Skilled Birth Attendants 42.3 • High prevalence of STI/RTI • Births is by adolescent mother 1/10 • MMR is ~ 500/100,000 live births
Percent Women aged 15-49 who Have Heard of HIV/AIDS MICS-2000
Percent Women aged 15-49 who Know all Three Modes of Vertical Transmission of HIV MICS-2000
Women & Violence • Violenceinside and outside the family • 74% increase in crimes against women 1980-1990 (rape, molestation and torture showing the highest rate of growth) • Children account for 30% of total rape victims
Vulnerability Factors of Adolescents • Early debut of sexual • activity • Lack of Knowledge • Lack of an enabling • environment where to • acquire this knowledge • Misconceptions
HIV/AIDS Awareness among Adolescents< 20 years - FHAC 2000 53 32 6.3 3.4 Correct knowledge about benefits of condom use to prevent STI/HIV Source: FHAC Coverage Evaluation AIIMS/INCLEN/USAID 2000 Used condom during last intercourse
Proportion of 15-19 yr olds willing to share food with a HIV positive person: Rural Manipur Kerala Punjab Tamil Nadu Delhi AP Himachal Pradesh Haryana Urraranchal Maharashtra Rajasthan MP UP J&K NE (ex sikkim & Manipur) Gujarat Sikkim Bihar Orissa Karnataka Chatisgarth Jharkhand West Bengal Assam All India 0 20 40 60 80 100
Vulnerability Factors of Children • Parent-To-Child • Transmission of HIV • Lack of Access • to Treatment • Lack of coordinated • Efforts for ‘Care & • Support’
Rationale for Prevention of Parent-To-Child Transmission of HIV in India 27 million pregnancies per year 108,000 infected pregnancies Annual Cohort of 32,000 infected newborns 0.4% prevalence 30% transmission 25,000 - NACO 50,000 - NNF 25,000-50,000 deaths within few months to 5 years
Some Lessons Learnt: Increased knowledge of women about how to prevent HIV/AIDS
Some Lessons Learnt: Reduced transmission of HIV from mother to infant
Multi-Sectoral Strengthening Focus on HIV as a Response health problem Care Prevention Prevention Care 1985 2005 Strengthening the Response: a Paradigm Shift Recognition of Response Multi-Sectoral Targeted interventions Prevention in general populations Care 1995