vulnerability of women & children to hiv/aids dr. kanupriya chaturvedi dr. s.k. chaturvedi
TRANSCRIPT
Vulnerability of Women & Children to HIV/AIDS
DR. KANUPRIYA CHATURVEDIDR. S.K. CHATURVEDI
What is Vulnerability?
“that may be wounded”
“Susceptible of injury”
“Exposed to damage”
(lit. or fig.)
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
Who Are Now the People Infected & Affected by HIV/AIDS in India?
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
21.6
26.2
65.8
76.1
59.7
84.7
8774.5
87.7
70.6
23.8
27.3
23.9
48.7
32
7441.3
54.3 74
12.7
35.4
43
56.3
88.3
43.4
31.1
59.2
92.8
54.7
41.1
54.8
63.9
Per cent
< 3030 - 4950 - 6970 & above
MICS-2000
Percent Women aged 15-49 who Know all Three Modes of Vertical Transmission of HIV
13.3
13
40.6
34.4
31.4
40.8
36.642.2
46.9
46.8
14
12.8
11.5
30.8
19
37.821.1
39.6 36.1
6.8
17.7
23.4
36.9
58.1
21
15
21.1
50.2
29.9
17.2
26.2
31.1
Per cent
< 2020 - 2930 - 3940 & above
MICS-2000
Women & Violence
Violence inside 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
0
10
20
30
40
50
60
RuralUrban Slums
Correct knowledge about benefitsof condom use to prevent STI/HIV
Used condomduring last intercourse
Source: FHAC Coverage EvaluationAIIMS/INCLEN/USAID 2000
32
53
3.46.3
Proportion of 15-19 yr olds willing to share
food with a HIV positive person: Rural
0 20 40 60 80 100
All IndiaAssam
West BengalJharkhandChatisgarth
KarnatakaOrissa
BiharSikkim
GujaratNE (ex sikkim & Manipur)
J&KUPMP
RajasthanMaharashtraUrraranchal
HaryanaHimachal Pradesh
APDelhi
Tamil NaduPunjabKerala
Manipur
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
50.3
35.7
85.1 87.8
0
20
40
60
80
100
Before counselling After counselling
Proportion of women who know how to avoid:
acquiring HIV/AIDS transmitting HIV/AIDS to baby
33
8
0
5
10
15
20
25
30
35
%
No ARV With ARV
who acquired HIV - PCR at 2 monthsProportion of infants of HIV (+) mothers
Some Lessons Learnt:Reduced transmission of HIV from mother to infant
1985
Focus on HIV as ahealth problem
Prevention
Care
Recognition ofMulti-Sectoral Response
Care
Prevention ingeneral
populations
Targetedinterventions
1995
Multi-SectoralStrengthening
Response
2005
Prevention
Care
Strengthening the Response: a Paradigm Shift