Vulnerability of Women Children to HIVAIDS DR KANUPRIYA

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? l l l 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 l Sex ratio: 933/1000 (~ 25 million missing)

Women & Education l l l 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 l 36% of married adolescents between 13 and 16, and 64% between 17 and 19, are already mothers or pregnant with first child l 52% of women have never used contraception (condom use < 3%) l Little control over fertility and reproductive rights l

Women & Access to Health Care l l l l 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 l Violence inside and outside the family l 74% increase in crimes against women 1980 -1990 (rape, molestation and torture showing the highest rate of growth) l 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 3. 4 6. 3 Correct knowledge about benefits of condom use to prevent STI/HIV Used condom during last intercourse Source: FHAC Coverage Evaluation AIIMS/INCLEN/USAID 2000

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 0. 4% prevalence 108, 000 infected pregnancies 30% transmission Annual Cohort of 32, 000 infected newborns 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

Strengthening the Response: a Paradigm Shift Recognition of. Response Multi-Sectoral Focus on HIV as a health problem Targeted intervention s Strengthening Multi-Sectoral Response Care Prevention Care 1985 Prevention in general population s Care 1995 Prevention 2005