Aids Women Chld

8/14/2019 Aids Women Chld

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Vulnerability ofWomen &Children to HIV/AIDS

DR. KANUPRIYA CHATURVEDI

DR. S.K. CHATURVEDI


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What is

Vulnerability?

that may be wounded

Susceptible of injury

Exposed to damage

(lit. or fig.)


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25% of all HIV infection fall in women, with anaccompany 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?


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Vulnerability Factors of Women

Overall Status Illiteracy

Low Control on

Reproductive Rights Low Access to Health

Care

Lack of Knowledge Violence Against

Women


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Vulnerability Factors of Women

Sex ratio: 933/1000

(~ 25 million missing)


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Women & Education

Close to 245 million women lack the basiccapability to read and write (over 50% ofwomen in India)

Womens literacy lower than men

Gross school enrolment rate is 65% forboys 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%)


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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, arealready mothers or pregnant with firstchild

52% of women have never usedcontraception (condom use < 3%)

Little control over fertility and

reproductive rights


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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


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Percent Women aged 15-49 who

Have Heard of HIV/AIDS

21.6

26.2

65.8

76.1

59.7

84.7

87

74.5

87.7

70.6

23.8

27.3

23.9

48.7

32

74

41.3

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

< 30

30 - 49

50 - 69

70 & above

MICS-2000


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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

36.6

42.2

46.9

46.8

14

12.8

11.5

30.8

19

37.8

21.1

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

< 20

20 - 29

30 - 3940 & above

MICS-2000


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Women & Violence

Violence inside and outside the family

74% increase in crimes against women1980-1990 (rape, molestation and torture

showing the highest rate of growth)

Children account for 30% of total rape

victims


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Vulnerability Factors of

Adolescents

Early debut of sexual

activity

Lack of Knowledge Lack of an enabling

environment where to

acquire this knowledge Misconceptions


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HIV/AIDS Awareness among

Adolescents

< 20 years - FHAC 2000

0

10

20

30

40

50

60

Rural

Urban Slums

orrect knowledge about benefits

condom use to prevent STI/HIV

Used condomduring last intercourse

Source: FHAC Coverage Evaluation

AIIMS/INCLEN/USAID 2000

32

53

3.46.3


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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

KarnatakaOrissaBihar

SikkimGujarat

NE (ex sikkim & Manipur)

J&KUPMP

RajasthanMaharashtra

UrraranchalHaryana

Himachal PradeshAP

DelhiTamil Nadu

Punjab

KeralaManipur


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Vulnerability Factors of

Children

Parent-To-Child

Transmission of HIV Lack of Access

to Treatment

Lack of coordinated

Efforts for Care &

Support


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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


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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


18/19

33

8

0

5

10

15

20

25

30

35

%

No ARV With ARV

who acquired HIV - PCR at 2 months

Proportion of infants of HIV (+) mothers

Some Lessons Learnt:Reduced transmission of HIV from mother

to infant


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1985

Focus on HIV as a

health problem

Prevention

Care

Recognitio

n ofMulti-SectoralResponse

Care

Prevention ingenera

lpopulations

Targetedinterventi

ons

1

995

Multi-Sectoral

Strengthening

Response

2005

Prevention

Care

Strengthening the Response:

a Paradigm Shift

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Aids Women Chld