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
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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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