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
32

63.9

54.3 74

41.3
74
41.1
21.6 59.2
27.3 31.1
54.8
43.4
12.7 92.8
35.4 54.7
88.3
Per cent 23.9 26.2

48.7 43
< 30 23.8
59.7
30 - 49
50 - 69 70.6
70 & above 84.7
65.8

56.3
MICS-2000 87.7
74.5
87

76.1
 Percent Women aged 15-49 who Know
all Three Modes of Vertical
Transmission of HIV
19

31.1

39.6 36.1

21.1
37.8
17.2
13.3 21.1
12.8 15
26.2
21
6.8 50.2
Per cent 17.7 29.9
58.1
11.5 13

< 20 30.8
14
23.4

20 - 29 31.4

30 - 39
46.8
40 & above 40.8
40.6

36.9

MICS-2000 42.2
46.9

36.6

34.4
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
60
53
50

40
32
Rural
30
Urban Slums
20

10 6.3
3.4

0
Correct knowledge about benefits Source: FHAC Coverage Evaluation
f condom use to prevent STI/HIV 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
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
Proportion of women who know how to avoid:
acquiring HIV/AIDS transmitting HIV/AIDS to baby

100
80
85.1 87.8
60
40 50.3
20 35.7
0
Before counselling After counselling
Some Lessons Learnt:
Reduced transmission of HIV from mother
to infant
Proportion of infants of HIV (+) mothers
who acquired HIV - PCR at 2 months
35
30 33
25
20
%
15
10
5 8
0
No ARV With ARV
 Strengthening the Response:
a Paradigm Shift
Recognitio
n Response
of
Multi-Sectoral
Strengthening
Focus on HIV as a
Targete Multi-Sectoral
Response
health problem
interventi
d
ons

Prevention Care
Prevention in Prevention
Care genera
populati
l
ons Care

1985 1 2005
995