HIV and AIDS

STATISTICS

It has been estimated that 39% of adults living with HIV/AIDS in India as of the end of 2002 were women.23 The increasing HIV prevalence among women can consequently be seen in the increase of mother to child transmission of HIV and paediatric HIV cases.

A new report from UNICEF shows that 30,000 newborns in India are born with HIV every year. The large number highlights the need for an aggressive campaign against HIV, and the need for women to be able protect themselves against diseases.

According to UNICEF's Alan Court, 25 percent of 400 women attending clinics in the city of Pune tested positive for a sexually transmitted disease and 13.6 percent tested HIV-positive, yet more than 90 percent reported only having had sex with their husbands. India recently announced that as many as 3.5 million people in the country may be infected with HIV.

Source:  

http://www.indianngos.com/issue/hiv/women/statistics.html

http://www.hivdent.org/ 

Women :Overview

In India heterosexual transmission is a major cause of the HIV / AIDS epidemic. Most women are socialised to submit sexually to men, to agree to male sexual preferences and to accept non monogamous behavious in their partner.

Cultural norms define a "good" woman as one who is ignorant about sex and passive in sexual interactions. Many women fear that their husbands may see them as "bad" women if they reveal a basic knowledge of sexual matters.

Women are afraid to question men about sexual behaviours, initiate a dialogue on sexual matters or assert their preferences.

Within this context, most women are powerless to negotiate the use of condoms or safer sexual practices in relationship with men.

KEY ISSUES

HIV + Women

  • Diagnosed later succumbs faster
  • Less access to treatment
  • Care - Provider for family ( neglects own health )
  • Rejection by family more likely
  • Rule as a child bearer threatened
  • Violation of rights - can not marry

Cultural and Traditional

  • Sex is a taboo ( not discussion ); women ill - informed on sexual matters
  • Man has a greater say in sex - no negotiating powers of women
  • Double standards - chastity for women; however multiple partners acceptable for men
  • Social Status on bearing children - use of condom opposes cultural tradition of having children
  • Fear of violence and rejection limits negotiating power

Socio - Economic

  • Low social status - second class citizens
  • Unequal access to social services
  • Globally 60 % of women live below the poverty line
  • 60 % illiterae
  • 60 % of 110 million school drop outs are girls
  • Limited knowledge of rights
  • Limited accessability to training -
    few marketable skills
    under employment
    unemployment - sell sexual services to earn a living in
  • Inaccesible and inadequate health services - girls sold into marriage , prostitution and slavery

Sexual

  • Increased violence - forced sexual relations
  • Sexual abuse
  • Early marriage for girls
  • Older men look for sexual virgins
  • 5 times more women with STIs
  • Women acquire STDs at an early age
  • 20 % to 30 % women suffer from RTIs - left untreated in most women

Biological

  • 2 to 4 times greater chance in infection
  • Female genitalia facilitates transmission

Source: http://www.indianngos.com/issue/hiv/women/overview.htm

 Women : Projects

The Rights of Women in Prostitution

Since the early 1990s, women in prostitution have borne the brunt of the HIV epidemic in India. On one hand, they suffer high levels of infection and re-infection. On the other, HIV intervention programs have labeled them vectors of infection.

In this context, SANGRAM began working in 1992 in the Sangli district in Western Maharashtra. Many health prevention programs regard women in prostitution as victims with little capacity to change anything let alone their health status. Many programs based on this approach treat such sex workers as vectors to be targeted.

SANGRAM began a peer-based condom intervention program with the philosophy that emphasizes women’s sense of identity as a community. The peer educators are women in the business as well as in the same community. Many share similar difficult stories of poverty, desertion, abuse, widowhood, or lack of life choices.

The peer-education program is based on two underlying premises. One is that insiders are more effective than outsiders in reaching the community. The other is that women in prostitution can reliably enforce condom use for their own protection.

The education program includes prevention and treatment. Part of the peer educator’s work involves preventing HIV through peer education and condom distribution as well as training and counseling women who are unable to enforce condom use. Another part is helping women with sexually transmitted infections and other health problems to access medical care and related services.

Three key concepts characterize SANGRAM’s peer education program: empowering, women-centered, and process oriented. Given the organization’s emphasis on processes and on strengthening the community from within, it is natural that the building of a collective was a next step.

In 1996, the peer education program broadened into VAMP—the Veshya AIDS Muqabla Parishad—a collective of women in prostitution. VAMP aims to consolidate a common identity among women and empower them to assert their rights and to work to create a safer and more enjoyable working and living environment.

As part of its responsibilities,VAMP now runs peer programs in eight districts in India with help from SANGRAM. Although the two entities are like mother and daughter, each has its own identity. VAMP is registered as a collective with its own board drawn from women in prostitution.While it is still guided by SANGRAM, VAMP has an overall vision to someday function independently. Apart from running the condom distribution program, VAMP represents the interest of its constituents in many ways. It mediates community disputes, lobbies with the police, helps women access government systems, and develops leadership potential.

Police harassment is a particularly critical issue for all women in prostitution. Not only are they routinely abused and beaten up by police, but they are also randomly picked up on charges of soliciting, which is a crime under the Indian Penal Code. Before the formation of the collective, women could not do anything about police harassment. Now they are treated with greater respect when they approach police officials for help. In some cases, VAMP has negotiated an end to police hostility and raids.

In early 2002, VAMP bought land in the border town of Nippani in the Belgaum district of Karnataka state. Since the collective had finally bought its own space, regular meetings that had taken place in Sangli for 10 years now took place in Nippani. Unfortunately, local thugs and policemen decided that the women attending the meetings were defiling the “pure and sacred” space and used force and violence to stop the meetings. They threatened to kill the leaders and to destroy the vehicles bringing the women to the meetings each week. The police turned a blind eye.

In response, SANGRAM and VAMP organized a coalition of organizations to send petitions to the police and state authorities in the affected district and held a press conference to take appropriate action against the police officers and to provide security for the women and their families who were forced to leave their home town because of threats of violence.

This does not mean that all VAMP members are now able to confront the police without harassment. However, women are now aware that they do have the ability to negotiate a situation and that empowerment can prove limitless in the change they can make for themselves, their families, and their communities.

For more information, contact:
SANGRAM
B-11 Akshay Apartments
Chintamani Nagar
Sangli 416416
India
Phone: 91.0233.311.644
E-mail: vamp@vsnl.com
meenaseshu@yahoo.com

Source: http://www.indianngos.com/issue/hiv/women/projects.htm

HIV Infected Children : Projects

Salaam Baalak Trust (New Delhi).
It is estimated that 3,000 children -- some as young as five years old -- live in and around New Delhi's bustling train station. Workers at Salaam Baalak Trust (SBT) know that if they do not reach out to these vulnerable children within a few days of their arrival at the station, they may lose them forever to the vicious cycle of sex and drug abuse.

SBT was one of the first NGOs to work on behalf of street children in India. It established a boarding home and a drop-in center near the railway station, but was in need of a separate safe haven for girls.

With the grant from USAID, SBT has established a full-time home for runaway and abandoned girls. The shelter was set up in a private home far from the red-light district and the girls attend government schools. The need has been so great that the home sometimes accommodates more than 40 girls at any time.

SBT has also been able to strengthen its outreach programs in vocational and literacy training, set up peer education training to promote healthy behavior and reduce the spread of HIV/AIDS, and develop a set of visuals on AIDS for use by peer educators, social workers, and shelter staff ?

Project Concern International (New Delhi).
Located on the outskirts of Delhi, the Seemapuri slum is home to 8,000 people crammed into an area the size of a football field. There is no clean water or toilet facilities. An open sewer runs down the congested by-lanes.

This is a community of rag-pickers where the poverty is so severe that everyone, including children, walk long distances to find garbage that has been thrown out overnight. The garbage is carried back to the slum, where it is sorted and stored in huge heaps between huts. On their own for much of the day, girls are often victims of sexual abuse or lured into commercial sex activities.

With the grant from USAID, Project Concern International (PCI) has established three drop-in centers within the ragpicking communities of Seemapuri, Red Fort, and Nizamuddin. At the centers children can come to rest, wash up, and attend classes. A pediatrician comes weekly to treat those who would otherwise have not seen a doctor.

Though open to all children, PCI finds that girls use the centers far more than boys. It is one place they can go where they know they will be safe. PCI has also established a full-time shelter home for children who need a more stable living situation. In an effort to arm children with the information to protect themselves, PCI staff provide counseling and AIDS awareness and prevention interventions. 

Committed Communities Development Trust (Maharashtra).
Kamathipura is one of the oldest and largest red-light districts in all of Asia. Thousand of sex workers live in this densely packed slum in the heart of Mumbai.

Many are girls who were brought from Nepal and Bangladesh and sold into prostitution. They live on the pavements in huts made of scrap wood and plastic sheeting. The brothels are just a few feet away in tenements, offering nothing more than small rooms crowded with beds separated by curtains. While the mothers try to look after their children during the day, when the trade starts up in the evening, children are left to wander the street, exposing them to violence and sexual exploitation.

Committed Communities Development Trust (CCDT) gained the trust an acceptance of the sex workers in Kamathipura and operated a day shelter and educational programs for the sex workers and their children in the district prior to receiving the grant from USAID. The grant now has enabled CCDT to open a Night Foster Care facility for adolescent girls, providing safe shelter, nutrition, medical attention, counseling, and education and vocational training. Activities also are underway to help improve parenting skills and establish day centers in new sex worker settlements. 

Prerana (Maharashtra).
Falkland Road is one of the largest and most notorious red-light districts in India. Many of the women here have been sold into bondage. Their children are left to fend for themselves while the women work a decade or more to buy their freedom.

With funding from USAID, Prerana established a Night Care Shelter to ensure the children's safety and a good night's sleep while their mothers are with clients. Some nights more than 50 children stay at the center, many of them teenage girls. While at the center, children receive meals, medical care, educational support, and counseling to break the cycle of second-generation prostitution.

Prerana also has helped mothers gain access to medical care and are pressuring the government for better treatment of women and children who are HIV positive. Where a woman is dying of AIDS or a household environment is too dangerous for a child, many mothers have trusted Prerana to place their children in permanent foster care to assure they are not sold into the sex trade. Women who want out of prostitution also know they can turn to Prerana for job counseling and vocational training. 

Society for Development, Research, and Training (Pondicherry).
Pondicherry, a charming former French colony on the Indian Ocean, has been hit hard by the AIDS epidemic. Thirty-five people out of 1000 are infected with HIV.

Situated on the north-south highway, Pondicherry is a major transport hub for truckers, and subsequently the sex trade. The Society for Development, Research, and Training (SFDRT) was one of the first NGOs to respond to the disaster brewing -- their intervention programs have targeted sex workers, truckers, bar owners, and liquor merchants.

They have an extensive condom distribution program and run two clinics to treat sexually-transmitted diseases, including HIV/AIDS. Because SFDRT had established such a positive rapport with the community, USAID provided this NGO with a grant to expand efforts to improve the lives of vulnerable children.

With USAID funding, SFDRT set up a day care center which caters to more than 30 children daily. Health check-ups, academic tutoring, counseling, and nutritional supplements are routine for mothers and children. Each day SFDRT delivers food to about 70 pregnant and lactating mothers and their children in the red-light district. Counselors arrange vocational training for sex workers who want out of the business. Training is provided to foster mothers who care for the children when mothers are ill or imprisoned. In addition, SFDRT counsels parents who are ill or dying, to assure that a child is not abandoned in the streets.

Community Health Education Society (Tamil Nadu).
The first reported case of AIDS in India was in Chennai in the state of Tamil Nadu. Because the epidemic is relatively advanced in that state, large numbers of AIDS patients are now dying.

The result is a steep rise in the number of children orphaned by the disease. Pervasive fear and ignorance means health care workers are still loathe to treat these children and orphanages will not take them in. The Community Health and Education Society (CHES), run by physician Pinagapany Manorama, took in these shunned children when no one else would. Word soon got out and doctors were referring destitute children and HIV-positive women to CHES.

And as AIDS spread, CHES grew. Dr. Manorama abandoned her private medical practice and turned her clinic into a care facility for people living with AIDS. With a USAID grant, CHES was able to move the children out of the clinic and into a real house where they were not surrounded by the dying. Today, 30 children live at Thooli with four live-in staff and two part-time workers. Volunteers provide counseling and medical care and others come just to play with the children. Academic classes are held on the ground floor of the house, since local institutions refused to admit the children, even though not all of them are HIV positive.

There are obviously more people than CHES can accommodate, so CHES is training other NGOs on how to care for people living with AIDS. In addition, CHES is strengthening home-based care for HIV-affected children with regular visits by counselors.

HIV AIDS - HIV Kids : Treatment
As a first definite step, Freedom Foundation Care Centre provides these children with shelter and a home they can call their own. Most are accommodated along with their mothers.

Next is the need to introduce some normalcy into the lives of these children. Since little is known about the past case histories of many of the children, the counsellors and the centres psychiatrist use 'play therapy' for encouraging more positive and creative energy. This also enables the children to cope with the more negative feelings arising out of the death or loss of parents as well as their own recurring illnesses etc.

The second step is to provide the children with an education and an opportunity to interact with other children in school. After much difficulty the care centre has succeeded in convincing schools authorities to admit these children.

The centre is also attempting to provide the children with the latest medical care. In the past 6 months Anti Retro Viral drug therapy has been initiated on the children, which costs more than Rs.2500 per child per month. This is delays the spurt of viral growth. Constant care is also provided by the doctors and resident care givers since ARV drug therapy spawns many side effects.

Thursday, February 05, 2009