RISK AND VULNERABILITY

RISK AND VULNERABILITY

Several factors put India in danger of experiencing a rapid spread if effective prevention and control measures are not scaled up and expanded throughout the country. These risk factors include:

Unsafe Sex and Low Condom Use: In India, sexual transmission is responsible for 84 percent of reported AIDS cases. HIV-prevalence rates are highest among sex workers and their clients, injecting drug users, and men who have sex with men (many of whom are married). When surveyed, 70 percent of commercial sex workers in India reported that their main reason for not using of condoms was because their customers objected.

Migration and Mobility: Migration for work for extended periods of time takes migrants away from the social environment provided by their families and community. This can place them outside the usual normative constraints and thus more likely to engage in risky behavior. Concerted efforts are needed to address the vulnerabilities of the large migrant population.

Injecting Drug Use (IDU): Studies indicate that many drug users are switching from inhaling to injecting drugs. This phenomenon is more localized in the Northeastern states of India, and injecting drug users show sharp increases in HIV prevalence. Forty-one percent of IDUs in a national survey reported injecting with used needles or syringes. Of those who cleaned their needles and syringes, only three percent used an effective method such as alcohol, bleach, or boiling water. Appropriate strategies are also needed to address the double impact of drug use and unsafe sexual practices.

Low Status of Women: Infection rates have been on the increase among women and infants in some states. As in many other countries, unequal power relations and the low status of women, as expressed by limited access to human, financial, and economic assets, weakens the ability of women to protect themselves and negotiate safer sex, thereby increasing vulnerability.

Widespread Stigma: Stigma towards people infected with HIV/AIDS is widespread. The misconception that AIDS only affects men who have sex with men, sex workers, and injecting drug users strengthens and perpetuates existing discrimination. The most affected groups, often marginalized, have little or no access to legal protection of their basic human rights. Addressing the issue of human rights violations and creating an enabling environment that increases knowledge and encourages behavior change are thus extremely important to the fight against AIDS.