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  • 1. RISK-GROUPS, VULNERABILITY AND GENDER BY SARA PRICE Deconstructing the Indian Response to HIV/AIDS:
  • 2.
    • WHO/UNAIDS defines risk-groups as:
    • India taxonomizes its risk-groups as:
      • “ People are said to be at risk of acquiring the HIV infection if what they are doing, or what they might do if placed in a facilitating situation, is associated with a high risk of HIV transmission.”
      • Men who have sex with men and transgenders (MSM and TGs)
      • Injecting drug users (IDUs)
      • Female sex workers (FSWs)
    Definition of Risk-Groups:
  • 3.
    • 1) Individuals must view their actions as characterizing their identity
      • Example: A person who engages in commercial sex must perceive themselves as a commercial sex-worker
    • 2) “Containment” logic produces both:
      • (1) The diseased cultural-Other (essentially a highly-stigmatized sub-population)
      • (2) A “general population” who is rendered normal, homogenous and “safe”
    • 3) In order to contain/prevent the spread of HIV/AIDS, at-risk individuals must choose to change their risky behaviors
      • Example: The solution provided in the “ABC” approach (Abstain, Be Faithful, Use Condoms)
    • 4) High-Risk Taxonomies are globally, socially and culturally universal
      • Example: Commercial Sex Workers (CSWs), Men-Who-Have-Sex-With-Men, and Intravenous Drug users are universally visible at-risk groups
    Problematic Assumptions Imbedded In Risk-group Prevention Strategies:
  • 4.
    • Map of the Indian
    • Sub-Continent:
    • Map of HIV Prevalence Among Women Attending Prenatal Clinics:
    Independent Research in Tamil Nadu: Exploring Married Women and HIV/AIDS Vulnerability *Red space indicates rates of between 0.51-1.75% prevalence
  • 5. MY RESEARCH IN MADURAI, TAMIL NADU:
    • Preliminary/Fact-Finding: Geared towards investigating risk-groups as an effective tool for HIV prevention
    • 15 interviews and a small convenience survey (3wk. period) included:
      • 2 Non-Governmental Organizations providing prevention and treatment services
      • 1 Public Hospital
      • 1 Private Hospital
      • 1 Community Based Organization
      • 2 health workers
      • Survey: 10 HIV+ ppl. 9 Females/1 Male
  • 6.
    • Findings:
    • All respondents reported a decrease in HIV incidence within risk-groups
    • All respondents reported a significant increase in the number of monogamous married women testing positive
    • All female survey respondents reported being infected by their husbands
  • 7. Literature Findings:
    • The patriarchal structure of the Indian joint family locates sexual and reproductive decisions in the hands of the husband and his parents
    • The co-production of masculine and feminine norms constructs men as sexually autonomous
    • Future Research:
    • Examining the married couple as a unit at-risk for HIV.
  • 8.
    • MY HOST FAMILY , G. GUNAMALAI, G. SELVAKUMARI (TO ME, OF COURSE THEY WILL ALWAYS BE APPAA AND AMMAA) AND NIVIDETHA . WHEN MANY IN MY COMMUNITY IN MADURAI WERE HORRIFIED BY THE WORK I WAS DOING, MY HOST PARENTS REMAINED PROUD AND SUPPORTIVE, EVEN BRAGGING TO THEIR FAMILIES ABOUT THE IMPORTANCE OF THE RESEARCH .
    • MY TRANSLATORS, RAJAKUMAR AND SULTAN , FOR BEING THE ONLY STUDENTS I MET WHO WERE NOT AFRAID TO HELP ME COMMUNICATE WITH PEOPLE WHO SUFFER FROM THIS EPIDEMIC
    • MY INFORMANTS , ALL OF WHOM FACE AN UPHILL BATTLE AGAINST HIV/AIDS EVERY DAY, WHETHER BECAUSE THEY ARE INFECTED OR BECAUSE THEY FIGHT FOR THOSE INFECTED DESPITE SEVER STIGMATIZATION FOR THEIR COLLEAGUES, FRIENDS AND FAMILY.
    • FOR MANY STUDENTS, THE SENIOR PROJECT IS NOTHING MORE THAN AN UNDERGRADUATE REQUIREMENT FOR COMPLETION OF THE DEGREE; I MUST SAY THAT FOR ME, IT IS AND ALWAYS WILL BE MUCH MORE. IT IS MY DEEPEST HOPE THAT ALTHOUGH THIS IS SIMPLY THE WORK OF AN UNDERGRADUATE STUDENT, IT WILL HELP IN SOME WAY TO INSPIRE OTHERS TO SEARCH FOR ANSWERS AND SOLUTIONS TO THIS PROBLEM. TO SPEAK ABOUT, ANALYZE, CRITICIZE AND QUESTION THE WAY THIS DISEASE WORKS IS ONE THING; TO SEE IT AT WORK IS ANOTHER.
    Acknowledgements: