Risk and Vulnerability What is the difference?
Risk <ul><li>A hazard; a source of danger; a possibility of incurring loss.  </li></ul><ul><li>For EMPHASIS it is about a ...
Risk enhancers <ul><li>unprotected sex with a partner whose HIV status is unknown,  </li></ul><ul><li>multiple unprotected...
Vulnerability
Source  http://www.oecd.org/dataoecd/33/60/36570676.pdf
<ul><li>http://www.constellafutures.com/fg/resources/B.1-HIV-in-India.ppt </li></ul>
What we know: Southern states <ul><li>ANC HIV surveillance in some districts for 7 years; in all for last 2 years. </li></...
Southern states: Female sex workers <ul><li>Transmission risk vary considerably depending on the typology of sex work: whe...
Southern states: Sex between men <ul><li>Complex tapestry of self classification (kothis; panthis; transgender) and associ...
Advocacy: enabling environment <ul><li>An  enabling environment  is an environment where public policy, laws, and practice...
Human rights not an optional extra <ul><li>We know that preventing spread of HIV is not just about individual behavior cha...
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Risk and vulnerability

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Risk and vulnerability

  1. 1. Risk and Vulnerability What is the difference?
  2. 2. Risk <ul><li>A hazard; a source of danger; a possibility of incurring loss. </li></ul><ul><li>For EMPHASIS it is about a behaviour that can directly result in HIV infection. </li></ul><ul><li>the probability that a person may acquire HIV infection. </li></ul>
  3. 3. Risk enhancers <ul><li>unprotected sex with a partner whose HIV status is unknown, </li></ul><ul><li>multiple unprotected sexual partnerships, </li></ul><ul><li>lack of adherence to infection-control guidelines in the health-care setting, </li></ul><ul><li>repeated blood transfusion, especially of untested blood, </li></ul><ul><li>injecting drug use with shared needles and syringes. </li></ul>
  4. 4. Vulnerability
  5. 5. Source http://www.oecd.org/dataoecd/33/60/36570676.pdf
  6. 6. <ul><li>http://www.constellafutures.com/fg/resources/B.1-HIV-in-India.ppt </li></ul>
  7. 7. What we know: Southern states <ul><li>ANC HIV surveillance in some districts for 7 years; in all for last 2 years. </li></ul><ul><li>25 - 40% of districts have STI sentinel surveillance among STI patients. </li></ul><ul><li>5 - 25% districts have facility based sentinel surveillance for KPs. </li></ul><ul><li>History of prevention programming: </li></ul><ul><ul><li>7 -12 years of FSW and high risk male prevention programming </li></ul></ul><ul><ul><li>IDU and MSM prevention programming more recent and more limited. </li></ul></ul>
  8. 8. Southern states: Female sex workers <ul><li>Transmission risk vary considerably depending on the typology of sex work: where; number of transactions per day; norms around condoms use. Example : In southern states, only 5 - 10% of sex work takes place in brothels, compared with 55% street based and 20 - 30% home based (Avahan). </li></ul><ul><li>HIV prevalence among sex workers varies widely. Where reported condom use is high often lower HIV prevalence. Example : Relatively low rate of 9.5% HIV prevalence among FSW in Tamil Nadu correlate with high rates of self-reported condom use. </li></ul><ul><li>STI prevalence rates are variable but generally high. </li></ul>
  9. 9. Southern states: Sex between men <ul><li>Complex tapestry of self classification (kothis; panthis; transgender) and associated sexual behaviour impacts on HIV risk. </li></ul><ul><li>Sex between men seems common in both urban and rural areas. Example: Study in 5 rural districts found 10% of single men and 3% married men reported anal sex with another man in the previous year. </li></ul><ul><li>Limited reports suggest high rates of STIs in MSM. </li></ul><ul><li>Many MSM also have sex with women. Example: In AP, 51% of MSM reported sex with regular female partner in previous 3 months. Condom use with last male partner 44%, with last female partner 16%. </li></ul>
  10. 10. Advocacy: enabling environment <ul><li>An enabling environment is an environment where public policy, laws, and practices: </li></ul><ul><ul><li>protect and promote the rights of PLWHA, SWs, MSM, and IDUs </li></ul></ul><ul><ul><li>support effective programmes </li></ul></ul><ul><ul><li>reduce vulnerability to HIV/AIDS, and </li></ul></ul><ul><ul><li>address its consequences. </li></ul></ul>
  11. 11. Human rights not an optional extra <ul><li>We know that preventing spread of HIV is not just about individual behavior change. </li></ul><ul><li>We need to understand and address the structural barriers that people at risk and living with the virus face. </li></ul><ul><li>Stigma and discrimination: </li></ul><ul><ul><li>reduces access to information about HIV prevention and care </li></ul></ul><ul><ul><li>undermines people’s ability to make informed decisions about their behavior and health </li></ul></ul><ul><ul><li>prevents people from implementing safer behaviors. </li></ul></ul><ul><li>Health and human rights are mutually reinforcing: where rights are protected, vulnerability to HIV infection is reduced and impacts of HIV/AIDS alleviated. </li></ul>

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