WOMEN BEAR THE BRUNT

The social, economic and gender impacts of HIV and AIDS in India was the subject of a nationwide study conducted by the National Council of Applied Economic Research (NCAER), with support from the National AIDS Control Organization (NACO) and United Nations Development Programme (UNDP). The findings, encapsulated in three reports, were released in New Delhi on July20, 2006 by C. Rangarajan, Chairman, Prime Minister’s Economic Advisory Council. Also present were Sujatha Rao, Additional Secretary and Director General, NACO, Maxine Olson, UNDP Resident Representative, and Suman Bery, Director General, NCAER.

The impact of HIV and AIDS is felt far beyond the health sector and has severe economic and social consequences - and it is women who are the worst sufferers. According to an NCAER report titled ‘Gender Impact of HIV and AIDS in India’, biological, societal and economic factors make women and young girls more vulnerable to the epidemic.

The report reveals that the low status of women, poverty, early marriage, trafficking, sex work, lack of education and gender discrimination are factors responsible for the increasing vulnerability of women and girls to HIV infection.

The main route of HIV transmission in India is through sexual contact and it accounts for about 86 percent of HIV infections in the country. Blood transfusion, parent-to-child transmission and drug use, particularly in the northeastern states and some metropolitan cities, account for the remaining 14 percent.

VULNERABILITY OF WOMEN AND GIRLS:

There are a number of factors - biological, socio-cultural and economic - which make women and young girls more vulnerable to HIV and AIDS. Women are at a biological disadvantage of contracting the virus as HIV is more easily transmitted to a female body as compared to men. In sub-Saharan Africa, young women in 15-24 age group were 2.5 times more likely to be infected as compared to men of the same age group.

Gender inequality and poverty are responsible for the spread as well as disproportionate impact of the epidemic on women. The gender inequalities get reflected in the sexual relations between husband and wife.

In India, women do not have the right to decide when to have sex; as a result, they cannot negotiate safe sex and ask men to use condoms. There is also lack of availability of female-controlled HIV preventive methods.

Cultural norms and attitudes condoning multiple sexual partners for men, and their pre- or post-marital sexual relationships increase women’s risk of getting infected with the virus.

IMPACT ON SCHOOL CHILDREN:

The study reveals that as compared to non-HIV households, the gender gap in the dropout percentages is more among students from HIV households in the 6-14 age group and for rural children in the 15-18 age group.

In HIV households, boys are mostly withdrawn from school to take up an income-earning activity and girls are discontinuing the schooling in order to take care of younger siblings and household chores.

In the case of boys, in more than 40 percent of the cases, "had to take up jobs" is reported as a reason for dropping out and in the case of girls, the percentage is nearly 33 percent.

Though the gender difference is not very significant in HIV households among junior students, in the case of older children, 32 percent of boys had to absent themselves from school due to their parents’ ill health. But more than 40 percent of the girls had to drop out from the schools to care of their ailing parents.

The study also found that since expenses in government schools are comparatively lower, children of HIV-infected parents opt for such schools. From a gender perspective, the percentage of girls attending government schools is much higher than boys.

While 67 percent of girls are studying in such schools, in the case of boys it is below the 60 percent mark. Such schools are much cheaper, if not free, and also come with other benefits like uniforms, mid-day meals and free books.

STIGMA AND DISCRIMINATION:

The study says that though stigma and discrimination are faced by a bulk of the HIV-infected people, there is evidence to show that women are targeted to a significantly greater degree.

The study tried to find out how the affected persons and their families reacted when they come to know about the presence of an HIV-infected person in the household.

More than 65 percent of people living with HIV and AIDS (PLWHA) were shocked to know they were positive. Interestingly, however, the percentage of families shocked when the PLWHA is a male is higher than when it is a female.

This could be indicative of the fact that a large number of women tested positive after their husbands had already tested positive. Hence the spouse and the family probably expected it and the disclosure of the status did not come as a shock, the report notes.

In what can be termed as an encouraging sign, the survey reveals that 74 percent of male and 70 percent of female have reported that their families are quite supportive despite an initial hesitation. However, it says gender discrimination is noticeable in that while nearly 5.5 percent of the HIV-infected women were asked to leave home, only 1.9 percent of the male PLWHA were subjected to similar treatment.

Again, while 12.4 percent of women are supportive of their HIV positive husbands, only 8.5 percent men support their infected wives. The percentage reporting problems like “deprived of using basic amenities” is more in the case of women - irrespective of place of residence.

Discrimination in the form of neglect, isolation or abuse was reported by a higher percentage of women in both urban and rural set-ups.

Quoting a UNAIDS Inter-Agency Task Team on Gender and HIV and AIDS, the report states that equality and non-discrimination should not only be important principles of human rights law, but are also vital for disease prevention and for ensuring equitable access to care, treatment, and support for those affected by the infection.

KNOWLEDGE OF HIV AND AIDS:

Gender differences are also visible when it comes to knowledge about HIV and AIDS infection, the modes of transmission, with men being better informed that women. While 58 percent of the men know about all the modes of transmission, only 54 percent of women had the same knowledge. Misconceptions about the modes of transmission were also higher among women. Knowledge about the linkages between sexually - transmitted diseases and HIV and AIDS was not only low among the general public, but in most of the surveyed states women were far less knowledgeable.

STATUS OF HIV - POSITIVE WIDOWS:

The survey discloses that households of HIV - positive widows are poorer than other HIV households. The families of HIV - positive widows have less income and they spend lesser than others on food. Their savings are also less and most of them are below the poverty line. The lack of income and employment opportunities could push them to making sub minimal choices like entering the sex trade, the report remarks.

The report also mentions that hardly 10 percent of the widows are living with their husbands’ families. While 40 percent of the widows are living alone, almost none of them are living with their natal family.

HIV - positive widows face double the stigma and are discriminated against by both their family as well as society at large. Most widows complained that they were thrown out of their houses after they were widowed.

Encouragingly, however, in spite of low incomes HIV - positive widow households are spending more on the education of children as compared to other households. In these households, almost an equal percentage of boys and girls study in government and private schools.

The report says that wherever possible they are giving equal opportunities to girls and it is possible that being HIV - positive widows, they realize the importance of educating their daughters.

But the drop-out rate is higher in these households and the report suggests this could be due to two reasons - in the absence of earning members, children may have had to take up jobs; or they have to take care of ailing family members.