Sadhna-Jain by dandanhuanghuang


									 Women in families living with
   HIV/AIDS in Delhi, India

Sadhna Jain, Sr. lect in Reader’s grade,
   Dept (Family and Child Welfare),
        Aditi Mahavidyalaya
      University of Delhi, India
Women are more vulnerable to
                     HIV/AIDS is
                   not just a
                   medical disease
                   but a social
Social factors turning HIV into an
         epidemic in India
               Limited educational
               Lack of knowledge and
               awareness about HIV/AIDS,
               Unequal access to health care,
               Unequal access to income
               generating activities ,
               Economic dependency on men,
               Lack of knowledge about sexual
               and reproductive rights
               Sexual violence.
Impact of HIV/AIDS on women
            Stigma, discrimination and
            Emotional exhaustion (time
            poverty, empowerment cost
            and opportunity cost),
            Unrecognized work load,
            Economic hardships,
            Critical shortage of food and
            Increased medical
         Women are
         providers and
         not receivers of
         health care
            They lack psycho-social
         support, training in
         nutrition, drug
         management, basic
         nursing techniques and
         universal precautions to
         provide efficient and
         quality care and to
         protect themselves.
       How is Delhi vulnerable to HIV /AIDS
        Total population > 14 million.
        Total number of PLHAs – 2592
        Prevalence rate –0.25 %
        From 2002 - Jan 2006 figure rose from 945 to 2592 ( nearly
         three fold increase ).
         Reasons
        Ever increasing number of migrant population,
        Large number of high risk groups like street children, sex
         workers, homosexuals, intravenous drug users & migrant
        High prevalence of sexually transmitted diseases among
         women in slums & JJ clusters.

Source Delhi State AIDS control Society report 200
• Investigate the impact of HIV/AIDS on
  women living in families,
• Assess the feelings of subjective well-being in
  women living with HIV/AIDS in families,
• Find out the availability of care and support
  services to women living with HIV/AIDS in
          Sample and Method
Women living with HIV/AIDS in families.
Multiple case study design
Interview guide for women living with HIV/AIDS in
Subjective Well-Being Inventory developed by Dr.
  Helmet Sell and Dr. Rup Nagpal,
Theme based group discussions.
  Demographic profile of the families
General information about the father
• Age Range: 30-42 Yrs
• Education level of the father: Illiteracy- Primary
• Occupation: Driver, ORW, business
• HIV status
• Negative: None
• Positive: 15
• Whether on ART: Were/are10 on ART
• Alive or dead: 5 alive
• Reason of death: AIDS related illness
• Mode of contraction of the disease: HUS
• Alcoholic status
• Alcoholic: 15
• Non alcoholic: None
General information about the mother
• Age Range: 27-40 Yrs.
• Education level of mother: Illiteracy-secondary level
• Occupation: House wife, domestic/patient care help,
  helper in NGO, ORW.
HIV status
• Negative: 06
• Positive: 09
• Whether on ART: 09
• Alive or dead: 14 alive
• Reason of death: AIDS related illness
General information about children
• Total number of children: 38
• Age range of children: 08-23 Yrs
• No. of male children: 17
• No. of female children: 21
• No. of married children: 01
• No. of HIV negative children: 29
• No. of positive children: 09
• No. of children on ART: 07
• No of maternal orphans: None
• No. of paternal orphans: 33
• No. of double orphans: 05
• Mode of contraction of the disease in children: PTCT
• No. of children going to school: 30 regular school/NFE classes
                 Results and not have surviving male adult
    Sixty seven percent of the families did
   Wives reported alcoholic nature of husbands and incidences of domestic
   Infection entered the family through unsafe sex with multiple partners
    by the male member of the family.
   Stigma and discrimination faced by women from extended family
   Women were invisible multipurpose workers.
   Avoidance of health seeking behavior by women.
   Daughter in laws were treated much worse than sons.
   Poor communication and understanding between couples before the
    contraction of the disease.
   The position of HIV widows was much worse than that of HIV infected
   All the families received material and psycho-social support from one or
    more NGOs.
 Education of children got affected by HIV.
 Many changes took place in the families after
  the contraction of the disease like joining of
  work force by the mother, placement of children
  in institutions, separation of siblings, property
  quarrels, less number of outings, altered parent
  child schedules, lesser availability of facilities
  financial crisis, children spending time alone,
  involvement of children in household work
  irrespective of sex, parental worries about the
  future of their children after their death etc.
   Thirteen percent of WLHIV scored between 40-60, while 73%
    scored between 61-80 and 13% scored between 81-120. The
    mean score of WLHIV was 69 much lower than that of normal
    Indian adult samples which is 90.8.
    Eighty seven percent of women scored below the mean positive
    score (42.9) of the test. The minimum and maximum positive
    score of the sample was 27 and 44 respectively while that of the
    test was 19 and 57 respectively. The minimum and maximum
    negative scores of the sample was 37 and 60 respectively while
    that of test was 21 and 63 respectively.
   The middle value of scores of WLHIV on factors general wellbeing
    positive affect, social support and primary group concern was
    lower while it is higher for factors like expectation achievement
    congruence, confidence in coping, inadequate mental mastery,
    perceived ill health and general well-being negative affect. The
    middle value of scores of WLHIV on factors transcendence, family
    group support and deficiency in social contacts were same as
    that of SUBI.
    Women were not happy about the way their life
    was functioning, did not find primary family as a
    source of overall well-being and social environment
    supportive in times of crisis in general.
    They were happy with their standard of living and
    ability to master critical or unexpected situations
    but they also had insufficient control over certain
    aspects of life that were capable of disturbing the
    mental equilibrium. They perceived themselves as
    not feeling well and generally had depressed
    outlook on life.
    The disease negatively impacted the every aspect
    of the family dynamics. Women were not perceived
    as seekers of health unless very seriously ill.
 Women bore the disproportionate brunt of HIV.
 There is a need for devising mental health program
  for women in particular and PLHIV in general.
 There is a need to shift the focus of attention from
  interventions to well-being and optimal health.
 Link between alcohol and HIV need to be exposed.
 The position of HIV infected widows was much
  worse than that of women infected with HIV.
 There is a need to scale up awareness generation
  program for general population.
      Strategies to mitigate impact of
            HIV/AIDS on women
   Supportive social environment
   Involvement of HIV positive women
   Access to health care
   Female controlled strategies
   Microbicides
   Social marketing of female condoms
   Training in income generating activities
   Improving inheritance rights
   Strong political commitment
Thank You

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