RISK-GROUPS, VULNERABILITY AND GENDER

BYSARA PRICE

Deconstructing the Indian Response to HIV/AIDS:

WHO/UNAIDS defines risk-groups as:

WHO/UNAIDS defines risk-groups as:

India taxonomizes its 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: Definition of Risk-Groups:

Problematic Assumptions Imbedded In Risk-group Prevention Strategies:

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

Map of the Indian Sub-Continent:

Map of the Indian Sub-Continent:

Map of HIV Prevalence Among Women Attending Prenatal Clinics: 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*Red space indicates rates of between 0.51-1.75% prevalence

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

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

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

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

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: Future Research: Examining the married couple as a unit at-

risk for HIV.

•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: