HIV Prevention for Girls and Young Women: the Report Cards initiative

Under the umbrella of the Global Coalition on Women and AIDS (GCWA), the International Planned Parenthood Federation (IPPF), together with UNFPA and Young Positives, are developing country Report Cards to strengthen HIV Prevention strategies for girls and young women. By the end of 2008, 23 country cards will have been produced, including one on India.

Each Report Card provides a country profile, information on HIV prevention from the legal, policy, service availability and accessibility, rights and participation perspectives and includes quotes and issues raised by young women and girls of the country. They also discuss key social and cultural issues, including the role of men and boys in HIV prevention. These form the basis for a series of recommendations aimed at increasing and improving the programmatic, policy and funding actions taken on HIV prevention for young women and girls, targeting national, regional and international decision makers. So what does India’s report card tell us about the extent of HIV & AIDS in the country?

India provides an interesting case study within the global HIV & AIDS epidemic. Over the last few years, the figure for the estimated number of people living with HIV (PLHIV) have been contested and revised. One thing that cannot be disputed is that, as in many other parts of the world, women are increasingly affected by the virus. India accounts for almost 1.4 million of the estimated 1.6 million young people (ages 15 – 24) living with HIV in the World Health Organisation’s South-East Asia Region.[i]

Awareness regarding HIV is lower among women, especially girls and young women in rural and tribal areas. Therefore, within the general population, women and young people are becoming increasingly more vulnerable to HIV infection. According to sentinel surveillance reports for 2005, 38.5 percent of HIV infected persons are women. The number of monogamous women getting infected from their husbands is rapidly increasing; highlighting the need to simultaneously target men and boys in HIV prevention programmes in order to develop a comprehensive and sustainable response. Home remedies and self medication are commonplace across India, as is the belief in traditional healers.

Young people in India cannot be categorised as a homogenous group and different sub populations are exposed to different risk settings depending on location. Social and cultural factors influence discussions on issues around sex and sexuality, particularly in rural and tribal areas. Sexual harassment and physical abuse continue to affect single migrant women and those deserted by their husbands, making them particularly vulnerable and susceptible to commercial exploitation, and therefore, increasingly at risk of infection. Poverty, as a result of a lack of resources and poor infrastructural support may force some women to trade sex for food and other necessities.[ii]

In light of this the Report Card makes the following prominent recommendations to donor and NGO programmers and policy makers, and the national and regional governments:

Ø Ensure comprehensive training of health care workers on issues relating to stigma and discrimination and privacy and confidentiality so as to foster an inclusive environment that will not deter people (particularly young girls and women and those in rural areas) from accessing services.

Ø Work with boys and men to improve their understanding and behaviour around sexual health and HIV prevention issues so as to reduce the transmission of HIV and STIs to their regular and recreational partners.

Following the production of the printed Report Card, a launch event was held in Bhopal, Madhya Pradesh with the aim of disseminating it to all key stakeholders including bi-lateral donors, UN agencies, federal government, NGOs and grassroots organisations. Hard copies of the Report Card have been sent to the Barli Development Institute for Rural Women, one of DiA’s partner organisations.

Prior to the launch individuals were not aware of the vulnerability of young women and this was reflected by the lack of programmes that organisations were running. As part of the launch, organisations became sensitised to the issues.

A large problem that was discussed was the plight of rural women being trafficked to large urban centres such as Delhi, Agra and Bombay and ending up in the sex work industry. The underlying cause of this was largely attributed to the plight of rural farmers who see/have no other option in terms of income generation. Identifying these specific factors is a key step to formulating prevention strategies.

The Report Card has also been translated into Hindi, as the English version is only really useful for policy makers and programmers in international organisations. This Hindi version can be of far more use on the ground because it is easily accessible to government departments.

Through building upon the relationships forged in the Report Card development process, the Family Planning Association of India in Bhopal (IPPF Member Association in India) has recently had the opportunity to make inputs to the National Rural Health Mission, which addresses sexual and reproductive health issues. There is a specific section on ‘Life Skills Education’; sexual health cannot be explicitly talked about in India, but progress is being made.

This initiative hopes to ensure that in countries like India, a country-specific and tailored response to HIV prevention can be developed.

James Fairfax

To read more about the IPPF Report Cards click here.

[1] WHO (2006) Summary Country Profile for Treatment Scale Up, India (Date accessed 13/07/06)

[1] Government of India (2005), National Aids Control Organisation and Ministry of Health and Family Welfare, Progress Report on the Declaration of Commitment on HIV/AIDS United Nations General Assembly Special Session on HIV/AIDS (UNGASS) (Date accessed 15/02/07)