Socio-Economic Impact of HIV and AIDS in Tamil nadu

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Table 1.3 Source of infection in Tamil Nadu upto 2004 Heterosexual promiscuity Number of Percentage cases 45,273 94.6 Homosexual 94 0.19 Peri-natal 1,807 3.78 transmission Blood and blood 171 0.36 products Injectable drug users 37 0.08 Others 475 0.99 Total 47,857 100 *Source: AIDS Cases Surveillance Report, Tamil Nadu State AIDS Control Society is to control this problem effectively as well as also to raise awareness on HIV infection and AIDS among all sections of the population. A study on community prevalence of STDs in the state, undertaken in 1998, placed the prevalence of any STD condition in Tamil Nadu at 15.8 percent and the overall prevalence of HIV in the community at 1.8 percent, with wide inter-district variation in STD/HIV status. The findings suggest a higher prevalence of HIV in rural areas than in urban areas and also among women rather than men. The age group at risk for any STD was 30-39 years. The major element in AIDS control strategy in the state is awareness creation and social immunisation. The focus has now shifted from mass awareness towards inter-personal and behavioural change communication. High-risk groups are identified and targeted, and interventions are made by establishing partnerships with NGOs. Supply of safe and tested blood is being ensured. Condom usage is promoted; students of classes IX and X are covered for awareness raising and immunisation through the School AIDS Education Programme, now operative in 1420 schools in the state. Voluntary Counselling and Testing Centres have been established in 11 places to screen the HIV status of individuals and to offer immunisation services. A surveillance system is also in place to assess the trend in the spread of HIV infection. Although the number of AIDS cases in Tamil Nadu is very high, the trend in ANC clinics in the state shows that the prevalence rate is coming down. From a rate of 1 percent in 1998, it has come down to 0.50 percent in 2005. Similarly, the prevalence rate of HIV at the STD clinics has steadily declined since 2000. It has come down from 16.8 percent in 2000 to 8.4 percent in 2004. Behavioural change among the core transmitter groups is a prerequisite for the slowing down of the epidemic. The main source of evidence for this behavioural change are the findings from Table 1.4 Observed HIV-prevalence levels in Tamil Nadu (1998-2004) (in percentages) Surveillance sites * 1998 1999 2000 2001 2002 2003 2004 STD(11) 16.30 10.40 16.80 12.60 14.7 9.20 8.40 ANC(30) 1.00 1.00 1.00 1.13 0.88 0.75 0.50 IDU (1) -- -- 26.70 24.56 33.80 63.8 39.90 MSM (2) -- -- 4.00 2.40 2.40 4.40 6.80 6 Socio-Economic Impact of HIV and AIDS in Tamil Nadu, India
four rounds of Behaviour Surveillance Surveys (BSS) conducted by the USAIDfunded AIDS Project and Control (APAC) in Tamil Nadu. For example, condom use among Commercial Sex Workers (CSWs) went up from 56 percent in 1996 to 88 percent in 1999. Similarly, condom use during paid sex among transport workers rose from 55 percent in 1996 to 80 percent in 1999 (APAC, 2000). However, the battle against HIV and AIDS has not yet been won in Tamil Nadu; through the first signs of a possibility of slowing down the epidemic have been seen. Given the scarcity of data, even this tentative conclusion must be viewed with caution. It is yet to be seen whether the flattering trend of antenatal HIV prevalence continues in the coming years. 1.3 Objectives of the present study The factors responsible for the highprevalence of HIV in the state clearly indicate that the problem of HIV and AIDS has deep social and economic roots. Hence, its impact reaches far beyond the health sector with severe social and economic consequences. It affects the individual, family and the community at the micro-level and various sectors of the economy at the macro-level. However, it has been found that the economic impact of the HIV epidemic is most significant at the family and community level – especially among the poor and marginalised groups – rather than at national, macro levels, particularly in South Asia (UNDP, 2003). The present study is an attempt to assess the impact of HIV and AIDS at the level of affected persons and their households. It is hoped that this study will throw some light on specific strategies that are needed to alleviate the problems faced by HIV affected households in a developing country. The objective of this study is to analyse the nature and type of socio-economic impact of HIV and AIDS on the affected individuals and their households in the state of Tamil Nadu. The study focuses on: 1) Impact on household income, consumption and savings 2) Impact on change of job/loss of employment of the HIV affected individuals and of the caregivers 3) Impact on the education of the children of the affected families 4) Effect on the health status of the PLWHA, pattern of morbidity, their health-seeking behaviour and the expenditure incurred by the households on medical treatment of opportunistic infections (OIs) 5) Coping mechanisms adopted by the HIV and AIDS affected families and the availability of social security 6) The social impact on the affected persons and their families, which includes stigma and discrimination faced by PLWHA at various settings; namely, in the neighbourhood, community, and health facilities and at the workplace. The study also documents the overall experiences of the PLWHA with reference to their reaction to their HIV status, discovery and disclosure of HIV status and the attitude of their family towards them. This report is divided into eight chapters and in the following chapter the methodology used for conducting the household survey and the qualitative research methods used for gathering information are discussed. Chapter three presents background characteristics of the sample households and a brief profile of the sample PLWHA who were The objective of this study is to analyse the nature and type of socioeconomic impact of HIV and AIDS on the affected individuals and their households in the state of Tamil Nadu Introduction 7
Page 1: Socio-Economic IMPACT of HIV and AI
Page 4 and 5: © United Nations Development Progr
Page 6 and 7: Acknowledgements This report would
Page 8 and 9: CHAPTER 6 Impact of HIV and AIDS on
Page 10 and 11: Table 5.2 Average per capita per mo
Page 12 and 13: Table 8.2 Distribution of sample PL
Page 14 and 15: Executive Summary Introduction AIDS
Page 16 and 17: The work force participation rate r
Page 18 and 19: In the HIV households, both the rat
Page 20 and 21: discrimination. This discrimination
Page 22 and 23: 2 Socio-Economic Impact of HIV and
Page 24 and 25: Tamil Nadu has been identified as o
Page 28 and 29: interviewed for the study. A detail
Page 34 and 35: Household selections were made with
Page 36 and 37: In o rd e r t o s e l e c t t h e n
Page 41 and 42: Chapter 3 Profile of Sample Househo
Page 43 and 44: Table 3.3 Distribution of sample ho
Page 45 and 46: households use firewood. Liquified
Page 47: Table 3.7 Current and the past occu
Page 52 and 53: Table 4.1 Distribution of sample ho
Page 54 and 55: income class, it is seen that while
Page 56 and 57: That the impact of the epidemic is
Page 58 and 59: Table 4.6 Change in job due to HIV
Page 60 and 61: Table 4.9 The situation with respec
Page 62 and 63: Most of the loss in income has been
Page 64 and 65: Occupational category Table 4.13 Lo
Page 66 and 67: 4.6 Observations The prevalence of
Page 70 and 71: lesser than that of non-HIV househo
Page 72 and 73: Table 5.3 ...(Contd.) HIV household
Page 74 and 75: Table 5.4 ..... (Contd.) HIV househ
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Table 5.5 Distribution of consumpti
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Table 5.6 Distribution of consumpti
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While the non-HIV households are po
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Table 5.7 .... (Contd.) HIV househo
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Table 5.8. .... (Contd.) HIV househ
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Table 5.10 Distribution of savers a
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households is, however, the highest
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growth of CPI in 2004-05 over 1999-
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the expenditure of households that
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While the burden of illness is bein
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76 Socio-Economic Impact of HIV and
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impact is measured not only by aski
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Annual household income (Rs) Age 6-
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The percentage of girls from HIV ho
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In both HIV and non-HIV households,
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Impact of HIV and AIDS on Health
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Chapter 7 Impact of HIV and AIDS on
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7.1.2 Prevalence rates of illnesses
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7.2 Details about nonhospitalised i
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Again, it is seen that fever remain
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Table 7.9 Distribution of non-hospi
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Table 7.12 Frequency of hospitalisa
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It is seen that both in rural and u
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Table 7.18 Distribution of hospital
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Stigma and Discrimination, Knowledg
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Chapter 8 Stigma and Discrimination
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8.3 Reaction to HIV status 8.3.1 In
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from counsellors helped them to com
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provide supportive environment for
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minimal risk of contracting the inf
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Table 8.10 Distribution of responde
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Table 8.12 Distribution of responde
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to mingle with children belonging t
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Conclusion and Policy Implications
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Chapter 9 Conclusion and Policy Imp
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also reluctant to divulge their sta
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Annexures Conclusion and Policy Imp
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Annexures Annexure I Summary of foc
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Discrimination at workplace Many of
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that now. One of the participants w
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Annexure II Box 1 Case study 1: Tam
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Box 2 Case Study 2: From riches to
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United Nations Development Programm
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Socio-Economic Impact of HIV and AIDS in Tamil nadu

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