HIV, Sex Work & IDUs: Overcoming Stigma & Gender Barriers Annie Mangsatabam Manipur, INDIA

HIV, Sex Work and IDUs -Overcoming stigma and Gender barriers Manipur is a borders state. Easy availability due to trafficking of drugs like heroin from the golden triangle has made Manipur a consumer state. It is estimated that there are about 28,000 IDUs in the state ( FHI and NACO study) Male IDUs is 95 % and female IDUs 5 %. Study from the Drug centres shows that 90% of them also share injecting equipments leading to an increase in HIV infection. In 1998 the HIV infection amongst IDUs was as high as 72% (MACS). The various intervention program by MSACS and other donor has brought down the infection to `19.8 % in 2006 (MSACS).

Feminization of the epedemic Sexual transmission of HIV from the IDUs to their spouse and subsequently to their children was on the rise. HIV infection amongst women was only 2% in 1998 but in 2006 the infection has gone up to 25% (MSACS) and subsequently to their children

Why did the infection spread so fast to the women population ? Normal accepted reason could be : Difference in the anatomical structures of the sex organs Difference in the physiological function of the sex organs The gender perspective like a Poor education b Sex being a male decision cDenial to equality of food/health d Poor negotiating skills to sex etc.

Besides this what went wrong : 1. The HIV program in the Manipur is very gender biased. MSACS has 67 Intervention program out of which only 5 are for women covering hardly 5000 women population. Hardly 10% of the resource allotted are for women. Women just do not have the opportunity to know about HIV not to speak of preventing themselves from HIV. 2. Most of them are young widows aged between 25 to 35 yrs and are sexually active, sometimes they become easy victims of sex work to earn a living. 3. Preventive devices adopted by National and state program are male friendly, e,g like condom which is to be used only in men. Women have to depend on men for their protection, 4. The slogan of faithful partner did not work because 90% of the women was faithful to their husbands but they got the infection because their husband.

What could be done to stop this spread amongst women : Certainly we need to empower women in all aspect especially related to HIV prevention: One need to ask : Do we have a gender policy in the country or organization taking up such intervention program. NACO. SACS, NGOs, UN bodies, Bilateral donors. Hardly we see anybody initiating such policy. Formulating a gender policy would make lot of difference in minimizing the epidemic amongst women.

What are the area we need to address to formulate such a gender : 1. Women to be equally represented in all the decision making process of the organization NACO/MSACS/ NGO etc. 2. Resources allotted should be in proportion. 3. Capacity building of women especially in life skills like negotiating for safer sex. 4. Identifying gaps and developing suitable intervention program 5. Utilization of women resources in implementation of the program like use of the female peer educators has found to be very useful. 6.Capacitating Women self help group for sustainability of the program. 7. Developing mechanism like female condom, verucide where women can protect the virus by themselves.

HIV, Sex Work and IDUs -Overcoming stigma and Gender barriers Trafficking of drugs like heroin from the golden triangle has made Manipur a consumer state. It is estimated that here are about 28,000 IDUs in the state ( FHI and NACO study) Male IDUs is 95 % and female IDUs 5 %. Study from the Drug centre shows that 90% of the also share injecting equipments leading to an increase in HIV infection. In 1998 the HIV infection amongst IDUs was as high as 72% (MACS). The various intervention program by MSCAS and other donor has brought down the infection to `19.8 % in 2006 (MSACS). Manipur is a borders state. Sexual transmission of HIV from the IDUs to their spouse and subsequently to their children was on the rise. HIV infection amongst women was only 2 % in 1998 but in 2006 the infection has gone up to 25% (MSACS) and subsequently to their children. Why did the infection spread so fast to the women population ? Normal accepted reason could be : Difference in the anatomical structures of the sex organs Difference in the physiological function of the sex organs The gender perspective like a Poor education b Sex being a male decision c Denial to equality on food/health d Poor negotiating skills to sex etc. Besides this what went wrong : 1. The HIV programmed in the state is very gender biases. MSACS has 67 Intervention program out of which only 5 are for women covering hardly 5000 women population. Hardly 10% of the resource allotted are for women. Women just do not have the orrportunitu to know about HIV not to speak of preventing themselves from HIV. 2. Most of them are young widow of age of 25 to 30 ye45ras and become easily sex worker to earn a living. 3. Preventive devices adopted by National and state programmer are male friendly, e,g like condom which is to be used only in men. Women have to depend on men for their protection, 4. The slogan of faithful partner did not work because 90% women was faithful to their husbands but they got the infection because their husband was not faithful to them. What could be done to stop this spread amongst women : Certainly we need to empower women in all aspect especially related to HIV prevention: One need to ask : do we have a gender policy in the country or organization talking up such intervention programmed. NACO. SACS, NGOs, UN bodies, Bilateral donar. Hardly we see anybody inititsating such policy. Formulating a gender policy would make lot of difference in minimizing the epidemic amongst women What are the area we need to address to formulate such a gender : 1. Women to be equally represented in the decision making process of the organization NACO/MSACS/ NGO etc. 2. Resources allotted should be in proportion. 3. Capacity building of women especially in life skills like negotiating for safer sex. 4. Identifying gap of women and developing suitable intervention program 5. Utiliziozng women resources in implemtation of the prograame like use of the female peer educatos has found to be vey useful. 6.Capacitastion Women self help group for staidly of the programme. 7. Developing mechanism like female condom, verucide where women can protect the virus by themselves. Developing gender policy for all organizations working on drugs and HIV NACO MSACS NGOs Programs Clients Areas to be addressed on gender policy –Decision making process –Capacity building –Number of interventions/programs –Material resources –Funds –Client –Employment