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Vulnerable Populations

What factors make some populations more vulnerable to HIV and AIDS?

Due to cultural, societal, legal and religious practices and beliefs, changes in the political or social environment, and factors such as war and poverty, certain population groups are shown to be at higher risk of contracting HIV and/or of having to deal with the consequences of HIV and AIDS. The list of vulnerable populations can become quite extensive and because of this we have chosen to focus on only a few.

Women and Girls

Women compromise about half of all people in the world living with HIV. However, in sub-Saharan Africa, where the epidemic is worst, more than half of adults with HIV are women and of the young people aged 15-24 living with HIV, three quarters are girls.

Women and girls are particularly vulnerable to being exposed to HIV where gender inequalities, embodied in national law or cultural or religious practice, create an economic and social dependence upon men. This dependence, generated by less access to education and economic opportunity, the inability to inherit or own property, and lack of legal protections, often limits women's power to refuse sex. Women and girls may be subject to gender-based violence, abuse, coercion or contractual sex for goods or money and are often unable to adequately protect themselves against these sources of risk to exposure to HIV.

Source: UNAIDS

Gender-based violence

Potential of sexual transmission of HIV is even more likely in incidences of rape than during consensual sexual intercourse, due to an increased likelihood of blood-to-blood contact. In some parts of Africa there are people who believe that raping a virgin, child or an older woman can and will cure HIV and AIDS. This is a myth and is completely untrue.

Sexual abuse/forced or coercive sex includes:

  • rape within marriage or dating relationships
  • rape by strangers
  • unwanted sexual advances or harassment
  • forced marriage, or denial of the right to use measures to protect against sexually transmitted infections (STIs) including HIV
  • trafficking of people for the purpose of sexual exploitation
  • Childhood sexual abuse
  • Child marriage

While it is true that not all situations on the list above will necessarily put a woman at direct risk of HIV transmission, being subject to sexual abuse in any of these ways increases the likelihood of a woman finding herself in a situation where she is unable to negotiate sexual behavior in the future, thus increasing the risk of HIV.

Source: p7 HIV/AIDS and Gender-Based Violence (GBV) Literature Review, August, 2006

Conflict situations

There is increased risk of HIV in conflict situations. Women are more vulnerable in conflict and refugee situations because of:

  • Population displacement
  • Breakdown of family and social structures
  • Lack of access to health care
  • Increased sexual and Gender-Based Violence
  • Rape as a method of warfare
  • Sexual interactions between civilians and combatants

Source: UNFPA Gender and HIV/AIDS Resource Pack (2006)

Young People

Half of all new infections worldwide occur in young people aged 15-24. Young people are more at risk of HIV because they become sexually active at a young age but often do not settle with one partner early on, nor do they use condoms regularly. Young people are also more likely than any other age group to experiment with drugs, including injection drugs, which further increases their risk of HIV.

Source: UNAIDS

People who use injecting drugs

People who use injection drugs are at high risk from HIV through the use of contaminated needles and syringes. Once HIV enters a community of drug users the infection can spread rapidly through sharing needles and sexual transmission. The infection can also move quickly into the general population if prevention measures are not put in place early on. UNAIDS reports that injecting drug use is estimated to account for almost one third of new infections outside sub-Saharan

Africa and is the entry point for HIV epidemics in many regions.

Injecting drug users are also made more vulnerable to the risk of HIV because of their social and legal status. In most countries, drug use is illegal and carries a lot of stigma. These factors impact the number of injecting drug users who choose to or who are able to access prevention, testing, and/or treatment.

Source: UNAIDS

Refugees/Internally Displaced Persons

Refugees - people who are forced to leave their country to escape conflict, violence or persecution - and internally displaced persons (IDP) - people who are displaced within their own country due to conflict, natural disasters, violence or persecution - are at increased risk of HIV infection. The risk of transmission is increased among displaced persons for many reasons; people who have left their home have lost the means to their livelihood, social networks and institutions break down, weakening social and sexual norms. Health and education services are disrupted which impacts access to prevention education, treatment and healthcare. Women and girls are also at a greater risk of sexual violence and exploitation. Rape is used as a weapon of war, and they may be forced to use sex as a way of securing basic necessities such as food or shelter.

The key difference between refugees and IDPs is that refugees are covered by international refugee law whereas persons displaced within their own borders are not, and it is therefore much harder to protect them and provide assistance.

Source: UNAIDS