El concepto de la sustentabilidad en la migración

2.7 lllik l<'aelol"'\ for lll\'/AlDS 1mong \\'omen

Inc ri,k Jiicton tor IIIV/AIDS among ,,omen arc� folio,,')

\'oun�c:r ARC

l·or women of all rnccs nnd elhniciucs., lhc largest number of 111\' und ,\IDS diuKOOM:�

durinl,l recent years ,,as for \\.'Omen ogc<l I 5.39 ^)CW"S (CDC 2007) From 2001 through 10 2004, the nwnb<:r of HI\ nnd AlDS diagnoses for \\'Onlen nged 15-39 year.. dccrcasc<l for white, block Dlld hlspantc \\.'Omen There \\'OS nn incn:ase in the number HIV und AIDS dingnoscs during this period for Asian nod Pncific lslnndcr \\'on1cn lllld for \mc:rican

\\"Omen ngc:d 15-39 )'ears (CDC, 2007). In Nigeri:1. HIV prcv.ilencc is higher omong

\\'Omen of rcproducti\'e ,igc I 5-49 ye31"$ (N�uonal An1en:1tnl HTV Scro-prcvnlcncc !>Urvey, 1991-2005).

L11ck ur Rc:cuRnition or P11rtncr', Risk Fnclon

Some women mny b<: un:i,,-nrc ol their male pnrtncr's risk factors for IIIV infection (such

b w1pro1.:-clc<l sex \\ith n1ultiplc: partners, .ex \\ith men, or 1nJection drug u.:.e (Hoder, Sm11.h, l\1oore nnd Holmberg. 2001). )'.!en who engage 10 SC.'< both ,,ith men and ,,omen can acquire HlV from u mu.le partner und lhcn tn111smit the virus lo fem1tlc: panncr.;. In 2003 rcpor1 or ^II study or !£IV- infeclcd people (5,156 men and 3.139 \\Omen), 34°/4 of black mco ,vho h.B,·c �'- ""th men (�IS�I), 26o/o of llis-panic }..ISt,.I, nnd 13o/o of wlutc

�IS1',,I reported hnving sex with \\'Omen (Mon1gomCl), Moko10IT, Gentry o.nd 9la.ir, 2003).

I lo\\evcr, 1he1r female p.irtncr.; may not ha\'c ^kno\\11 of their male J)fflnc:rs bisexual 11clivil)' onl>· 14°'• ol' the whtlc women. 6% of block \\'Omen. 1tnd 6'/o of Hasp;uue \\-omen in the study ockno,vlcdgcd lul,ing a bisclCUlll partner. In nnolhcr CDC sunc)', 6.5�· of )Dung men who had C\/c:r hnd sex \\ilh men also reported sex \\ith \\'Omen (Vlllleroy,

!lllacKcllu, Behel ond Sccura. 2003). \\'omen \\ho ho\'e sc, onh· \vtlh women IU!d ,vho have no other nsk factors such ^GS injection drui; ^U)C an: ^aJ very lo\\ ri�k for HI\ infc-ction (CDC.. unpublished dam. 2006).

lligh-lllik llctcro1u11al IUsk F1cton

1'--lost \\omen nre infccltd ,.,,ilh HlV through high-risk heterosexual contoct (CDC. 2007).

11111ck nod li15J>-111ic \\'Omen occounl (or 111% of1he \\'Omen living \\ilh HIV 1\IDS ¹ n 2005

UNIVERSITY OF IBADAN LIBRARY

who ncquircd I-UV through high-risk hctcro�,uru conlllCt (CDC. 2007). Lack ol kno\Ylcdgc, lo\\er perception of risk, drug or nlcohol use, nnd difli:rcnt 1nterprc1n11on of safer ,ex mny conlributc to this disproportion Espinoza. Hall, linnlncn, J007) In Nigeria

nnd sub-S:ihnron .\fric.i. the n1.1jor risk foctor is hctcrosexu.'11 risk factor which occur:;

because of the di:.advan1.0gcd economic position of "-omen nnd their socinl :.llllus. \Vomen and young girls nrc also affected by tmrmful consequences of m1gn11ion. trnfficking, displacement during confliclS and prostitution (\\ llO, 2005). Earlier sc:xu41 initiation anti sexual n,ixing. where )OWlP !,'.\iris tend to h:i,e sex \\ith older men for money or odYuntagcs (l�iOH. 2006). Relntionsh1p dynamics olso ploy n role. l·or example, some women ITlll) not insist on condom u.se bccliusc they fc:ir that their partner ,.,.iJJ physically abuse them or l ^ea ve them (Suarez-Al-Adam, RD.ffacUi, nnd O'Lcnry, 2000). Such sc:runl inc:quruil) is n major i!>-luc 1n relationships bet,,ecn young \\omen ru,d older men. In a CDC stud)' of urbo.n h1sh schools.. more than one thud of block and I lispnnic ,,omen had their lir.;1 sexu:il encounter with ^II m-ile ,vho ^\\ib older (3 or n1orc )ear..) (1'-filler, Clnrl.: nnd 1'.ioore, 1997). These yuung ,,omen compan:d ,yith peers ,�hoM: pannc:rs hod been opprox1matcly their O\\lTl egc had lx.-cn )oungcr al first sexual intcrcour,c:, le�$ likel) 10 lw,c: used condoms during first o.nd most rcc:cntly reported intercourse or le� likely to

hnve used condoms consistently,

Olologlc: \ ulncnibllhy 11nd Sc1:uDII)' Tnin,n1llted Dhcas�

\ \\omun is signillcnntly more lil..ely thnn o mo.n to contrnct I If\" infection during vaginul intcrcoUTSo (Europcnn Study Group on Hetc:roSCXWll Tmnsmi�ion of HIV, 1992; _Pndion.

Shboski. and Jcw<!II, 1991 ). Additlon:ill). lhc: rn:sc:nce or some sexual I} transmitted di!IC� gn:ntly 1n(rc:ascs the likelil1ood of ncquiring or trnnsmiuing HIV inlcc:uon

(ncming nnd \V1Wc:rhc1l, I 999) The rates of i;ononhcu nnd syphilis a.re higher _.unung

\\Omen of colour thnn nmong "·hitc women. lncse higher mtcs ^11te cspc-cillll) mnn:cd ⁰¹ younger ages, (I S-24 )cars) (CDC. 2006).

Soclocconomlc ^1,111c,

1'/carl> I 1n 4 block:! und I in S llispMics live in povcrt)· (US Census Bun:.,u, 2003}

Soc1occonomic problems ll�so<:intc:d ,vith poverty, including limited .. cc:c:ss ¹⁰ high quality or health cure, the cxch,llli;c of sex fur d.ru�. 111oney, or to m�t other nc:cds; nnd bi�c:r

22

UNIVERSITY OF IBADAN LIBRARY

AFRICA DIGITAL HEALTH REPOSITORY PROJECT

tc,·cl� of substnncc use ca.n directly or indirectly incrc:i.,;c I IIV ri�� foc1or, (Diaz. Chu. and

l3uchlcr, I 99,l). 1\ study of 111\' 1mnsm1ssion wnong black .,.,-omen 1n North Ctuohna

lound 1hn1 \\omen \,ith diagnosis of HIV infection ,,ere s1gr111iwn1ly more hl cly than

\\on1en v,ho \\ere not inh:ctcd 10 be une,nployc:d; 10 ha,e had more sex p:i.nru:rs. to use

cr,11;k/coc111nc; 10 exchange .ex for money, shelter, or drugs; or to recc1,e public lllSlstznce

(CDC. 200S).

R11ci111/blhn1c l)lffcrcncC$

rhc rote of 111\i d1nsno� nnd the n I.: factors for HIV inlccuon dilfcr for ^\\Omen of

\'nrious roccs or cthructlJCS o situnuon that must be considered \\-hen creating �'alllon programmes. For c,<nmple, e,cn though the :innual estimnled ^ra1c of Hf\' � for black \\Omen dcc-rcnscd sign,licantly from 82.7 pc:r 100,000 popul:iuons ⁱⁿ 2005 11 remain1:d 20 llrnc:s the r.ilc of \\hitc \\omen (CDC, 2007: CDC. 2006, \Vhitmorc.. Slltcbc:r

nod Hu, 2006). Ovcrull.thc rotc.s or IIIV diDgnosis ^lll'C n1uch higher for bllld: 11.nd lhsp,n,e

\\Omen than for the \1hitc, Asian and Pocilic Islanders. or ,\mcrican Indians mld Al:,skn

Nnti"c \\'omen. The rot� for blllcl,;. "omen ^lll'C higher than the nucs for all men. accpt for block men (CDC., 2007� CDC. 2006 \\ hitmort. !i.i.tcbcr and llu. �005) Unlil.--e ,,omc:i ^m

other regions of the ,vorld. ;\fricrui \\"Omen ore ot least 1.2 times more lil:cl) to be infected

\\ilh lilV thM their men unJ th1) rauo i� highest 11mons )Oun£ p,."Oplc :.£,-d IS-:?: ^}C3l'5 of

ugc (1'�1011. 2007).

,1u1ttrtc Rid,

Fnc1or-s .. 1nc \\Omen 1nlc:ctcJ \\'ith IIIV rcpon more than one ri"I.: factor, h.ighlishtins the o,�

111 r ^h l.: fnctor, 5uch as in,:qu.a.ln)· ¹⁰ rel111ton.,h1ps, soc1o.xunom1c ,� ,uhstJll>.."C �­

nnd p:;yc:holnilCill I, ,uc: l·nr c"1n1plc, in the Nonh C.'llrolin:i )1W� ot HI\" mfC\'.UOn ,n hlack ,,u,ncn, the p.ar1ic1r,ants m\,�t co111n11,nl} rcp,.,n,-J th.3t, thcir n.-a.� IOC" � beha,·1our \�,:re l1nnnci1d Jcr,:nJcncc nn mole p.lnncr-. f«ling 1n,111C1blc. lo\, srifcsitcm c:ou11tcJ \\lth the nectl 10 lc.:I lo\'N b) n1alc tii;wc, nnJ a1_..,hol anJ drus ^I.U.:' lC'OC.

200S)

UNIVERSITY OF IBADAN LIBRARY

U Coa11qa111a ef lllV lafmlM la W1•m

HIV 111d AJl)S ^Ill "OfflCft ha�c UCUKndow CCCIICQUfflCC'S '"tuch ,ocludt- �tother r.,.

Child fl'llfliltl,.-wn 1t.flC'1) of HIV lransnu.oe of•nv from 111fcctcd n10thcr u, child

II the Cl!M of� or HIV UU«ullft ^ID chlldtm t,cto,,. IS ^)QR and the rul'. of \t rcr �

c:11lmaled at I S-40% tn �-c� ^councnn of the "llrld d1stnbutcd as folio"� IM. 1n u1cro, 2ot. dw1ng bb.>w and 10,. lhrough hfQS& fcicdina (" HO, lOOSl A• more \\-"Omen bccQffle 1nf«tcd. lhcrc 1s a grt>\\-Uli Ill\' and AIOS epidemic amon, children \\ho acqwrc the 1nfe\:Uon through �fTC."1 (I �tOII. 2007) Othct cocucqucnocs Include-, child � lnc:n:.ucd moNh� mnong \\'OIDffl. etq,hms. lou of cnucal fllfflll) and commurut�

n11111ro"'n and ^lt:IOWCO and fm:illr dwoluuon of f.amibcs \\'hen '"omen d,c

2.9 �IQtbcr-To-t·blld•Tran1mndoa (�ITCTI or ^Ill\'

111\1 ll11nm1li: 1,m fron, mothcr•to child durtng prt'g!W)C), labour, and dch,ay or bras!

1ta11ne IS uthc"'hc oolcd pcnnaul tnrum1uion OI mother-to-child lr.msmb-sfoo of HIV

t-10:11 cluldtcn less IS )CJID h,mg ...,,th 111\1 IIO,\UU'C the Infect.ion through l\lTCT \\iuch

,-an ^{OCCUJ dunng} Jfftnmc>, labour. and dch,uy, or hras1 feeding (I �{011, 2007) In the ut>5cncc of 1ntm'ffluon,, the rw: ^{for such} tr.insmls.sion is IS-JO,.. 1 n non-bn:3st feeding inlc-c:tcd rru,lhcrs (F�1011,2007) 110\\"C'o'tt, "'ith appropn:itc tmUmcnt and intcncnuon the

�h:ul«:.1 of 11 cluld b.."\.--Om111g Infected can be rtd� (rum around !5% to I� lh&r1 ,::o,.

(ln1cm1111onnl AIDS S11.:1c1y, 200SJ 'Ille nu: of �fTCT c:m be raluccd ¹⁰ less lh:ui 2% try inlCl'\cnuon lh:11 include lllltir,:1ro,1r:1I (,\R\') rrorh>la,b IJl\cn lO "omen 1n prt'!;IUDI.)

onJ lnbour, ,,1th obstctnail 1ntcl'\'C:n1ions including clc:cthc � dcll\CI) (F�IOH, 2007). Rc�au-ch rubli!ll'K'J In 199-f sho"'CJ 1h31 7..1dovudinc (W\') an AR\' drug ga,-cn to pr,:gauull \\Otncn inf«1cd ,�ith IIIV 1111J lhcar nc\\boms n:Juccd the riu: for this type of

I UV trnrWnisslon (Conor. Sperling onJ Gcbcr, 199-1) S ¹ 1KC then the 1�rq; of p�t

\\llntcn 1111d 1m11n1cn1 for those \\ho nr-c 1nfc:dcJ hA,"C �ullcd 1n a dmrruiuc dccl� ^ll1 the 111111100 llf chilJrcn pcrirnu.111)' 1nfc,:1cJ \\lth I IIV: ho\\>:"\"Cf n1u.::h ,,on rcm.:un to ^t,e donc.­

nbout I 00.200 lnfimlJ 1n the United Stutes arc infected \\1th 111\' annual I) (COC. :?007).

�11111)· ,,r thl!!,C lnfc,:tlon., invol\'c \\lllnc:11 ,, ho ^\\'l:l'C not t�cJ c:ul)· cn..�h 1n �) ur who clid not rccci,"C prevention ^JCI'\ ic't3 (CDC, :!007).

UNIVERSITY OF IBADAN LIBRARY

The bunicn of MTCT of I IIV is higher in sub-Saharan Africo llwt lhe rest of the ,vorld bccnusc of high le, c:ls of hctcrosc'«l:11 transmission, high prc,'llkncc: of I IIV in \\"On1cn of rcproducti\'C ogc group, higher proportions of females in the n:producthc ogc infected ,,i1h IIIV, high total fcnili1y rule (rFR), high rule: of prolon�cd bn:-.isl fecJing nnd poor 11cc:css lo cfTec:th·e intervention Dimcd ⁰¹ prc\'cnling �1TCT (f 1\110)-1 2007). ,\t p�cnt I IIV prcwlenccllf'llnSrnission nue, if oppropriotc 1n1cncnlion i!; not 1mplc:mcnted, ubout

100,000 babies ,-.ill be ^{inf ec} ted through 1\1 J'Cl Olhc:r mcosurcs of reducing the ri�l of MTCT of 1 IIV include, use of ,\RV prophylD,,xis lor lhe infru,is for lhc lir.;1 six ,,ccks utlcr delivery and complete ovoid.'lllcc: of b=t ti:c:ding ir occc:p1oblc, feusiblc, nnordublc, sure and sustoinabl ^c: . llo,,-.:,cr, \\here rc:plllcc:mcnl feeding i, 001 po�siblc: it should be no1cd

that lhc: longer lhe period ofbl'C3St feeding lhc higher lhc nsk of transmission.

'r11blc 2.2 tl'.,1ima11:d �1111:nltudc of \ll'Cf of I IIV in Nl1:c:ri11

- PopUIJt1on 140 million

Dinh rote per unnun1 4211000

Binh per annwn S,900.000

HIV prevalence 1n '\NC ,,·omen 4.40,;, 1'01111 nwnbcr of infants born 10 HlV ^260,000

infected \\-Omen exposed to the risl.: of

�iTC r IUSWT'llng prcgn11ncy,

Number of l llV positive infonts per onnum 65,000 10 117,SOO

Source: Notlo1111l Guideline, on pre,,ncion of mother-to-chlld Tn1n1ml�sion or

111v (P�rrcn, ²⁰⁰¹

2.10 ttt,k i'nc1or, for �lo1her-1·0--child-Tnao1mbsloo or HIV

11u: rule of molhcr•to-child-lrllmmbs1on of HIV i$ arre1:1cd by so many factors. These foclo1'5 bli,·c: been grouped into vinil, rru11emnl, obstclrie. felal. 11nd bn:.!ll>l fc:cding fo,ciors.

I I

UNIVERSITY OF IBADAN LIBRARY j

lncsc factors ore grouped in the tahlc: below inta fncturs \vilh strung e, idc:ncc nm! the ancs wlth limited evidence.

Table 2.3

- \'lral l\11lcrn11J

Obstetric

J1c111/lnf101 Orcn..,t feeding

Source:

111c1ors 1USoci11cd 1'llb incr.:ascd ruk or l\lolbtr-To-Child

Transmiuion ^{of IIJV}

StronR E\'idt

,--

-. . .

• - lligh m atrmnl virul lood nr11clcrist1cs

. _{Viral eh}

AdvnncxJ dtSCO..'<:

--lmmwic d cfic1cncy

nrv ^infcx lion ocquin:J during or bl'Cll.5tfc:cding mn.�millcd 1nfcxtion prcgnA.nCy

Sciomlly 1 I', I ^{.ii nri o}

-Vugin:il deli very

-Rup1urc: or mcmbrune3 for 1norc 1h11n 4 hoW'5

• Prolon11cd I ^obour

• PrcDllllurity

- Fir.it o f mul liplc dclivcncs

Limited l-.:vldcncc

-Viral n:sistnncc

--:-vitrunin ·\ dclic,cnc>

• ,\ncnuu

- Chonoamnionitis

• Frequent unprou:crc:d �ex fl.1uhiplc: �cxual partn ;rs

• Sn1ol..1ng ,\lcuhol

• Intravenous drug nbusc

- Genclii: (I II ./\ \Ubtyp,:s. mutnlloru;

of 1urrocc CD4 u:cc:p111r

• lnv115ivc or trnumolie pro.:c:durc

• Instrumental dolivencs - ,\n111ioccn1cs1s

• l:pisiotomy/gc:nital lolcmllons

• ExrcmA) ccphnlic version

Ante-pan wn,'i ntrn-pan um hacmorrho)lt _

.. 1',1il<cJ fcedin g .scasc

• Lesion, or the �kin 1111,Vor mucus 111cmhr.mc e.g. oral thrush

-Genetic

---·. ---1

Drcrut di

(Al>,ccs.o;.'m nstilisfcrnckcd nipples)

l'Cll.'it feeding Prolonged b

N11floo1I Guideline, on Pre, cnllon or \totbcr-10.Cbihl-tnon•nll,,lon of HIV (PMTcn (111\tOII, 2007)

26

UNIVERSITY OF IBADAN LIBRARY

AFRICA DIGITAL HEALTH REPOSITORY PROJECT

2.11. Ill\-' and AIDS l'rcvcnlion

There ^lff no cure for 1-fl\i and A(DS .ind life-prolonging drugs nrc expensive nnd lar11cly unavailable in less de,cloped eoWltne!> (l.amptey, \\'igley. Carr. nnd Collmore, 2002).

llnu pn:,cnuon ,viii remain the b.1ckbone of progrummc:- to curb the cp1Jenucs of Ill\' 11nd ,\IDS for the foreseeable future (Lnrnptcy et ol , 2002) To reduce further the incidcnc�· of I IIV infc.:t1on, CDC onnounccd a ne,, initi:.iti\'e, ·\dvuncing IIIV Pre\lcnt1on (,\HI') CDC. 2003) This initiative comprises: mwng HIV tc:Ming ^II routine pan or

mcdicul core, implementing new models of diagno�ing Inv Infections out.side medical

settings, preventing nc,v infections by ,,ork1ng ,vith HJV-1nf�'Clcd persons und their

In document Migración sur-sur : el caso de los migrantes cubanos en el área metropolitana de Monterrey. (página 45-55)