Hiv In Manipur India Health And Social Care Essay

Despite the fact that HIV/AIDS has become a serious public wellness job in Manipur for the last decennaries impacting people of all societal groups, the cognition and understanding degree of the general population is frequently marred by misconceptions taking to the marginalisation of HIV/AIDs and PLHAs. This article is based on prolong fieldwork carried out in two territories of Manipur viz ; Imphal and Chandel in the twelvemonth 2008 with the purpose to measure cognition and understanding degree of the general population sing HIV/AIDS, their attitude towards PLHAs ; and to unearth the myth, belief and patterns related to HIV/AIDS which might exposed them to HIV infection. A sum of 200 respondents i.e. 100 respondents from each territory dwelling of equal figure of male and female from the general population were interviewed for the intent.

Knowledge, attitude, behaviour, and pattern towards HIV/AIDS in Manipur, India: a cross sectional survey.

HIV/AIDS has spread like wildfire since its first sensing in 1981and has claimed 1000000s of lives across the universe. Harmonizing to the UNAID study, there were 33 million people populating with HIV, 2.7 million people were freshly infected with HIV and 2.0 million people died of AIDS in the twelvemonth 2007 alone ( UNAID study, 2007 ) . The spread of HIV/AIDS continues to intensify with every passing twelvemonth despite attempts to control it by the states across the continents. AIDS continues to be one of the slayer diseases of the twenty-first century without any remedy so far. It knows no societal, gender, caste and geographical boundary thereby impacting people from all walks of life: immature and old, rich and hapless, male and female, and cutting across different states of the universe.

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In India, HIV/AIDS has become one of the most ambitious public wellness jobs. The first HIV/AIDS instance in India was detected in 1986 at CMC, Vellore, from blood samples taken from commercial sex workers in Madras. Since so, it has spread heterogeneously and steadily to all the other States and Union districts. India is now, the 3rd largest HIV/AIDS affected state in the universe and remains the largest in Asia ( NACO, 2007 ) . The entire figure of people populating with HIV/AIDS ( PLHAs ) in India in 2007 was estimated to be 2.31 million ( 1.8-2.9 million ) . Out of this, 39 % of PLHAs are estimated to be females ( Technical brief, NACO, 2007 ) . Heterosexual is still the prevailing manner of HIV transmittal in India. However, the transmittal form of HIV in India is uneven with southern provinces describing more of heterosexual transmittal than the northern provinces. In the north eastern provinces, it is a combination of both shooting drug users and unprotected sex.

Six provinces in India reported high HIV prevalence of more than 1 % among female parents go toing ante-natal clinic. Manipur is one such six provinces besides Andhra Pradesh, Karnataka, Maharashtra, Tamil Nadu and Nagaland. With barely 0.2 % of the state 's entire population, yet lending about 8 % of India 's entire HIV positive instances, AIDS has emerged as a new and serious public wellness exigency in Manipur.

Though the major transmittal path in Manipur still remains through shooting drug users ( IDUs ' ) , sexual transmittal is non far behind. A recent one-year lookout surveillance study ( NACO, 2006 ) revealed that HIV prevalence among IDUs has well come down over the old ages but Manipur still has HIV prevalence of IDUs ' above 10 % . The rapid addition in HIV transmittal through insecure sex in the province in recent times is extremely refering. The prevalence of HIV among female sex workers ( FSW ) in Manipur is 13.07 % , following merely to Maharashtra ( 17.9 % ) and among work forces holding sex with work forces ( MSM ) is 16.4 % . ( HIV sentinel surveillance/technical brief, NACO ) . Vertical transmittal of HIV infection from hubby to get married monogamous married woman in Manipur is deriving impulse over the last few old ages with a study of more than 1 % prevalence of HIV among female parents go toing prenatal clinic.

HIV/AIDS is progressively acute every bed of societal strata making even to the remotest country in Manipur. Negi K.S et.al ( 2006 ) in their survey observed that most of the persons in community do non hold correct and complete information about HIV/AIDS and its bar. The latest study of Manipur State AIDS Control Society ( MSACS ) revealed that Manipur has 40,000 HIV positive reported instances among the general population. HIV/AIDS has therefore, go a serious public wellness job in Manipur, impacting people from all societal strata. Therefore, maintaining the widespread job of HIV in head, the present survey has been planned to measure the cognition and apprehension of the general population sing HIV/AIDS, their attitude towards PLHAs '' ; and to unearth the myth, belief and patterns related to HIV/AIDS which might expose them to HIV infection.

Material and methods:

This was a cross-section and experimental survey carried out in two territories of Manipur viz Chandel and Imphal from June 2008 till mid-November 2008. A sum of 200 respondents consisting of 100 respondents each from two sub-divisions i. vitamin E Lamphelpat in Imphal West and Chandel in Chandel territories, were contacted in their place and interviewed. The respondents who were at least 18 old ages of age and above were indiscriminately selected and interviewed after taking their informed consent. Equal Numberss of male and female respondents from both the territories were selected for the intent. A pre-tested questionnaire consisting of points on socio-demographic background, cognition, attitude, behaviour and pattern of HIV/AIDS was used for roll uping informations from each of the respondents. The interview though, based on the questionnaire was a combination of closed and open-ended, and the interview was carried out in free flowing mode where respondents revealed beyond what is being asked. This was supplemented by participant observation.

Imphal is the capital metropolis of Manipur and lies at the bosom of the province. It is a commercial and official hub of the province. There are different communities populating in Imphal, the majority of which is constituted by the Meitei community followed by Muslims, different tribal groups, and non-Manipuri migrators. Imphal territory being the capital metropolis holds an border over other territories and has the best wellness attention installations available in the province. Besides that, it is besides place to many apex authorities and non-government offices including assorted NGOs ' working for the public assistance of HIV/AIDS in the province. It besides has an border over other territories in footings of substructure, conveyance and communicating, educational establishments, etc. Imphal is divided into two districts-east and west. The country of the survey was in located in Lamphelpat sub-division of Imphal-west territory. This sub-division is the most thickly populated country ( 2001 nose count ) in Imphal West. Majority of the people in Lamphelpat follow Hinduism, Muslim, Meitei Sanamahi and Christianity.

Another country of the survey is Chandel territory, situated on the southern portion of Manipur 64km off from Imphal metropolis. It is inhabited by scheduled folks preponderantly belonging to the Naga cultural group followed by folks belonging to Kuki/Zou cultural groups. There is besides a minor population of non-tribal communities belonging to Meitei, Muslim and non-Manipuri migrators. The field survey was carried out in the territory headquarter of Chandel sub-division where the survey population comprises of different Naga folk. Christianity is the dominant faith practiced among the tribal population of Chandel sub-division.

Datas analysis:

Data was entered in SPSS-Pc version 11.5/15 ( Check ) . Data was expressed in per centums and comparings between the groups were done utilizing Chi-square trial. Unpaired't ' trial was performed for happening out differences between groups for quantitative variables. 'p ' value less than 0.05 was considered important.

Consequences

Demographic profile of the survey population:

A sum of 200 respondents from both Imphal and Chandel territories were interviewed utilizing the framed KABP questionnaires. There were 100 respondents from each of the territory consisting of 50 male and 50 female. The respondents in Chandel belonged to the tribal population of the Nagas while that of Imphal belonged to the Meiteis.

The respondents belonging to different age groups were maximal for: 18-30 ( 45.5 % ) , 31-40 ( 29 % ) , 41-50 ( 16 % ) , 51-60 97 % ) and 61-above ( 2.5 % ) in falling order.

In footings of matrimonial position, the respondents comprises largely of married work forces ( 54 % ) and adult female ( 61 % ) , followed by single work forces ( 44 % ) and adult females ( 34 % ) .

The educational position of the respondents in Imphal countries largely studied till secondary ( 33 % ) or up to alumnuss ( 33 % ) while in Chandel, most of the respondents studied till secondary ( 30 ) . Gender wise, male respondents were found to be more educated than female. At least 39 % respondents in Chandel were either illiterate or have primary instruction as against 5 % respondents in Imphal. Overall, most respondents studied till secondary ( 31.5 ) followed by alumnuss ( 29 % ) .

In footings of business, bulk of the respondents were unemployed ( 28 % ) . Majority of female respondents were housewife ( 21.5 % ) . Employment position of the respondents was seen to be more ( 17 % ) in Imphal than in Chandel ( 7 % ) . Most of the respondents in Imphal comprise of unemployed ( 32 % ) , followed by those employed ( 17 % ) while in Chandel, homemaker ( 29 % ) and pupils ( 26 % ) constitute the majority of the respondents.

With regard to faith, 71 % respondents in Imphal follow Hinduism, 25 % Meitei Sanamahi, 3 % Christianity and 1 % other faith. As compared to this, all the respondents in Chandel follow Christianity.

Findingss:

Cognition: From the survey, it was found that except for one respondent from Chandel, all the other respondents in both the survey countries have heard of AIDS. On farther question about what AIDS disease was, bulk of them could non give correct reply. Merely 5 % respondents in Imphal and 6 % respondents in Chandel gave right reply to this. Male respondents ( 8 % ) were somewhat knowing about what AIDS disease was than female respondents ( 3 % ) .

With regard to the inquiry on what is HIV? 17 % respondents in Imphal gave right reply as against 22 % right reply in Chandel. Gender wise, the figure of male respondents ( 32 % ) with right response was extremely important ( p & lt ; 0.000 ) than female respondents ( 7 % ) . 57 % respondents from Imphal and 47 % respondents in Chandel knew about the difference between HIV and AIDS. A important difference ( p & lt ; 0.001 ) was observed between the two genders as male respondents ( 65 % ) who gave right response was significantly higher than female respondents ( 39 % ) .

Sing the etiology of HIV/AIDS, bulk of the respondents from both the countries i.e. 69.5 % were knowing about the causative agent for HIV. The staying figure of respondents had misconceptions. A important difference of P & lt ; .020 and ( P & lt ; .006 ) was observed in Imphal and Chandel severally in this facet.

Sing the manner of HIV/AIDS transmittal, bulk of the respondents i.e. & gt ; 90 % from Imphal and Chandel had right cognition about it when it concerns agitating custodies, infected blood transfusion, sharing towels, unprotected sex, coughing/sneezing, and sharing septic acerate leaf. & gt ; 75 % had right cognition on mosquito bite, kissing/hugging, and infected female parent to child. A important difference of P & lt ; 0.022 was noted in Imphal with regard to sharing of towels while in Chandel, a important difference of P & lt ; 0.001, P & lt ; 0.005, P & lt ; 0.001 was observed with regard to mosquito bite, sharing of towels, and kissing/hugging severally.

The response on the cognition of common symptoms of HIV/AIDS was met with 93 % and 87 % respondents mentioning weight loss and loss of complexion/appetite as the most common symptoms severally of PLHAs. Respondents besides considered fever/cough ( 79 % ) , diarrhoea ( 74.5 % ) , OI like T.B/cancer ( 74 % ) , roseola on the tegument ( 73 % ) and swelling in inguens ( 71 % ) in falling orders as other symptoms of PLHAs.

On the beginnings of information on HIV/AIDS, bulk of the respondents i.e. & gt ; 90 % from Imphal country have mass media like Television ( local channel ) , wireless, newspaper ; street dramas, as their chief beginning. Another, 72-88 % reported NGOs ' , and a negligible 18-4 % reported church as their chief beginnings of information. No important difference was observed in imphal. In contrast, Chandel reported high per centum i.e. a‰?84 % of respondents acquiring information from church, and NGOs. A important difference of response i.e P & lt ; 0.037, P & lt ; 0.002, P & lt ; 0.001 and p & lt ; 0.013 in the beginnings of information was noted in wireless, telecasting, newspaper and NGOs.

Attitude:

The survey found that bulk of the respondents from both the survey countries i.e. 53.3 % were strongly in favour of the attitudinal statements that HIV/AIDS is a penalty of God for bad behaviour. A important difference ( p & lt ; 0.012 ) was observed in Chandel as female respondents ( 68 % ) were extremely in favour of the statement than their male opposite numbers ( 42 % ) .

83.5 % and 91.5 % respondents besides considered HIV/AIDS as a job chiefly associated with immoral behaviour and shooting drug users ( IDU ) severally. No important difference was observed in the above statements. Respondents ( 71.5 % ) besides opine that PLHA should non acquire married. A important difference P & lt ; 0.005 was observed in chandel with regard to this response. A humongous 94.5 % besides expressed their concern for compulsory HIV proving prior to marriage while 85 % respondents voiced the demand for separate wellness Centre for PLHAs.

46.5 % respondents said PLHAs should be isolated to forestall farther transmittal while 46 % respondents said they would non wish to mix with PLHAs. A important difference of P & lt ; 0.047 and 0.002 severally was noted in the above statements in chandel.

67.5 % respondents besides said they would experience ashamed if they were infected with HIV/AIDS and 39.5 % respondents agreed that PLHAs should non be operated for any surgical job. A important difference with regard to these statements was seen at P & lt ; 0.023 and p & lt ; 0.002 severally among male and female respondents of chandel.

As respects to pre-marital sex, merely mere 16 % respondents had no issue while the bulks were non in favour of it. There was a important difference of P & lt ; 0.040 in the response among male and female respondents in chandel.

76.5 % respondents strongly believed that PLHAs are destined to decease Oklahoman or subsequently. No important difference was observed in both the two survey sites. However, when it comes to learning school kids about safer sex, whacking 96.5 % respondents agreed to it with no important difference seen in the response in both the two survey country.

Sing corporate duty of the society to care for PLHAs, 84 % respondents were in favour of it. However, a important difference of P & lt ; 0.006 was noted merely in respondents of chandel.

Behaviors and Practices: The general mean age for the oncoming of sex was 23.37A±5.73. However, it was noted that respondents in Chandel ( 20.21A±4.08 ) had earlier onset of sexual intercourse than those in Imphal ( 27.36A±4.99 ) . Out of 200 respondents, a sum of 113 respondents responded to this inquiry of age at first sexual brush. Education was found to be straight relative to the oncoming of sex. Less educated respondents had earlier onset of sex than those educated 1s.

The mean for age at matrimony was 25.51A±5.64 and instruction was found to hold some influence on the age of matrimony every bit good. Less educated respondents marry earlier than those educated 1s. A important difference was observed in the age of matrimony among female respondents from Chandel as the induction of matrimony begins every bit early as the age of 14 ( 20.42A±41 ) .

From the analysis, it was found that few or more respondents were found to hold hazardous behaviour susceptible to HIV infection. 7.5 % respondents admitted holding been exposed to blood transfusion for assorted medical jobs. 41 % said their organic structures have been injured by crisp objects such as blade/knife. The response to the latter statement was favourably high in chandel & gt ; 53 % . However, no important difference was observed.

Negligible male respondents i.e. 3.5 % revealed to hold used opprobrious drugs such as intoxicant, diacetylmorphine, drugs, etc. No female was found utilizing opprobrious drugs. 62 % admitted being physically involved with their spouse i.e. either with partner of non-regular sexual spouse. Here, a important difference of P & lt ; 0.002 was observed in imphal with more male acknowledging to it. Another 10.5 % consisting largely of male respondents were found to be indulging in sex with non-regular spouse. A important difference of P & lt ; 0.018 in imphal and P & lt ; 0.001 in chandel was observed.

With regard to utilize of rubber in sex either with regular ( partner ) or non-regular sexual spouses, 18.5 % respondents said they used it systematically. In chandel, a important difference of P & lt ; 0.004 was noted with male respondents utilizing rubber in sex.

17 % respondents of the married twosome used household planning of any signifier. 40.5 % respondents consisting largely of male respondents said they have attended awareness camps/programmes on HIV/AIDS. A important difference of P & lt ; 0.014 and p & lt ; 0.011 in imphal and chandel severally, was observed.

It was besides noted that 34 % respondents had done HIV proving at least one time in their life. Another 39 % respondents showed their willingness to travel for HIV proving if necessary. More male respondents were seen to demo willingness to travel for HIV proving. A important difference was observed in both the survey countries i.e. P & lt ; 0.007 in chandel and P & lt ; 0.035 in chandel.

Another 28 % respondents said they would delegate specific utensils if anyone in their household was infected with the virus. No important difference was seen here. 16 % respondents besides admit that people do insult/tease people with the virus. A important difference of P & lt ; 0.001 was observed as really less female respondents in chandel admit to PLHAs being teased/insulted. Another 50.5 % besides said spiritual places are usually denied to PLHAs which is considered baronial place. The response from female respondents was more and a really high important difference of P & lt ; 0.000 was observed between the two genders in chandel.

Discussion:

The present survey revealed that though all the respondents heard about AIDS, many of them did non cognize what AIDS precisely was. For most respondents, AIDS was normally synonymous with sexual promiscuousness, immoral behaviour and shooting drug users. This belief was chiefly propounded by the fact that most PLHAs '' in the survey countries were believed to be associated with at least one of the above characters. Similar findings were reported by Viser MJ et.al, 2006 ; Smith DJ. 2004.

When it comes to HIV, really few respondents had right cognition about it despite the fact that AIDS has become a 'dining table talk ' . Out of the few respondents that have right cognition on HIV, male respondents were more. This may be due to the fact that the overall educational position of male respondents was somewhat higher than their female opposite numbers. The other ground could be because male members of the society are more outgoing, hence are more updated about their societal environment through media beginnings like newspaper and magazines.

Majority of the respondents besides could non province the difference between HIV and AIDS. It was interesting to observe that some respondents had wholly different impression approximately HIV as a separate disease non related to AIDS at all. Many of them were still incognizant of the term HIV when used in isolation from AIDS. It was found that HIV and AIDS were frequently times used together without truly understanding the difference between the two. Respondents from Imphal were found to hold somewhat better cognition about HIV than respondents from Chandel. This could be due to the fact that unlike respondents from Imphal, respondents in Chandel had less or no entree to media such as newspapers, local channel, and street dramas, etc whereby HIV/AIDS instruction is given out at regular intervals.

Sing the manner of HIV/AIDS transmittal, bulk of the respondents had right cognition about it particularly refering to the four primary manner of transmittal i.e. through insecure sexual contact, blood transfusion, sharing septic syringe and female parent to child transmittal. However, few respondents had misconceptions when it comes to transmission through mosquito bite, agitating custodies, sharing towel, coughing or sneeze, and kissing/hugging. These misconceptions is chiefly to make with the false beliefs that HIV/AIDS is transmitted through any blood merchandise and organic structure fluids ( workout suits ) and as such anything that makes direct contact with the blood as in the instance of mosquito or organic structure fluid is considered hazardous. Therefore, there is pressing necessity to sensitise decently the general population about the right manner of HIV/AIDS transmittal. Similar findings in the line of deficiency of proper sensitization/education on HIV/AIDS taking to misconceptions, was besides reported by Hartwig K.A et.al 2006. As was observed in the analysis, many of the respondents from chandel particularly female respondents tend to trust on information obtained from local chitchats, which are frequently times marred by hyperboles and misconceptions responsible for stigmatisation and favoritism of PLHAs and the disease HIV/AIDS.

The misconceptions refering to HIV/AIDS was closely related to the ways through which information about the disease is obtained. Respondents from Imphal had mass media like local channel ( T.V ) , and newspaper, etc as their chief beginning of information whereby HIV/AIDS instruction is given out by dependable beginnings whereas, in Chandel, media function was negligible. This could be explained on the footing of unavailability to local channel ( T.V ) and newspaper. In Chandel where cent per centum of the respondents are Christians, church act as one of the major beginnings for distributing information/knowledge on HIV/AIDS. It was found during participant observation that non all church leaders were decently trained nor good equipped with information on HIV/AIDS yet many of the church leaders did non waver to reprobate HIV/AIDS as a shameful, ugly and fatal disease fated to bechance upon promiscuous and immoral individual in the society. So, church members were encouraged to pattern abstention from sex boulder clay matrimony and be in sync with the scriptural moral rule so as to avoid HIV/AIDS disease. This could be one of the grounds why stigmatisation of PLHAs was more terrible in Chandel than in imphal.

It is besides interesting to observe that female members of the society in both the survey country were found to be 'social witting ' i.e. what society thinks and were more prone to take part in and trust on local chitchats which is largely influenced by 'socio-cultural feelings ' than medical truth. Therefore, it is non surprising that more figure of female respondents had scruples on HIV/AIDS and stigmatisation towards PLHAs.

Another interesting thing to note was in the manner how people perceived PLHAs. Knowledge on the symptoms of HIV/AIDS patients revealed that many of the respondents considered loss of weight and skin color, organic structure roseola, etc as the major symptoms of HIV/AIDS. This cognition purportedly comes from the cultural belief that most PLHAs in the survey country physically exhibit such symptoms. However, lost of weight and skin color is non medically sole to PLHAs and as such, if non decently sensitized on this, it will take to the incorrect premise that anybody with weight lost or skin color who may non needfully be infected with HIV/AIDS have a strong potency, if non already, to be stereotyped and marginalized as PLHAs '' .

Data besides shows that a monolithic figure of respondents still see HIV/AIDS as immoral disease or diseases of shooting drug users. A big figure of respondents from chandel besides considered HIV/AIDS as penalty of God for 'bad ' behaviour. This belief as analyzed was chiefly influenced by which HIV/AIDS is transmitted i.e. through insecure sex and sharing of septic panpipes. It may be mentioned here that sexual promiscuousness and shooting drug users are culturally viewed in the society as 'fallen ' or 'immoral ' individual in both the survey country and as such, anybody practising any of the said behaviour are by and large considered immoral and therefore, stigmatized. This could be one of the chief grounds why HIV/AIDS is extremely stigmatized since it is believed to be largely associated with people of low morality or whose moral characters are questionable in the society. Notwithstanding the fact that many guiltless female PLHAs may acquire infected through their partner or some could hold been infected through inadvertent blood transfusion, PLHAs are by and large regarded as 'wayward ' in the eyes of the society and as such, are stigmatized. The other grounds stated for HIV/AIDS being considered as the most stigmatized disease is besides because of the nature in which PLHAs, at an advanced phase of the disease, died an ugly decease, physically looking awfully haggard with skeletal like build and complete loss of one 's natural skin color and medically, from multiple timeserving infections. However, the physical perceptual experience may non ever be true for all PLHAs.

Another noteworthy observation made in both the society was refering to the prevalence of gender disparity when it comes to morality and promiscuousness. Culturally, sexual promiscuousness and 'immoral behaviour ' such as drug and intoxicant maltreatment, or waywardness are tabooed yet society tends to be more tolerant towards male members than female. It is an unfastened secret for male members in the society to be accepted more readily than female despite go againsting unsanctioned societal norms. This explains why many of the female respondents expressed that they would experience abashed if infected with HIV/AIDS, a disease symbolic of immoral behaviour. This determination is in conformance with the findings of Smith DJ, 2004.

A disagreement between cognition and behavior/practice of the people towards PLHA was besides observed. Though most respondents demuring few were cognizant about the primary manner of HIV/AIDS transmittal, they admitted to hold maintained some distance or reserve in mixing with PLHAs despite cognizing good that making so will in no manner put them at hazards. Gray LA and Marle S, 1991 reported similar observations. This could likely be a instance of utmost cultural stigmatisation of PLHAs in general whereby common people fear the stigma of being stereotyped by tie ining with PLHAs.

Respondents besides expressed the feeling that PLHAs should hold separate wellness Centre on the land that it will be safer for both the infected and non-infected population as they could non swear the instruments of wellness attention Centre to be to the full safe from HIV infection. Majority of the respondents besides viewed that PLHAs should neither acquire married nor have kids as making so will merely increased the figure of PLHAs who in all chance will merely populate to endure and died a agonizing decease. However, few people were of the position that every bit long as PLHAs marry amongst themselves, that should non be a job.

Since HIV/AIDS is a extremely stigmatized disease ; bulk of the respondents expressed the demand for mandatory HIV proving between twosomes prior to marriage so as to avoid a day of reckoning hereafter as was put in by many respondents. This is because of the belief that HIV/AIDS is a catching and an incurable disease which when infected will invalid and shorten the life p of the individual concern. As one respondent said `` one time you get infected with HIV/AIDS, it is for supports and you can non run off from it instead you 'll decease with and by it '' . The stigmatisation towards PLHAs is besides revealed in that the general populations tend to hold negatively preconceived impression about anyone infected with HIV/AIDS even if that individual happens to be morally well behaved.

Despite holding negative perceptual experiences about HIV/AIDS, when it comes to corporate duty of the people towards PLHAs, bulk of the respondents from both the countries expressed their sense of taking duty to care for PLHAs. However, the cogency of this statement may non defy societal stigma as disagreement between cognition and pattern has been discussed in old statements. One of the grounds for having such duty could be due to the humanist side of adult male underlining other negative feelings. The humane nature is highlighted farther when the respondents said PLHAs should seek medical aid at the earliest with a cautiousness that all patients seeking surgery should be exhaustively tested for HIV/AIDS.

Prenuptial or extra-marital sex was non favored by many and more so in Imphal. Respondents in Imphal were somewhat more reserved about sex than those from Chandel. In Imphal country, prenuptial and adulterous sex was seen more as societal tabu while in Chandel it was more to make with the misdemeanor of scriptural moral rule besides it being considered socio-cultural tabu as good. Few respondents largely male, had impersonal position on this, stating it was a affair of personal pick. It may besides be mentioned here that by and large people have reserves about discoursing sex and gender in the unfastened or in public because of the cultural upbringing whereby treatment of sex or gender is confined to or between married twosome. A survey by Goyal RC, et al 1994 ; Hartwig KA et.al, 2006 besides reported similar findings on the reserve of openly discoursing sex and gender.

Another interesting characteristic noted in this survey was the induction of sex for both male and female and the age at matrimony. The overall average age for the induction of sex was 23.37A±5.73 old ages. The overall average age at matrimony observed in the survey was 23.04A±5.22 and 28.65A±4.52 old ages for both female and male severally. The average age at matrimony in the survey site was found to be above the legal age at matrimony in India which is 18 for female and 20 one for male. Here, instruction is seen to play an of import function in detaining induction of sex and age at matrimony. A important difference was observed in the age at matrimony among female respondents from Chandel where the induction of matrimony begins every bit early as the age of 14 ( average 20.42A±4.1 old ages ) . This may be because female respondents largely in-between age in Chandel had small or no instruction at all. Besides instruction, cultural upbringing is besides seen to hold indirect impact on the age at matrimony. The patriarchal construction of the society in both the survey country is such that male members of the household are given penchants over female in any affairs as it is through male line that coevals of the household is continued.

Analysis of sexual behaviour and patterns besides revealed that most of the respondents who do non see themselves at being hazard to HIV infection were in fact, practising hazardous sexual behaviour. Quite a figure of respondents admitted practising insecure sex within and outside matrimony. Though, sexual relation outside matrimony is a socio-cultural tabu, yet it is non purely upheld. Theoretically and culturally, bulk of respondents were non in favour of sexual relation outside of matrimony. However, during the survey, it was found that such cultural apprehension of sexual tabu did non truly forestall some of them from indulging into it as was admitted by few respondents. The sexual behaviors/practices of male respondents were at higher hazard for HIV infection than female respondents. This could be due to the prevalence of gender disparity in the societal set up whereby society is more tolerant towards male promiscuousness and immoral behaviour than that of female. As such, female respondents from both the country were more reserved for the obvious fright of shame and incurring stigma. Therefore, none of the female respondents from Imphal admitted to hold indulged in extra-marital matter while in Chandel, a negligible figure of them reluctantly admitted indulging to it after initial equivocation. Male respondents were relatively found to be more blunt and unfastened about their indulgence in sexual relationships in and outside of matrimony.

For those respondents who admitted to hold engaged in 'tabooed ' sexual relation, really less figure of them admitted utilizing rubber systematically. Here, it may be noted that despite many of them accepting rubber as a good option for safer sex, it is non being used systematically on the land that rubbers do non give full sexual satisfaction. The ground given to explicate was that culturally ; rubber is stigmatized and is considered meant for sexually promiscuous people. Condoms are besides believed to hold inauspicious consequence on adult females wellness and as such usage of it, in most cases is sooner ruled out. In instance of married twosome, usage of rubber is considered non a necessity as the socio-cultural significance of matrimony is for the intent of reproduction and sexual fulfilment. Therefore, usage of rubber is merely taken as blockading the really intent of matrimony. This is one of the grounds why some respondents who admitted of fall backing to household planning preferable preventive pills. A survey carried out in rural Lebanon by Kulczycki A, 2004, reported similar findings on the usage of rubber and the stigma attached to it.

It was besides observed that some of the participants had undergone blood transfusion for either medical or surgical grounds, increasing the opportunities of HIV transmittal. Many respondents were willing to accept PLHAs and even take duty for them but this is contradicted by the admittance that they would non needfully desire PLHAs to be neither a resource individual for any socio-religious event nor a spiritual figure in the society because harmonizing to the local people, a spiritual figure should be person whose moral character does non offend the normative moral Torahs of the society whereas in the instance of PLHAs, their moral character is ever questioned and as such can non keep a spiritual place unless the individual in inquiry unfeignedly repents and take a repentant, reform life.

Decision: From the analysis of the present survey, it can be concluded that false socio-cultural impression of HIV/AIDS as a morally corrupting disease is taking precedency over medical facts, taking later to stigmatisation and favoritism of PLHAs in the society. The survey revealed that although bulk of the respondents have high cognition about the four primary manner of HIV/AIDS transmittal, such cognition are frequently times marred by socio-cultural misconceptions. It can besides be inferred that behaviour of the people are greatly influenced by cultural beliefs instead than by medical facts. Therefore, incompatibility is observed between high cognition about the four primary paths by which HIV/AIDS is transmitted on one manus and high negative attitude towards PLHAs on the other manus. Local chitchats which are largely diluted with cultural misconceptions act as the fastest medium for the extension of intelligence on HIV/AIDS. Church elders/leaders particularly in chandel have strong influenced on people 's attitude towards PLHAs. This could be one of the grounds why despite attempts from NGOs to educate people on HIV/AIDS, the disease is fast distributing in the survey country.

Therefore, proper sensitisation of the people about HIV/AIDS along the socio-cultural line is the demand of the hr in order to take several misconceptions which are responsible for the marginalisation of PLHAs. It is besides suggested that spiritual leaders should be given particular attending when sing of leaving proper instruction on HIV/AIDS in order that their influence on people may chase away cultural misconceptions taking to stigmatisation of HIV/AIDS. The survey besides may reason that stigmatisation of the disease was one of the root causes for the spread of HIV/AIDS in the country as fright of societal stigma and shame have discouraged many PLHAs to come out in the unfastened about their position thereby jeopardizing others in the procedure as such PLHAs continued to take a normal sexual life.

Recognition:

This research is financed by UGC under the strategy of Rajiv Gandhi National Fellowship for ST/SC pupils to prosecute M.Phil/Ph.Daˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦..

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