Socio-Economic Impact of HIV and AIDS in Manipur 2004-2005 and 200631 Dec 2006
HIV and AIDS has emerged as a serious challenge for the developing as well as the developed world. India, with 5.21 million people living with HIV in 2005, accounts for nearly 69 percent of the HIV infections in the South and South-east Asian region. This is despite the fact that India remains a low prevalence country with overall HIV prevalence of 0.91 percent.
The study on “Socio-Economic Impact of HIV and AIDS” was undertaken by NCAER in six high-prevalence states, namely, Andhra Pradesh, Karnataka, Maharashtra, Tamil Nadu, Manipur and Nagaland. This study was sponsored by both UNDP and NACO. Of the six states considered for this study, Manipur ranks fifth highest in regard to the total number of HIV-positive cases.
According to the Sero-Surveillance report prepared for Manipur on the basis of blood samples drawn from the high-risk groups, it has been observed that the serosensitivity rate is the highest in respect of IDUs at 60.49 percent, followed by relatives of people living with AIDS at 41.9 percent. Studies of this nature are of importance at this time as this is a critical time for India’s response to the epidemic.
Objectives The main objective of this study is to analyse the nature and type of socioeconomic impact of HIV and AIDS on households, and is based on the data collected from a primary survey conducted by NCAER.
Data and methodology In the state of Manipur, the field survey was conducted during the period of April to June 2005. Keeping in mind the objectives of the study, NCAER conducted a survey of both HIV and non-HIV households. The purpose of surveying both HIV and non-HIV households (control group) is to compare their socio-economic characteristics, pattern of household expenditure, prevalence of morbidity, differences in enrolment and dropout of children and time-use pattern of all household members.
The survey covered 1,015 households and out of this, nearly one-fourth i.e., 254 households have people living with HIV and AIDS (PLWHA) and the remaining 761 were non-HIV households – with similar socio-economic background – who were selected for the study. Out of the 254 sample HIV households, 81 were from the rural areas while 173 were from urban localities. Based on the Sentinel Surveillance reports, out of eight districts, six were selected for conducting the survey.
These were Imphal (East & West), Executive Summary xiii
Thoubal, Bishnupur, Churachandpur, Senapati and Chandel. One of the challenges of conducting a survey of this nature is PLWHA, and securing their consent for interview. Keeping in mind the ethical issues and the directions of the Institutional Review Board at NCAER, it was decided to seek assistance from both the counsellors of the State AIDS Control Societies and representatives of the NGOs working in this field to conduct the survey. In the state of Manipur, Voluntary Counselling and Testing Centres (VCTC) counsellors and other officials working with the various NGOs were used for canvassing the questionnaires. They were trained by the NCAER team and were advised to select the sample from a diverse socio-economic profile of households.
The household survey was conducted using a structured interview schedule. In addition to the household survey, case studies and focus group discussions (FGDs) were conducted in order to collect information that would supplement the findings of quantitative survey. The FGD was conducted at Imphal, with the members of Manipur Network of Positive People. Two case studies were also conducted, one in Imphal and the other at Churachandpur.
Profile of sample The sample of HIV households included 36 percent of households whose heads belonged to the Scheduled Caste and Scheduled Tribe (SC/ST) community. About 50 percent of the heads in HIV households were from the age group of 31-50 years and about 30 percent of the household heads were from the 51-60 years age group. One-fourth had completed high school or senior secondary level. The percentage of household heads that had studied beyond the senior secondary level was as high as 25 percent.
Only 27 percent of the HIV household heads were illiterates. While 53 percent of men are currently married, this percentage is quite low at 33 percent in the case of women; 47 percent of the sample HIV-positive women are widows. However, the same in case of men is just 2.2 percent. In respect of the PLWHAs education, 22 percent of men and 40 percent of women PLWHA are illiterates. The percentage of graduates and above is 30.4 for men and 18 percent for women. It may be concluded from this that in Manipur a large chunk of the PLWHA who are mainly IDUs are from well-educated background.
A significant number of households own a house, flat or plot of land (80% of HIV and 84% of non-HIV households). Almost the same ratio is maintained in case of rural HIV-positive households. But, there is a marked difference in the ownership of assets and other consumer durables between HIV and non-HIV households. In almost all durable items like fans, tape recorders, refrigerators etc., a lower percentage of HIV households have reported ownership.
Employment and income A sizeable number (about 27%) of the heads of the households were working as salaried employees, 15.4 percent as non-agricultural wage earners, and 17.3 percent were in trade and business. One-third of the sample households were from the highest annual household income category of Rs. 84,000 and above. This is expected as a large chunk of the