Fortalecer la capacidad de adaptación en Assam

El punto de partida para adaptarse al cambio climático a largo plazo podría ser la adaptación a la variabilidad climática a corto plazo y a los fenómenos atmosféricos extremos. Tomar decisiones más informadas sobre el uso de remesas puede mejorar la adaptabilidad de los hogares que las reciben

Male migration and risky sexual behavior in rural India: is the place of origin critical for HIV prevention programs?

<p>Abstract</p> <p>Background</p> <p>Recent studies of male migrants in India indicate that those who are infected with HIV are spreading the epidemic from high risk populations in high prevalence areas to populations in low prevalence areas. In this context, migrant men are believed to initiate and have risky sexual behaviors in places of destination and not in places of origin. The paucity of information on men's risky sexual behaviors in places of origin limits the decision to initiate HIV prevention interventions among populations in high out-migration areas in India.</p> <p>Methods</p> <p>A cross-sectional behavioral survey was conducted among non-migrants, returned migrants (with a history of migration), and active (current) migrants in rural areas across two districts with high levels of male out-migration: Prakasam district in Andhra Pradesh and Azamgarh district in Uttar Pradesh. Surveys assessed participant demographics, migration status, migration history, and sexual behavior along the migration routes, place of initiation of sex. District-stratified regression models were used to understand the associations between migration and risky sexual behaviors (number of partners, condom use at last sex) and descriptive analyses of migrants' place of sexual initiation and continuation along migration routes.</p> <p>Results</p> <p>The average age at migration of our study sample was 19 years. Adjusted regression analyses revealed that active migrants were more likely to engage in sex with sex workers in the past 12 months (Prakasam: 15 percent vs. 8 percent; adjusted odds ratio (aOR)=2.1, 95% CI 1.2-3.4; Azamgarh: 19 percent vs.7 percent; aOR=4.0, 95% CI 2.4-6.6) as well as have multiple (3+) sex partners (Prakasam: 18 percent vs. 9 percent; aOR=2.0, 95% CI 1.3-3.2; Azamgarh: 28 percent vs. 21 percent; aOR=1.9, 95% CI 1.2-3.0) than non-migrants. Contrary to popular belief, a high proportion of active and returned migrants (almost 75 percent of those who had sex) initiated sex at the place of origin before migrating, which is equivalent to the proportion of non-migrants who engaged in sex with sex workers as well as with casual unpaid partners. Moreover, non-migrants were more likely than migrants to engage in unprotected sex.</p> <p>Conclusion</p> <p>Findings of this study document that returned migrants and active migrants have higher sexual risk behaviors than the non-migrants. Most migrants initiate non-marital sex in the place of origin and many continue these behaviors in places of destination. Migrants’ destination area behaviors are linked to sex with sex workers and they continue to practice such behaviors in the place of origin as well. Unprotected sex in places of destination with high HIV prevalence settings poses a risk of transmission from high risk population groups to migrants, and in turn to their married and other sexual partners in places of origin. These findings suggest the need for controlling the spread of HIV among both men and women resulting from unsafe sex in places of origin that have high vulnerability due to the frequent migratory nature of populations.</p

HIV transmission among married men and women in districts with high out-migration in India: Study brief

This brief describes a study examining the links between male out-migration and HIV transmission among married men and women and other mechanisms by which HIV is transmitted within marital relationships in districts with high out-migration

Relationship between reported prior condom use and current self-perceived risk of acquiring HIV among mobile female sex workers in southern India

<p>Abstract</p> <p>Background</p> <p>With the evolution of Health Belief Model, risk perception has been identified as one of several core components of public health interventions. While female sex workers (FSWs) in India continue to be at most risk of acquiring and transmitting HIV, little is known about their perception towards risk of acquiring HIV and how this perception depends upon their history of consistent condom use behavior with different type of partners. The objective of this study is to fill this gap in the literature by examining this relationship among mobile FSWs in southern India.</p> <p>Methods</p> <p>We analyzed data for 5,413 mobile FSWs from a cross-sectional behavioral survey conducted in 22 districts from four states in southern India. This survey assessed participants’ demographics, condom use in sex with different types of partners, continuation of sex while experiencing STI symptoms, alcohol use before having sex, and self-perceived risk of acquiring HIV. Descriptive analyses and multilevel logistic regression models were used to examine the associations between risky sexual behaviors and self-perceived risk of acquiring HIV; and to understand the geographical differences in HIV risk perception.</p> <p>Results</p> <p>Of the total mobile FSWs, only two-fifths (40%) perceived themselves to be at high risk of acquiring HIV; more so in the state of Andhra Pradesh (56%) and less in Maharashtra (17%). FSWs seem to assess their current risk of acquiring HIV primarily on the basis of their past condom use behavior with occasional clients and less on the basis of their past condom use behaviors with regular clients and non-paying partners. Prior inconsistent condom use with occasional clients was independently associated with current perception of high HIV risk (adjusted odds ratio [aOR)] = 2.1, 95% confidence interval [CI]: 1.7-2.6). In contrast, prior inconsistent condom use with non-paying partners was associated with current perception of low HIV risk (aOR= 0.7, 95% CI: 0.5-0.9). The congruence between HIV risk perception and condom use with occasional clients was high: only 12% of FSWs reported inconsistent condom use with occasional clients but perceived themselves to be at low risk of acquiring HIV.</p> <p>Conclusion</p> <p>The association between high risk perception of acquiring HIV and inconsistent condom use, especially with regular clients and non-paying partners, has not been completely internalized by this high risk group of mobile FSWs in India. Motivational efforts to prevent HIV should emphasize the importance of accurately assessing an individual’s risk of acquiring HIV based on condom use behavior with all types of partners: occasional and regular clients as well as non-paying partners; and encourage behavior change based on an accurate self-assessment of HIV risk.</p

Migration and HIV in India: Study of select districts

Report of a study assessing the important role of migration in the spread of HIV in districts with high out-migration in India. The study suggests a considerable spread of HIV linked to migrants’ extramarital sexual behaviors, and subsequent delay in treatment for infected spouses. In order to control the spread of HIV, the study provides programmatic recommendations made by the study participants and the counselors from ICTCs and ART centers. These suggestions include village-level mapping of at-risk persons, mainstreaming HIV prevention interventions within current health resources, improving various village level HIV prevention programs, and involving women left behind by migrant spouses to participate in these programs

Vulnerability of agriculture to climate change increases the risk of child malnutrition: Evidence from a large-scale observational study in India

Introduction: The impact of climate change on agriculture and food security has been examined quite thoroughly by researchers globally as well as in India. While existing studies provide evidence on how climate variability affects the food security and nutrition, research examining the extent of effect vulnerability of agriculture to climate change can have on nutrition in India are scarce. This study examined a) the association between the degree of vulnerability in agriculture to climate change and child nutrition at the micro-level b) spatial effect of climate vulnerability on child nutrition, and c) the geographical hotspots of both vulnerability in agriculture to climate change and child malnutrition. Methods: The study used an index on vulnerability of agriculture to climate change and linked it to child malnutrition indicators (stunting, wasting, underweight and anaemia) from the National Family Health Survey 4 (2015–16). Mixed-effect and spatial autoregressive models were fitted to assess the direction and strength of the relationship between vulnerability and child malnutrition at macro and micro level. Spatial analyses examined the within-district and across-district spill-over effects of climate change vulnerability on child malnutrition. Results: Both mixed-effect and spatial autoregressive models found that the degree of vulnerability was positively associated with malnutrition among children. Children residing in districts with a very high degree of vulnerability were more like to have malnutrition than those residing in districts with very low vulnerability. The analyses found that the odds of a child suffering from stunting increased by 32%, wasting by 42%, underweight by 45%, and anaemia by 63% if the child belonged to a district categorised as very highly vulnerable when compared to those categorised as very low. The spatial analysis also suggested a high level of clustering in the spatial distribution of vulnerability and malnutrition. Hotspots of child malnutrition and degree of vulnerability were mostly found to be clustered around western-central part of India. Conclusion: Study highlights the consequences that vulnerability of agriculture to climate change can have on child nutrition. Strategies should be developed to mitigate the effect of climate change on areas where there is a clustering of vulnerability and child malnutrition.PRIFPRI3; 2 Promoting Healthy Diets and Nutrition for all; 1 Fostering Climate-Resilient and Sustainable Food Supply; ISIPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH

Exposure to pornographic videos and its effect on HIV-related sexual risk behaviours among male migrant workers in Southern India

Objective: Research on pornography and its association with HIV-related sexual behaviours is limited in India. This study aims to examine the prevalence and correlates of viewing pornographic videos and examine its associations with HIV-related sexual risk behaviours among male migrant workers in India. Methods: Data were drawn from a cross-sectional survey conducted in 2007–08 across 21 districts in four states of India. Respondents included 11,219 male migrants aged 18 years or older, who had migrated to at least two places in the past two years for work. Bivariate and multivariate methods were used to examine the association between viewing pornography and HIV-related sexual risk behaviours. Results: Two-fifths (40%) of the migrants had viewed pornographic videos in one month prior to the survey. Migrants aged 25–29 years, literate, unmarried and away from native village for more than five years were more likely to view pornography than their counterparts. Migrants who viewed pornographic videos were more likely to engage in paid (Adjusted odds ratio [AOR]: 4.2, 95% confidence interval [CI]: 3.7–4.8) and unpaid sex (AOR: 4.2, 95% CI: 3.7–4.7), report inconsistent condom use in paid sex (AOR: 2.3, 95% CI: 1.7–3.0) and experience STI-like symptoms (AOR: 1.7, 95% CI: 1.5–1.8) than their counterparts. Conclusions: The findings regarding migrants\u27 exposure to pornography and its linkage with high HIV risk behaviour suggest that the HIV prevention programmes for migrants need to be more innovative to communicate on the negative-effects of viewing pornography. More importantly, programmes need to find alternative ways to engage migrants in infotainment activities during their leisure time in an effort to reduce their exposure to pornographic videos as well as risky sexual behaviours

Extreme weather events induced deaths in India 2001–2014: Trends and differentials by region, sex and age group

This study examined the trend in extreme weather event related mortality reported in India during 2001–14 and explored the regional, age and sex differentials in such fatalities. We used age and sex-segregated data on the number of accidental deaths by unnatural causes released by Government of India under the National Data Sharing and Accessibility Policy. Various extreme weather events were grouped into five broad categories: cold wave, extreme precipitation, heat wave, lightning, and tropical cyclone. During 2001–14, 25% of all accidental deaths due to unnatural causes happened as a result of extreme weather events. Deaths due to extreme precipitation and tropical cyclones declined over time, whereas increasing trend was observed for lightning, and extreme temperature conditions. Most of the extreme weather event induced deaths were due to lightning, followed by extreme precipitation and temperature extremes. The burden of death was highest in the central part of India. States of Andhra Pradesh, Bihar, Uttar Pradesh, Maharashtra and West Bengal were affected the most by extreme weather events. More males and older population died than their counterparts. Findings suggest that people are adaptive to some extreme weather events such as cold wave and cyclones; whereas adaptation and coping with the heat wave and extreme precipitation seems to be less. Building awareness on the adaptive mechanisms to different extremes and a community-centered alert system can help in reducing fatalities due to extreme weather events. Keywords: Extreme weather, Mortality, Climate change, Extreme temperature, Lightning, Cyclon