Report on the Global HIV/AIDS epidemic

What makes people vulnerable?

Figure 16. HIV prevalence rate among pregnant 15-24-year-olds,
by educational status, Uganda
30
{
252
oilliterate
20 primary education
Osecondary education
V
U 15 -U")
10 -1991-1994 1995-1997 -Source: Kilian A et al. AIDS 1999, 13:391-398
Men and women on the margins
Groups who are made to live on the margins of society exist in every country,
although they differ from place to place. What marginalized groups have in common
is an increased vulnerability to HIV. Those who engage in stigmatized behaviour are
less likely to be cared about or even acknowledged by society's decision-makers,
who do not want to spend their political or financial capital on AIDS programmes for
them. Even where prevention and care services for them exist, individuals whose
practices are against the law - or whose presence in the country is illegal - may be
reluctant to risk exposure by participating in them.
Whether the individuals concerned are illegal immigrants, drug users, sex workers
or men who have sex with men, their vulnerability is proportional to the lack of
information and services available to them and to their constrained margin of
manoeuvre.
One useful approach to reducing vulnerability is to encourage the participation of..
nongovernmental organizations, which may enjoy more credibility with certain
groups and be able to reach them better. For example, in countries where sex
between men is stigmatized, community-based organizations of such men have
been particularly active in both AIDS prevention and care, and in some places they
are receiving increased government support (see pages 67-68).

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