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Who is being infected with HIV and what makes people vulnerable to HIV infection?


Risk and vulnerability and drivers and risk factors are the critical “need-to-know” concepts underlying HIV prevention programming.

Risk is defined as the probability that a person may acquire HIV infection. Certain behaviours create, enhance and perpetuate risk. Examples include unprotected sex with a partner whose HIV status is unknown; multiple unprotected sexual partnerships; injecting drug use with contaminated needles and syringes. Vulnerability results from a range of factors that reduce the ability of individuals and communities to avoid HIV infection. These may include: (i) personal factors such as the lack of knowledge and skills required to protect oneself and others; (ii) factors pertaining to the quality and coverage of services, such as inaccessibility of services due to distance, cost and other factors (iii) societal factors such as social and cultural norms, practices, beliefs and laws that stigmatize and disempower certain populations, and act as barriers to essential HIV prevention messages. These factors, alone or in combination, may create or exacerbate individual vulnerability and, as a result, collective vulnerability to HIV.

Source: Adapted from UNAIDS (1998). Expanding the global response to HIV/AIDS through focused action: Reducing risk and vulnerability: definitions, rationale and pathways. Geneva.

The term driver relates to the structural and social factors, such as poverty, gender inequality and human rights violations that are not easily measured that increase people’s vulnerability to HIV infection. Risk factors are defined by the Dictionary of Epidemiology, 3rd edition as “an aspect of personal behaviour or life-style, an environmental exposure, or an inborn or inherited characteristic, which on the basis of epidemiologic evidence is known to be associated with health-related condition(s) considered important to prevent”. These include behaviours such as injecting drug use, unprotected casual sex, and multiple concurrent long term partners with low and inconsistent condom use. Recently the term driver is also used to describe those risk factors which are so widespread as to account for the increase and maintenance of an HIV epidemic at the population level.

Source: Last J (ed). (1995). A dictionary of epidemiology, 3rd edition. Oxford University Press.

1) Recently the term driver is also used to describe those risk factors which are so widespread as to account for the increase and maintenance of an HIV epidemic at the population level.
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