Societal vulnerability: contextual analysis.

This book chapter explores how the social aspect of vulnerability to HIV/AIDS has been understood and acted upon. The concept of social vulnerability is based upon the knowledge that collective societal factors strongly influence personal and programmatic vulnerability. Political and governmental factors which influence social vulnerability to HIV/AIDS include 1) inattention or unconcern 2) laws that criminalize certain behavior 3) interference with the free flow of information 4) a lack of HIV-related services and 5) discrimination against people with HIV/AIDS or against certain groups. Sociocultural factors include 1) gender roles 2) attitudes towards sexuality 3) stigmatization and marginalization of various groups and 4) illiteracy and lack of educational opportunity. Economic factors such as poverty and income disparity lack of resources for prevention programs and lack of work or job opportunities also influence social vulnerability. The new approach to HIV prevention is based on a combined risk-reduction and vulnerability-reduction strategy which depends upon an analysis of available information to identify those who are most vulnerable to infection. These efforts will require the cooperation of various governmental agencies nongovernmental organizations and the private sector as well as public health ministries. The identification of poverty as a factor increasing vulnerability also presents special challenges to public health workers.