Programmes : HIV / AIDS Intervention

Introduction Migrant Labourers:

Studies from across the world have linked migration to multiple sexual partners and increased HIV transmission. It has been said that migrants and other mobile individuals are bridge populations for HIV transmission from urban to rural areas and between high-risk and low-risk groups. A large number of people move around different areas for work, the majority are men migrating for employment. Long working hours, isolation from their family and movement between areas increases the likelihood that an individual will become involved in casual sexual relationships, which in turn may increase the risk of HIV transmission. In many cases, migration does not change an individual sexual behavior, but leads them to take their established sexual behavior to areas where there is a higher prevalence of HIV. Therefore not all migr ants are at equal risk of HIV. Being mobile in and of itself is not a risk factor for HIV infection. It is the situations encountered and the behaviors possibly engaged in during mobility or migration that increase vulnerability and risk regarding HIV/AIDS.

Female sex workers Current situation of FSWs

Two types of CSWs are given services in this programme i.e. 956 street based and 306 home based. The target group enhances health problems due to ignorance, poor access to healthcare and low socioeconomic status. The diseases are linked to overcrowding, unsafe water and unsafe sex. They suffer cultural shock due to language barrier, non-conducive atmosphere and poor family support.

High living cost results in poor and delayed treatment and increased costs, loans and loss of wages, adversely affecting quality of life. Sex workers are bought and sold as commodity. Debts push them in vicious cycle and don’t allow expenses on condoms and STD care. Natural or man-made calamities make the real life situations worst, as they come last in priority for rehabilitation. It makes them seek migration again to newer places to repeat the vicious cycles. Single male temporary migrants and truckers face similar situations.

The sequel of consequences of ill health is disastrous to their family. The study describes impact thrust on marginalized parents took him into their hands and made him sleep close to him. The parents were informed about the results of the functional assessment later the therapist suggested that they discontinue their usual management techniques and they were given some bed time routine to be followed. The child is more composed now and there are less occurrences of the disruptive behavior.

Intervention:

At this backdrop the project provided migrants and the sex workers with healthcare facilities. Creating awareness and treatment seeking behavior among them became the priority. Health care is extended through mobile health care services and tuned to cover such laborers at vulnerable places or spots.

Technical strategies for interventions:

Implementing Strategic Behavior Communication activities

Conducting Mass Awareness Activities

Facilitate Condom Promotion

Management of STDs - aiding and developing improved HIV/AIDS and STD management programmes

Provide counseling and psychosocial support

Provide treatment, care and support services to migrants and PLHA

Provide diagnostic services and refer PLHA for clinical service

Facilitate formation of PLHA support group

Mobilize community and create an enabling environment

Sensitization of community leaders

Community Mobilization

Reach:

SIDUR made concerted efforts to foster a comprehensive network - down to the grassroot level – of educated personnel and volunteers who are familiar with local culture and languages working with the targeted group to prevent HIV/AIDS.

To support these and other efforts, the organization devoted resources to enhancing existing systems and institutions to promote HIV/AIDS prevention. For example, SIDUR supported outreach programmes, encouraging a greater awareness of the risk of HIV/AIDS infection among female and male migrant workers and their clients. We also worked with organizations that include transient and part-time workers in the education process. A key focus here has been encouraging learners to share the results of their training with their clients and communities.

Supported a multi-phase campaign with audio- video and print media that have been distributed in the community. The campaign has been directed primarily at young people and has moved from a general awareness campaign to one increasingly aimed at high risk behaviors such as unprotected sex and sharing needles among injecting drug users.

Achievements –

  1. No. areas Covered -28
  2. HRGs registered -1,262
  3. BCC sessions - 18767
  4. STD treated - 1,077
  5. ICTC tested - 1,019
  6. No. of condoms outlets - 37
  7. No. of condoms distributed - 2,70,481
  8. No. of peer leaders - 20
  9. No. of positives – 10

Best Practices:

  1. Organization providing mobile medical unit and general medicines to increase STI treatment.
  2. Facilitating other services to the target group like
    • Delivery cases linking with nearby government hospitals.
    • Providing identity cards from labour department.
    • Settling labour payment disputes with the contractor.
    • Giving information on free food distribution area’s in times of no work days form migrants.
  3. Conducting congregation event in migrants’ residential area at their leisure time.
  4. Selecting competent Peer Educators –
    • Sensitization about the procedures of selection.
    • Allocating probation period 1 to 2 months.
    • Conducting test.
    • Selection public orientation on responsibilities.
  5. BCC – Allowing HRG’s to ventilate their problems to the maximum.
  6. STI treatment public ICTC – Linkages with local business units for transport (PL).

Challenges:

  1. STI treatment – All DSRC’s are in a distance therefore the clients are finding it difficult.
  2. Unavailability of medicines and STI kits in Government Hospitals