Background

TARGETED INTERVENTION PROJECT ON HIV/AIDS

The Launch Of The Project In Rourkela City
About Opening of TI HIV AIDS –Information Centre Rourkela
Railway station

HIV/AIDS is the most dreaded disease after cancer and contrary to our expectations; the menace has been sprawling unrelentingly reaching as far as our urban town. The virus gets into one’s body through vital body fluid of an infected person and destroys the essential cells and system that give the body basic immunity from all pathogens. Though a perfect cure is still awaited, it is possible to prevent the transmission of the virus from a host to the general population. The Odisha State AIDS Control Association (OSACS), the apex body of Odisha government on AIDS control, has launched Targeted Intervention Project on HIV/AIDS to effectively reverse the sprawl of the epidemic from all parts of the state over the next five years.

With OSACS’s support, SEWAK launched Targeted Intervention (TI) Project in Rourkela Steel City and Municipality Area in November, 2008. The town, also called the ‘commercial capital of Odisha’ has a total population of 431.6 thousand, and is the home to one of the largest public sector steel plant of the country and hundred of small and big public and private sector enterprises. The Project targets the ‘Female Sex Worker’ (FSW) and ‘Men having Sex with Men’ (MSM) population in the city who constitute a High Risk Group to HIV/AIDS infections as well as potential transmitters of the disease. It also targets a bridge population with an assumed number of 1, 00,000 people consisting of clients, industrial labors, truckers, and migrant, who are more or less vulnerable to such infections through association with the former.

CHIN is a network of five national level NGOs led by Christian Medical Association of India (CMAI). It will survey and identify the areas where peoples’ expectations and NRHM commitments work at cross purposes and strive to transform the situation to one of coordination, professional excellence, and service. It will encourage and scale up public participation at community level and up, set up lobby and advocacy for NRHM commitments, provide effective BCC to service providers, side by side with pressurizing the local health system to be responsive and responsible to people it is supposed to care for.

Objectives of The Project

The specific objectives of the project are to:

  • Saturate coverage of core group i.e. Female sex workers, Men having sex with men, transgender community, and injectable drug users through their identification by primary data collection, Social mapping, Focus Group Discussion, Key informant interviews, in-depth interview and probing stake holders, and secondary data collection.
  • Scale up interventions among highly vulnerable populations namely truckers, migrants, industrial workers, as well as other bridge population
  • STI coverage among targeted population through preferred providers in the hot spot level STI clinic
  • Referral and linkages with other services for care, support, and treatment like ICTC, ART, RNTCP, STD clinic etc.
  • Creating enabling environment through opening of Drop-in center, Self-help Group and other community forums
  • Encouraging community participation through behavior change communication
  • Condom promotion with a view to reduce STI, and HIV among high risk population; Condom promotion by SHGs in each HRG site
  • Stigma reduction through community events, video show, street play, and rally
  • Encouraging gender equity by involving women in the targeted intervention program
  • Application of Strategic Information Management System for participatory planning
  • Training and orientation for both FSW and MSM peer educators on life skill education
  • Condom demonstration and re-demonstration for correct and consistent use. Promotion of lubes among MSM and social marketing of Female condoms among commercial sex worker.
  • Referral to ICTC Organizing STI health camps in the operational hotspot for reducing STI vulnerability and for prevention of HIV.
  • Networking and linkages of FSWs with SHG federation under Mission Shakti, Odisha.
  • Linking all FSWs with Private preferred Provider STI clinics for availing STI services.
  • Linking FSW, MSM, & PLHA with all India radio program i.e. ‘Jibanara Jaya Jatra’(the winning mission of life)
  • Coordinating with truck owners association, community level health providers like ASHA, AWW, ANM, beauty parlor owners etc. for awareness generation. Organizing street theatres at the hot spots on the issues of HIV/AIDS
  • Linking Positive cases with community care centers and ART centers for availing health services; Coverage of VDRL testing for all HRGs on priority basis, and
  • Promoting alternative source of income, and ensuring social security and opportunity for sex workers through right based approach
The Target Population

At the time of launch, OSACS set a target of 250 FSWs and 150 MSMs to be covered under project provision. These persons who get into the trade directly or inadvertently for a variety of reasons, such as institutional, instinctual, or social compulsion die a miserable death while infecting thousands of other with the epidemic.

FSWs

FSWs have many sexual partners:generally, fulltime FSWs have at least one client per day or 30 clients for month. Some FSWs have more clients than others, having several clients per day and 100 or more in a month. So, the project focuses mostly on this group. Further,they become vulnerable within the sex circuit,to harassment by Police, exploitation by clients, and violence.

MSMs

HIV epidemic also move from HIV victims to the general population via a male sex partners. They are rarely brothel based that makes it difficult to identify them. These people may have a family and are leading a normal life. But their sexualassociation with a PLHA brings not only themselves to danger but also to their partners.

Bridge Population

Consist of clients like amateurs, trucker, industrial workers, and vagrant or migrant workers and tradesman travelling through the railroad. They acquire the disease through contact with the high risk group and transmit the virus in the family circle. The project estimate that around 1 lakh people from Rourkela and neighboring regions belong to the bridge population category.

During the Baseline survey in the first year of the project, SEWAK located 19 hotspots in the steel city and municipality area with an assumed FSW and MSM population of 640 and 110 respectively.It subsequently identified 244 FSWs and 71 MSMs to be administered through Behavior Change Communication.

Project Activity & Achievements
Seed Treatment
Seed Treatment

The TI project implementation office is located at EM/2, Basanti Colony, Rourkela-769012. Six qualified staffs have been assigned with the responsibility to implement TI project in the Rourkela city. The project also recruits six ‘peer educators’ from among the high risk group to facilitate coordination among the project staff and the target group as well as to promote sensitization of the latter.

Sl. No. Major Activities Year 2009-2010 Year 2010-2011
1 Counseling to  High Risk Group members 750 1085
2 Focus group discussion with FSW/MSM 11/1 13/2
3 One to One Correspondence with HRG and Bridge Population 7562 7270
4 Referral of probable cases to ICTC 718 816
5 Tested at ICTC 288 351
6 STI/RTI and STD Treatments of FSWs and MSMs 160 111
7 Organization of Health Camps in the hotspot areas 5 7
8 Hot-spot level awareness meeting 79 66
9 Advocacy meetings with civil society, as PRI Members and police, Beauty parlor operators 6 5
10 Video Shows 26 37
11 Street play 5 7
13 Condoms Distributed 59000 112645

Up to 2011, 600 FSW and 180 MSMs have been identified in the project area. The project staffs have also identified 10 PHLV (People Living with HIV) who by now receive regular treatment through governmental facilities.