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Targeted Intervention Projects

Campaign by RAJASTHAN NUT SAMAJ SUDHAR SAMITI

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Story

At present Working Area: District of Kota Rajasthan 

TARGETED INTERVENTION: In 2014 the organization successfully got a composite TI project (FSW, MSM) at Kota. This project is running in the Kota district with support from RSACS.   

Key attributes of Targeted Intervention Projects include:

  1. Peer-led approach - People from the high-risk community are engaged to deliver services and act as agents of change.
  2. Targeting high-risk behaviors and practices and not identities/ individual choices.
  3. Linking with services and commodities provision.
  4. Dissociating risk from behaviors e.g. risk of STI and HIV infection from sex works.
  5. Involving communities and their issues within the broader framework of interventions.
  6. Adapting to the cultural and social milieu of the target audience.
  7. TI projects provide a package of prevention, support, and linkage services to HRGs through an outreach-based service delivery model.
  8. The services offered through the Targeted Interventions include:
  9. Detection and treatment for Sexually Transmitted Infections.
  10. Condom distribution.
  11. Condom promotion through social marketing.
  12. Behavior Change Communication.
  13. Creating an enabling environment with community involvement and participation.
  14. Linkages to Integrated Counseling and Testing Centers.
  15. Linkages with care and support services for HIV positive HRGs.
  16. Community organization and ownership building.
  17. Specific Interventions for MSM / FSW.

DIRECTION:

FSW - FEMALE SEX WORKER

MSM - MEN SEX Men

  1. HIV/AIDS AWARENESS: 31% FSWs belong to 15 to 25 years of age group and 69% FSWs are part of 26 to 40 years of age group. 73% MSMs belong to 15 to 25 years of age group and 27% MSMs are part of 26 to 40 years of age group.
  2. 60% FSWs and 23% MSM are married.
  3. 66% MSMs belong to the Hindu religion, among them 30% SC, 6%ST and 30% General. Furthermore, there are only 34% of MSMs are belong to Muslims.
  4. 75% FSWs belong to the Hindu religion, among them 25% SC, 11%ST, 27% OBC and 37% General. 17% of FSWs belong to the Muslim community.
  5. 26% FSWs and 50% MSMs are literate.
  6. We didn`t find any FSWs who have left their origin and similarly vast majority of MSMs 73% are still in origin only 27% have left their origin.
  7. 65% FSWs and 39% MSMs are professional sex workers.
  8. 34% FSWs and MSMs are earning below 2000 and 31%FSWs and MSMs are earning 2001 to 4000 and 34% FSWs and MSMs are 6001 and above only FSWs and MSMs are earning 4001 to 6000 Rupees per month.
  9. 80% FSWs and 15% MSMs are using their time to enjoy cinema. 20% FSWs and 72% MSMs are want to meet with friends in their free time.
  10. 100% MSMs and 99% FSWs are known as ward HIV/AIDS.
  11. Source of heard about HIV/AIDS are 18% MSMs and 12% FSWs from friends, 51% FSWs and 34% MSMs from TV, 2% MSMs form radio, 17% FSWs and 5% MSMs from NGO worker.
  12. Miss conception e among in MSMs is high regarding HIV/AIDS. Some still believe that the Shaving blade is one of the causes of HIV/AIDS.
  13. Miss conception percentage among FSWs is high regarding HIV/AIDS.
  14. 100% MSMs and 85% FSWs are replied that they can`t say because of awareness towards HIV/AIDS is nil.
  15. MSMs having no absolute knowledge about the prevention method of HIV/AIDS.
  16. Most FSWs think if they will have fewer partners so they can skip from HIV/AIDS.
  17. About the cure of HIV/AIDS 57% FSWs and 65%, MSMs are unaware they can`t say there is any cure or not. 18% FSWs and 10% MSMs replied that there is not any cure form it.
  18. 50% MSMsand 90% FSWs replied that safe sex is one way to avoid this infection.
  19. 21% MSMs and 80% FSWs replied that if they will suspecting of having STD/HIV so they will consult with a spouse. 64 %MSMs and 15% FSWs having faith in friends.
  20. 88% of FSWs and 45% MSMs are aware that it is available only in some major hospitals.
  21. 78% FSWs and 40% MSMs replied they know someone having HIV infection.
  22. FSWs and MSMs have done first sexual encounters in the age of 14 to 17 years.
  23. 100% FSWs and MSMs heard about the condom.
  24. 54% of FSWs and 40% MSM sheared about condoms from TV. 29% FSWs and 20 % MSMs from radio and 10% FSWs and 10% MSMs from new paper.
  25. Using the ratio of condoms it is amazing among FSWs but only 75% MSMs are using a condom.
  26. 47% of female sex workers replied that they want to avoid pregnancy.
  27. FSW 90% accruing condoms from the medical shop but only 30% MSMs are
  28. MSMs didn`t use condoms in the last encounter.
  29. 1-2 client load is daily for 80% MSMs and 2-4 for 20%.
  30. Risk freestyle of sex is 70% MSMs told by masturbation, 20% told by oral sex.
  31. 90% MSMs replied that they are having sexual relations with friends.
  32. 75% MSMs are having oral sex, 15% anal and 10% thigh sex.
  33. 65% MSMs are not using condoms during sex only 35% are using but not all the time.
  34. 73% FSWs know that the brand of free condom is Nirodh only 2% told about Masti is a free condom.
  35. 42% FSWs are not using a condom with their regular partner and 58% FSWs are using a condom with them.
  36. 47% of FSWs are not using a condom with paid clients.
  37. 72% of FSWs deny that most of the time they are not using a condom because of stigma.
  38. 74% of the populations of FSWs did not use a condom in the last sexual intercourse.
  39. 71% of FSWs are not ever suggested by their partner for condoms during sexual intercourse.
  40. 38% of FSWs and 40% of MSMs never heard about STI.
  41. 60% FSWs and 70% MSMs didn't hear about STI.
  42. FSWs and MSMs were not understanding the meaning of STI. Only 23% deny having STI in the last 12 months.
  43. 47% of FSWs and 80% MSM are not aware of facilities available in their area.
  44. 22% FSWs and 50% MSMs never had an HIV test.
  45. comfortable with HIV positive or PLHIV during work 80% MSMs can`t say, 49% FSWs deny that they will be uncomfortable and 50% told they can`t say.

GOAL-To arrests the spread of HIV/ AIDS amongst FSWs and associated high-risk populations in the Kota district so as to reduce the morbidity, mortality, and impact of AIDS in the intervention area.

STRATEGIC OBJECTIVES:

  1. To reach out to around 1000 FSWs in Kota district, for prevention of STI/ HIV/AIDS through BCC.
  2. To provide quality STI services to MSMs and FSWs.
  3. To promote condom uses among MSMs and FSWs through the social marketing of condoms.
  4. To build the capacity of project staff, and PE on HIV/AIDS/STI/Condom Promotion BCC & Program management in one year

PROJECT STRATEGY:

  1. Behavior Change Communication: Communication continues to be one of the most important strategies in the fight against HIV/AIDS. In the absence of a vaccine or a cure, prevention is the most effective strategy for the control of HIV/AIDS. It is imperative to continue intensive communication efforts that will not only raise awareness levels but also bring out behavior change.
  2. Information, Education, and Communication is a process that informs, motivates and helps people to adopt and maintain healthy practices and life skills. It aims at empowering individuals and enabling them to make correct decisions about safe behavior practices. IEC also attempts to create an environment, which is conducive and supports access to treatment and services for those already infected.
  3. To make communication effective, it would be used in the local language and idiom, keeping in mind social norms, cultural beliefs, and sensitivities of the target group's Commercial sex worker community. BCC programs will concentrate on interaction, clarifying doubts, addressing misgiving on the issues of sex and sexuality, which are traditionally not discussed openly in a conservative society particularly of Rajasthan.
  4. For effective IEC campaigns a full range of activities and approaches from mass media campaigns for public education to the use of targeted interventions for FSWs to help individuals negotiate safer practices continue to be used. The BCC program will also integrate one to one interaction with condom demonstration, in the same way as it was done last year. Similarly one to group training will also include the condom demonstration and one member of the group will be required to narrate the use of a condom by demonstration.

The premise for working on this strategy is because of:

  1. Most of the female sex workers do not have accurate and complete information on HIV/AIDS.
  2. The link between STD and AIDS is not clear to most FSWs.
  3. STDs are not taken seriously since they are curable.

 For the proposed intervention the following methods would be used:

  1. Use of Mass Media
  2. Advocacy at various levels
  3. Use of Peer Educators
  4. Training
  5. Developing creative and attractive messages
  6. Using the success stories by utilizing the persons whose behavior changed
  7. The skilled building of FSWs in alternative trade

The special communication methods proposed to be adopted are:

  1. Group meetings, street plays, songs, and dramas, Spiritual discourses, and meditation.
  2. Networking with the National AIDS Telephone Helpline.
  3. Printing leaflets and disbursing it to the various group through various stakeholders.
  • Procuring the IEC materials such as a health education package for the commercial sex workers (three sets of flashcards, one poster, one leaflet, and a user manual). A package on HIV/AIDS containing three posters, a flipbook, and a folder, for slum dwellers. For workplace education in Industry, an IEC package consisting of posters, booklets, stickers and a video set of options has been produced. The other print media developed for awareness were: posters, pamphlets and booklets on general information on HIV/AIDS/STDs, voluntary blood donation, timely treatment of STDs and developing a positive attitude towards those infected with HIV/AIDS.

Mid Media: Especially in the non-brothel sites where commercial sex workers are in general known by the community, but can to be pointed out some activities such as film shows, street play is very important. Through mid media activities, we create awareness about STI/HIV/AIDS, safe sex using Condom to the FSWs in Ajmer District.

IEC Activity: Through pamphlets, leaflets, posters, booklets, stickers, and wall painting, etc. activities will be done to prevent HIV/AIDS amongst FSWs in Ajmer District.  

Expected output: This is a very sensitive project and at the same time, a very important and essential intervention. Working with FSW, especially when they are involved in the sex trade because of family compulsions or family tradition and operate as a ‘community’ is very challenging. Breaking through their close network will be a challenge and at the same time, we are committed to the confidentiality aspect of their life and this study. Maintaining and respecting this confidentiality, we would bring about the following outputs at the end of the intervention:

  1. A reliable database about the strength and profile of FSWs in the target area, including their health, STI and HIV status.
  2. A few short studies on the social causes and implications of the sex trade, health and medical needs of the people involved in it, etc.
  3. Plan for about rehabilitating the FSWs who want to leave the trade.
  4. Plan for a rehabilitation program for their children.
  5. Recommend the follow-up plan for the intervention.
  6. Awareness of HIV/AIDS increased and the incidence of STI/HIV/AIDS reduced among FSWs.

Change in their knowledge level – transmission modes, treatment relationship, myth & misconceptions: In the initial phases, our team faced severe resistance by the FSWs and they did not agree to go against the client wish. Gradually they started understanding it to pursue their clients to use a condom if he wants to have sex. About the RTI/STI, FSWs have myths & misconceptions that Urethra Discharge and vaginal infection are normal problems, but our team counseled them about UD & other STI/RTI diseases and provided the correct information about these diseases and provided them a scientific reference material.  

Change in their attitude – condom use, risk perception, reducing no. sex partners: FSWs profession is to sell sex and is in the market after satisfying the clients. A client who varies from the migrant population to the young college-going students come for sex and enjoy, which they do more without using a condom. But after that, there are heavy consequences of acquiring serious diseases. Most of the clients said that condom does not provide pleasure therefore they don’t use it. FSW gets more prices if she allows sex without a condom.

Our team contacted these FSWs and did advocacy for using a condom in all sexual intercourse and do not give consent to having sex without a condom with any of the clients. Some modification of behavior was noticed at the brothel sites FSWs, apparently, they said that they have changed their practice and now agreeing with only those clients who are ready to put on a condom. Some attitudinal change was also observed. Our team motivated them to use/change regular condoms during sex, to reduce risk about STI/HIV/AIDS. The most resistible groups were identified to be truck drivers.

Change in their behavior – seeking health care from a qualified doctor, by the clinic doctor, buying condoms: Our team organizes health camps and give medical treatment to FSWs. So far 200 clients have shown up for the health camp. Through our project, we continuously work towards modifying their behavior of seeking treatment through qualified Doctors and knowledge by our qualified staff. RNSSS’s team motivates FSWs to procure condoms regularly and use them during sexual intercourse. The team of RNSSS also caution them about quacks/JholaChhap doctor and their unethical and irrelevant treatment. 

Organisers
RAJASTHAN NUT SAMAJ SUDHAR SAMITI

RAJASTHAN NUT SAMAJ SUDHAR SAMITI

Beneficiary Charity

Suresh Kumar lachiya

Suresh Kumar lachiya

Organiser

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