------------------------------ Our Registration : Society Registration Act 1973, FCRA, 12A, 80G ------------------------------

HIV / AIDS

ASRA Beliefs:-

HIV/AIDS is more than a health issue. It is also an economic issue whose enormity threatens to roll back advances in economic development made over the past few decades. Over the past ten years, growing awareness of the devastating impact of HIV/AIDS has translated into greater international commitment to confront the epidemic and increasingly the economic issues surrounding it.

Increasingly, this means that donors are focused on expanding livelihood options and food security, seeking to strengthen the economic prospects of people living with HIV/AIDS (PLWHA) and their families and link them to longer term, more market oriented services, including financial services such as savings and loans. The role that microfinance plays in economic strengthening of people living with or made vulnerable by HIV/AIDS is growing, but increasingly nuanced as it requires strategies and solutions that cut across the provision of a wide variety of both health and financial services.

ASRA Has been worked with the support of many organization for full fill the gaps between PLHIV and community and prevent peoples.

Targeted Intervention Project Dewas and Indore :-

Objective -
1. To Provide BCC Services for safer sexual practices to 100% of target population and to ensure safe sexual behavior change in at least 30% of target population.
2. To Provide Condom promotion Services to 100% of target population and to ensure correct and consistent condom use amongst at least 30% of target population.
3. To Provide Quality STI services to 100% of target population.
4. To mobilize the community for ownership of the programme, creation of enabling environment to ensure quality services.
5. To ensure effective programme management to enable the community /target population to develop ownership of the program and sustaining of the project.

Brief Introduction of last 3 year Project Implementation

Asra has run TI project in Dewas and Indore Districts with support of M.P. State Aids Control Society since October 2008 and Jan 2010. Projects is focused on the core group containing Female sex workers and MSM.

The Asra goal for the target group is to prevent new HIV and STI infections among the core group of DEWAS and Indore District in next 3 years. The objective is to cover all the Female Sex Workers .

The efforts made by ASRA, Dewas in the year 2009 –2012 achieved by making inroads in many areas of interventions for HIV/AIDS prevention and control among transporters, communities and floating population in general Rapport was established with efferent stakeholders. The efforts made by Asra Samajik Lok kalyan Samiti, Dewas in the year 2009-2012 have further strengthened the activities. This year a cadre of supporters like peer educators. Volunteers and supporters were strengthened in field area also a cadre of supporters in the form of Anganwadi workers, stak holder and their supporters form nearby communities have been developed and strengthened. Building the capacity of the team to achieve the desired objective was also one of the focus areas. Linking the community and established health set up for long term sustainability of the project was also started.

Achievement :-
1. Implementation of Pilot project of Public Private Partnership (PPP) Programme – Community based approach of STI/RTI service delivery strategy is a decentralized way of service provision focusing mainly primary stake holders (FSWs) and secondarily clients of PSH through a network of preferred providers of PSH, identified and oriented, mentored on a regular basis.
Note - Out of 100 districts only TI Dewas (MP) and Jalpaigudi (West Bengal) have been selected by NACO for this pilot project.
2. Asra has been member of Academic committee {State Level} as a TI Representative.
3. A developed culture “STAR of THE MONTH” according to monthly performance of PEs in the project through support of PEs and committees formed by HRGs.
4. Organized one day conference of HRGs {SAKHI SAMMELAN} in project areas and around 700 HRGs were participated.
5. A cadre of peer Educators, volunteers and supporters have been developed / trained to disseminate the information on STD/HIV/AIDS/RTI and condom promotion.
6. Large number of IEC materials distributed on the above issues foe effective communication and information dissemination.
7. Developed a card of private practitioners trained n syndromes cases.
8. Condom out- lets setup with peer Educators to enhance the accessibility and correct use of condoms among the truckers.
9. Linkages with community influencers’ religious leaders, anganwadi workers, and transporter, union leaders, Govt. Authorities, police, health department etc. developed and streamlined.
10. Target communities have been made aware and encored to go for STD treatment in the operational areas.
11. A counseling center set- up project office, which is extending counseling as well as education support to the clients visitors.
12. A recreation center {DIC} has also been established in the office, which provides the clients a comfortable environment and free space for their entertainment and experience sharing.
13. Apart from truckers nearby community members including women have also been sensitized on the issues related to STD/HIV/AIDS.
14. Social marketing of condoms is in place in this year.

Targeted Intervention Project with Transit Migrants as Pilot Project at Indore

Deliverables -
1. Implement the transit migrant interventions as per revised Policy on Migration and HIV. The deliverables include provide information on risk and vulnerabilities of HIV/AIDS to spouses of migrants, out going migrants ( male and female), returnee migrants ( male and female).
2. Provide technical and management support in implementation of the interventions.
3. Build capacity of staffs, volunteers for effective implementation.
4. Sensitize and involve community (migrants, returnee migrants, lab our contractors, mukkaddams), other stake holders like officers of Department of Railways and Transport, rickshaw pullers, auto rickshaw drivers, hawkers etc.
5. Collect, collate, analyze and share data from various sources as per requirement of implementation with SACS.
6. Provide monitoring and supervisory support
7. Ensure reporting as per requirement of SACS.
8. Ensure convergence of the activities under Migrant Intervention with HRG TIs in the area.

Targeted Intervention Project – Truckers

Consciousness on the hazards of unsafe behavioral practices among the truckers and helpers in the context of STI and HIV/AIDS is an issue of disquiet and concern. There are about 5 to 6 million truck drivers in India of which 40% are long distance drivers (LDT). These Particular Plase Highwey Bhedaghat , Highway In Nagpur Highway In Kanagi Highway In Patan Highway In Katni are Total 2000 to 5000 thou dance of trakers Of these LDTs, 36% are client of sex workers. Therefore encouraging the usage of condoms to avoid STI and HIV/AIDS of which their knowledge is negligible or either they are ignorant about its implications becomes a central part of socio economic development interventions. Truckers Intervention Project aims at enhancement in the knowledge about HIV/AIDS among the long distance truck drivers and the helpers, whose average trip is more than 800 kms one way.

Project Objective -
arrow_sbconsultancy To promote the adoption of safer sexual behavior and practices by the truckers through Dialogue-based peer-led Interpersonal Communication (IPC) and Behavior Change Communication (BCC) strategy.
arrow_sbconsultancy To promote use of condoms among truckers through improving access
arrow_sbconsultancy To reduce the incidence of various Sexually Transmitted Infections among truckers through appropriate clinical intervention.
arrow_sbconsultancy To create an Enabling Environment by involving different stakeholders in their activities at intervention locations for the programmed sustainability.

Main component covered under project -

1. Behavior Change Communication
Although LDTs have knowledge about HIV and STIs, yet this has not translated into enhanced self risk perception and desire for preventive action. It is proposed to initiate intensive peer led approach which has the advantage of reaching the large number of target population. ASRA will adopt the model of peer based inter personal communication, incorporating necessary modifications. The communication strategy will have the following communication approaches:
arrow_sbconsultancy Dialogue based peer led Interpersonal Communication, which is critical to enhance the credibility of messaging in the field. It promotes critical thinking and self reflection by the participants.
arrow_sbconsultancy Creative, synchronized and thematic mid-media, which is very necessary to supplement IPC activities with street plays, exhibitions, games etc. it serves to widen the exposure base of the program, increase awareness of the service and generate demand.
arrow_sbconsultancy Selective mass media, particularly outdoor signage, radio and cassettes provide a mechanism to promote program services and expand awareness on a large scale.

2. Peer-led dialogue-based IPC
Dialogue based IPC uses tools and methods that stimulate a discussion on an issue and enable the group to problem-solve and arrive at an agreed course of action. Peer-led IPC uses members of the population (present or ex-truckers) as facilitators to manage the discussion. The advantages of peer-led IPC are that it:
arrow_sbconsultancy Has greater credibility than outreach-led communication strategies
arrow_sbconsultancy Uses familiar language and the experience of having “lived the life” of a truck driver/helper to ensure
arrow_sbconsultancy Better community mobilization, reduced stigma and an environment of sharing
arrow_sbconsultancy Facilitates a higher degree of acceptance and ownership of the programmed goals amongst the population

3. STI Care
The approach to service delivery for truckers will be to ensure that irrespective of their point of service access, truckers receive standardized, high-quality services and care.
As information provided through BCC raises the awareness of truckers, they will seek access to services including STI care. ASRA shall provide STI care through facilities in its area. The approach will be Syndromic Case Management (SCM) as described in NACO’s STI.
As truckers are always in a hurry to move on, it may not be possible to wait to treat them until after they have had laboratory tests. Thus SCM is the most appropriate method of treating STIs in truckers. ASRA will establish a combination of static clinics and referral STI care facilities in the project area.

4. Referral services
Along with the above services, STI care services will be provided through a network of referral doctors, to ensure that services are available at all times and at all points at the selected halt points.

5. Counseling
The project counselor will be adequately trained in counseling and will only perform STI counseling. The counselor will counsel all truckers treated for STIs, but if the client is referred to a voluntary counseling and testing centre (VCTC) the pre- and post-test counseling will be done by a VCTC counselor only. The trucker will receive a treatment card so as to enable him to visit other clinics of the national chain part of the National Networked Targeted Intervention for Truckers (NNTIT).

6. Condom Management and ensure Availability
For the past fifteen years condoms have been distributed free of charge under various programmes. NNTIT will only provide social marketing of condoms under a specific NNTIT brand. For this purpose a social marketing organization (SMO) will be contracted by NNTIT.
arrow_sbconsultancy The condoms for social marketing will be specifically branded and packed and will carry the NNTIT logo and colour scheme.
arrow_sbconsultancy The team of workers and peers will not be responsible for condom distribution. Field staff of the SMO will be charged with this function.
arrow_sbconsultancy The SMO will build a network of traditional and non-traditional condom retailers in the project area and stock condoms with these retailers for sale.
arrow_sbconsultancy The SMO will ensure that adequate IEC on condoms are made available to the retailers and prominently displayed in the outlets. The necessary IEC will be supplied by NNTIT.
arrow_sbconsultancy The SMO will also conduct condom demonstrations to clear misconceptions about condom usage.
arrow_sbconsultancy In addition to condom availability at the intervention location, the SMO will also be responsible for condom distribution and promotion at key sites along the highway – rest stops, restaurants, petrol pumps, etc. The placement of condoms must be based on data about trucker needs and purchasing habits.


7. Creating an Enabling Environment
ASRA will build an enabling environment by involving different stakeholders in their activities at intervention locations. They will form a project support committee in the project area which will include the district’s DHO/DLO. The ASRA will conduct monthly review meetings of the programme with the help of this committee and report to the NNTIT. All activities of the project will be explained clearly to the committee members.

8. Linkages with Other HIV Services
Truckers should have access to additional HIV services through the TIs. This would include referrals to ICTC and ART, provision of resource directories of available services, and in select cases, the placement of ICTCs at high volume halt points, in conjunction with SACS.

9. Condom Availability and Potential Outlets for Condom Social Marketing
The condoms are available in all the three sub halt points. Rigorous canvassing and efforts by JBSK team in Condom social marketing have made a variety of condoms more accessible, affordable and acceptable in sub halt points not only to long distant truckers but also for Eunuchs and general populations spreading the awareness of HIV/AIDS and STDs. The potential use of alternative distribution system through stockiest (within the community), was an essential aspect of social marketing and through identifying non-traditional outlets such as dhabas, petrol pumps, garages, tea stalls, provision stores, broker office and many more. In addition to outlets which were stocking condoms, there are 20 CVMs located at different locations in the halt point. CVMs were installed near hotspots. Approximately 2000-5000 branded condoms are sold every month from halt point for the last one and half year. Good linkages and personal rapport with CSM companies like PSI, HLL and HLFPPT have ensured the smooth supply system and maintenance.

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