Submitted to U-landshjelp fra Folk til Folk, Norge

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1 Submitted to U-landshjelp fra Folk til Folk, Norge

2 HOPE- DELHI Annual Report January to December, 2014 Background of the Project HPPI initiated a Targeted Intervention (TI) project for the Female Sex Workers (FSWs) of Patparganj area of East Delhi district by the name of Hope Delhi Project since 2008 in partnership with the Delhi State AIDS Control Society. The project was expanded to include 500 additional FSWs in HPPI has also contributed to the country s overall success of curbing HIV transmission in the FSWs through its Hope Delhi project. The project has been able to achieve certain key landmarks in the past couple of years like condom use in the last sex act by the Female Sex Workers, which has gone up to 95%. The HIV and STI rates in the project have already shown a substantial decline over previous years. It is important that the gains achieved by the project should be sustained. The Delhi State AIDS Control Society has extended its support to HPPI to implement the project until March The project aims to make the FSWs of Patparganj more empowered and selfdependent, so that they become fully capable and equipped to handle their health and social problems by themselves in the coming future. Main activities of the project People reached: During the reporting period, project staff has connected with 30,198 people through one to one sessions and group sessions with information about HIV/AIDS, STI, their treatment and proper use of condoms for safe sex practice. The people were encouraged to undergo HIV testing at ICTC regularly. People tested for HIV: In 2014, the project staff conducted sessions with migrants and female sex workers, to encourage them to undergo testing. Consequentially, 1,793 people from the operational area got HIV testing done at the Integrated Counselling and Testing Centres of Anand Vihar and in Headgewar Hospital. There are some people who underwent testing twice or thrice, which reflects of a healthy habit, however there is still a long way to go with respect to behaviour change of the masses. Only one new person has been found HIV positive this year and the project is following up with her regularly and has connected her and 5 other HIV positive women with positive living groups. Trio s for ARV adherence support: 6 HIV positive FSWs are organised in TRIOs this year. The people in TRIOs are the patients, one family member and a passionate/project staff. These TRIOs are equipped with necessary knowledge to take care of patients in emergency cases. Counselling on safe sex practices: The project conducted 3,135 counselling sessions for 10,220 FSWs and migrants. In the sessions, discussions on HIV/AIDS, STI/STD infections and proper use of condoms took place, enlightening them on safe sex practices, types of condoms (Latex and polyurethane), female condoms and their availability, etc. The people learnt about the proper handling and storage of condoms, its physical properties, which reflect its suitability for use and a detailed account of the method of usage. The sessions ended with distribution of IEC material and condoms. Dr. Sunita Gupta, the doctor of the

3 project s STI Clinic provided counselling services to the FSWs together with STI screening and treatment. Over the period, many FSWs have adopted condom usage practice in each sexual intercourse and the STI infected females follow up their treatment on time. In addition, 1,431 FSWs received treatment on STI with syndromic management in the project s STI clinic, during the reporting period. Peer Educator s (PEs) capacity building training: The project conducted 9 meetings with 126 peer educators who volunteer to connect with people of high risk groups in their area to fight against HIV and AIDS. These peer educators receive regular trainings of HIV/AIDS, their roles and responsibilities and means to leverage their outreach and mobilise people in the operational area. Mr. R. K. Tyagi from District AIDS Prevention & Control Unit of East Delhi district helped the project in training the PEs. Condom Promotion: Condom promotion is an important activity in the Hope Projects. Hope Delhi conducted 6,551 condom demonstrations to promote the use of condoms for the prevention of HIV. 26 condom outlets have been established by the project, which have aided in the distribution of 209,413 free and 1,800 condoms through social marketing during different awareness sessions and events. Management of STIs: The project counselled 3,219 FSWs and referred them to Government Hospitals for the screening and treatment of STIs. In addition, 659 FSWs have been screened for Syphilis and no one was found positive. The FSWs have become more aware and active in visiting the project clinic as well as the Government clinic. Participation of Youth in project activities: The youth has been very active in working together with the project staff in organising street plays, people management during awareness camps and four health camps, plantation drive, etc. The enthusiasm is visible by the huge numbers of 11,511 youth participating in the project activities. Networking meetings: Networking meetings help to connect with local leaders, local health functionaries, district officers and local NGOs operating in the area. In 2014, the project conducted 323 networking meetings with district level health staff, staff of ICTC, FICTC Centres, ART Centre, DOTs Centre, Government Hospitals, and groups of FSWs to create an effective linkage between the vulnerable community and healthcare providers. Opinion forming meeting: In the project, there are many issues, which we can solve only with the advocacy meetings. The issues faced by FSWs at ICTC, ART Centres, Government Hospital are dealt with and solutions are worked out in the meetings. The number of people participating in opinion forming activities has been less than committed because of the shyness of people to come forward and get noticed. 3,306 people however, registered their presence in the activities. The Impact of the project The project has provided a good platform to interact with the FSWs and migrants in the operational area. The project team, with consistent efforts has been able to garner trust from the target group and is ably connecting with them over the sensitive issue.

4 The regular intervention with the people through health camps, awareness camps, video shows, street plays, etc., have upped the knowledge quotient of the target group, making them aware of the causes, effects, precautionary measures, etc., of the disease. FSWs and migrants also have demonstrated appropriate health seeking practices in terms of utilisation of STI and HIV counselling and testing services. Consequentially, there has been a steep decline in the number of people detected with HIV and STI. More than 90% FSWs have been guiding their clients to use condoms correctly, after attending condom demonstrations. The project has developed a rapport with key community stakeholders who ensured an enabling environment in the project for safe sex and health seeking practices. IEC materials have helped to further enlighten people and clarify their doubts, especially in times when the staff cannot be reached. This is also a major step towards ensuring sustainability of the intervention. Attachment 1: The Project in Numbers S. Goal Diff- Activity Results No (+/-) 1. No. of people directly reached 30,000 30, No. of people HIV Tested 1,400 1, No. of people/ female sex workers counselled 2,000 10,220 1, No. of people organised in positive living groups No. of people in positive living control actions Trio s for ARV adherence support No. of Hope Activists Monthly activism No. of youth in youth activities 6,000 11,511 5, People trained under HOPE Programme Condoms distributed 300, ,413-90, People in opinion forming activities 13,000 9,550-3, Individual FSWs contacted twice in a month 10,200 10, Individual FSWs accessed clinical services , Individual FSWs treated for STI with syndromic management 120 1, Individual FSWs given presumptive treatment Individual FSWs screened for Syphilis 1, Number of Days Clinic Conducted Meeting with ICTC, FICTC, STI Clinics, Dot Centre, ART Centre, CCC, Govt. Hospital, District level officer and Local Authorities/Leaders 20. IEC Material distributed 7,500 10,090 2,590 Comments: The project achievement is low in activities due to delay in extension of agreement with Delhi State AIDS Control Society, restricted supply of condoms from DSACS and unavailability of Syphilis Testing Kits in Government Hospitals.

5 Attachment 2: Case Story Urmila, aged 30, a sex worker from Delhi, lives in the railway colony. She was abandoned by her husband at a very young age and has been living with her brother in law since then. The brother in law ill-treats her, beats her up and does not give her enough to eat due to which she resorted to the profession to earn her daily bread. The project staff met Urmila on one of his visits to the locality, and was told about her by some neighbours. The staff approached her and shared the organisation s work with women of her profession and how the organisation provides medical check-up and treatment to sex workers sufferings from all sorts of sexually transmitted diseases (STDs), while maintaining their anonymity. Urmila hesitated and did not respond for the first time. The staff constantly tried to connect with her and encouraged her to share her problems, illness or symptoms she was facing with her body. It took a few more visits to gain her confidence by sharing stories similar to hers and how others were helped by the organisation. Soon enough Urmila dropped her hesitance and shared all the problems she was facing due to being in the profession. She also agreed to undergo a medical check-up followed by adequate treatment. Now, Urmila is one of the active FSWs in the project, who understands the threat and is always seeking services from the project. She also encouraged her friends in the profession and has helped them to connect with the project activities as well.

6 Attachment 3: Pictures from the Project Meetings with stakeholders in the project A project visit by NHQ representative to engage with peer educators Training sessions with peer educators Project Coordinator explaining about HIV /ADIS during a meeting with female sex workers Project staff having a light entertaining session with FSWs Health check-up camp in action

7 Get-together with community on Dussera festival Project staff feeling proud to take part on voluntary blood donation Day. Advocacy meeting with Health functionaries Condom demonstration by Peer educator to FSWs Project participation on the World AIDS Day organised by a local partner. Distributing pamphlet to spread the awareness about HIV/AIDS