India

The HIV/AIDS program was started 4 years ago and is now providing HIV/AIDS awareness, prevention, counseling, testing, and treatment services to hundreds of community members per month. We have the most integrated public private partnership (PPP) HIV/AIDS services set-up in the state with a PPP Integrated Testing and Counseling Center, PPP Link Antiretroviral Treatment Center, and a ‘DOTS’ treatment center for tuberculosis (often occurring in HIV+ patients). Our care and support program assists 247 HIV positive individuals with medical, psychosocial, and livelihood generation services. We specifically tailor our prevention and care programs to the needs of the tribal communities that we work with, addressing the needs of vulnerable populations such as children, migrants, truckers, and female sex workers.

Medical services provided:

• Counseling and testing for patients at risk to exposure/exposed to HIV/AIDS
• Psycho-social and support network counseling for new positive cases
• Anti-Retroviral Treatment for PLHAs
• DOTS treatment for TB
• In-patient treatment for critical patients suffering from complications or opportunistic infections

Summary of activities during 2nd Quarter:

• Referred and transported patients to ART center in Indore to receive Anti-Retroviral Treatments and check-ups with doctors
• Provided ART medication to stable patients from link-ART center
• Provided outreach support and counseling for suspected new cases and High-risk individuals in the field
• Provided in-patient support, counseling and testing for drop-in cases and potential new cases at Integrated Counseling and Testing Center
• Provided in-patient support for unstable HIV patients suffering from complications, TB, or other opportunistic infections (OI)
• Salaries paid for Devika and Chotu

Results achieved:

• Transported PLHAs to Indore to receive ART medication and check-ups from doctors
1. April- Transported 47 Patients for CD4 Tests, Medications, and Health Assessments
2. May- Transported 24 Patients for CD4 tests, Medications, and Health Assessments
3. June- Transported 24 Patients for CD4 Tests, Medications, and Health Assessments
• Tested 756 patients for HIV/AIDS
• Identified 15 new cases of HIV/AIDS in Jhabua district
• Increased the amount of patients receiving link-ART treatment in Meghnagar to 40 from 35
• Decreased the number of patients requiring transport and treatment at the Indore ART centre by 5, through tracking their CD4, ART compliance and registering them at our Link-ART Centre.
• MPSACS submitted RMF’s integrated tribal proposal to NACO as part of their yearly Plan of Action
Submitted a proposal for NACO/MPSACs sanctioned STI clinic in Jeevan Jyoti hospital
• Hired 18 staff members for or UNFPA sponsored TI with FSWs in Jhabua and Neemach Districts (12 Peer counselors, 2 District Counselors, 2 District Mobilizers, 1 accountant, and 1 reporting officer)
• Conducted three residential training programs for Staff under the UNFPA program

Number served/number of direct project beneficiaries:

Next reporting period:

The single largest challenge facing our HIV prevention, diagnosis and treatment efforts is the lack of awareness among the surrounding community in Jhabua. Only 35 percent of women and 59 percent of men in rural Madhya Pradesh have ever heard of AIDS.
In addition to the lack of awareness, many of the tribal population in Jhabua are forced to migrate to neighboring states to earn a living. While migrating, the workers are exposed to other bridge populations and high-risk groups and increase their chances of infection. Furthermore, many leave their homes for as many as 9 months of the year, making sustained awareness building, follow up with potential new cases and providing treatment for HIV+ individuals very difficult.
 

Tribals also face problems in Jhabua due to poor road and transportation infrastructure in the rural areas, limiting their access to health services. Furthermore, primary health centers are limited in number and often inadequate, especially in dealing with HIV/AIDS (there is one public and one private ICTC in Jhabua, and another Government ICTC in Alirajpur). In addition to the lack of health facilities, there are many indigenous superstitions and cultural constraints that pose a challenge in raising proper awareness and promoting prevention methods.
 

During the next quarter, we also expect to see a rise in new positive cases as families and individuals return from migratory work to Jhabua to harvest their crops. Approximately 33 new at risk individuals have already been identified as needing counseling and testing. We expect this number to increase as our outreach workers get more information from the field and individuals and establish linkages with HRGs in the area. Furthermore, because the rains have come and many of the individuals are engaged in agricultural work, it is more difficult during this season to convince individuals to come in for testing and counseling. If the information we have received is correct from stake-holders in the area, then the single biggest contributor to new HIV/AIDS cases in Jhabua is the seasonal migration and lack of awareness. If we see a large spike in new positives over this quarter that would seem to confirm this theory.