TI-Core Group

Peace Trust – TANSACS – TI – Core Group Project


Karathe Programme inaugural

The challenges related to health and diseases are one of the greatest challenges and they take different forms and intensity at different phases of life. While many diseases are curable, some are only manageable due to appropriate treatment facilities. Among the few diseases HIV/AIDS needs urgent intervention. The people with HIV/AIDS and those with most at risk specially Men indulging in sex with men, Trans Gender and Female Sex workers need an on going care and support especially when they are prone to such infections as STI and HIV. Tirunelveli District in the state of Tamil Nadu, South India is considered as one of the high HIV prevalent districts in the state by the National AIDS Control Organization. According to the Tamil Nadu HIV Sentinel Surveillance Report 2007, in Tirunelveli District, the HIV prevalence rate among ANC was 0.28%, among Female Sex workers at 0.8%, STI/HRB was 19.6% and among MSM AND FSW• was 5.6 % for whole of Tamil Nadu. Access to clinical care and support, treatment for STIs and supportive community care for the MSM AND FSW, FSW and Transgender community in Tirunelveli is non-existent. In Tirunelveli District according to AP AC mapping there are about 2205 MSM 2258 FSW and 17 TG’s.


Stake Holders Meeting

The MSM and FSW and Transgender groups are difficult to reach because of their invisibility and due to the stigma and denial attached to such behaviors. The sexual behavior of the MSM and FSW and TG groups is of serious concern, since usually they have multiple partners. Very few men and women in India are open about their sexual orientation. There are many men and women in India, especially in large cities and growing cities like Tirunelveli who engage in sex with other men before marriage. Many continue to have ex with men and women even after marriage. There are also men who have sex only with men and regard themselves as ‘gay’ or ‘homosexual’. There is an equally well-established transgender (hijra) community in Tirunelveli District. Sex between men is proscribed by the Indian Penal Code. Being ‘gay’ or ‘homosexual’ is widely regarded as deviant and morally reprehensible. The illegal status and public disapproval of their sexual orientation drives Men having Sex with Men in Tirunelveli”underground” for their sexual needs. This heightens their vulnerability to sexually transmitted infections (STIs) and HN/AIDS.


Working Area:


THOZHA programme

1. Mannur
2. Mellaneelithanallur
3. Sankarankovil
4. Kuruvikulam
5. Vasudevanallur
6. Kadayanallur
7. Alangulam
8. Pappakudu
9. Nanguneri
10. Valliyour
11. Radhapuram
12. Tirunelveli Corporation (New Bus Stand and Melapalayam area Only)

 
Goal of the Project:

“Reduce the vulnerability to STI/HIV infections and prevent further spread and re-infections among the MSMs and FSW Community attain total saturation and provide a continuum of care services to those indentified with HIV among the core groups and facilitate MSM and FSW community ownership in the eleven blocks of Tirunelveli District”.


Objectives of the projects:


Staff motivation Programme

To address to the specific needs of the MSM and FSW community in free availability of condoms, lubricants, STI treatment, reduction of stigma and discrimination in the community, a space for them to be themselves and treatment for personalized STIs this proposal is designed. Further MSM and FSW who are found HIV positive need more varied types of support, like nutrition, psychological and psychosocial, Institutional care and Anti Retro Viral Therapy and those who are found HIV positive will referred to appropriate Care Continuum services apart from availing the services offered by the project.


Activities

Prevention:

    • Behavior Change Communication
    • One to One Interaction

BCC events:


Awareness Programme


Peer Educators’ Conferance


Session to Stake holders


BCC Materials

    • Poster Exhibition
    • Street Theatre
    • World AIDS Day Observation

Quality STI Care:

    • Syndromic Case Management
    • Presumptive Treatment
    • STI Identification, referral and treatment
    • Referral Card Collection and treatment
    • Linkages with trained HCPs, PRAMs, Private Hospitals, Govt., Hospitals etc.,

Follow-up Strategies:

    • Periodical Medical Check-up
    • Syphilis Screening

Condom Promotion:

    • Free Condom Distribution for Core Groups
    • Social Marketing of Condoms
    • Retailers training program
    • Traditional Outlets
    • Condom stockiest by NGO or CBO
    • Demand generation for condom promotion
    • Condom Negotiation Skills
    • Condom Demonstrations
    • Correct and consistent usages of Condoms
    • Lubricant Condom for MSM and FSW
    • Message on dual protection of condoms
    • Experimenting innovative initiatives of promote condoms
    • Display of condom dispensers

Enabling Environment:

    • Formation of advisory committee at project level for prevention and care
    • Involving secondary target groups
    • Advocacy with Power structure (Secondary Group) of Core Groups Typology Wise / Area Wise)
    • Advocacy with FBOs, CBOs, NGOs, Media, Opinion leaders, PRI Members etc., Common activities at the district level / Specific activities at NGO level.
    • Advocacy with District Administration / Officials

Community Mobilization and Peer Education    :

    • Appointment of Community Health Educatiors (1:60 for FSW / MSM)
    • Mobilizing the support of CBOs and other related organizations
    • Voluntary based Peer Education
    • Training program for peer educators (six topics /six sessions)
    • Networking of peer educators at project level / district level
    • Institutionalization of Peer Educators Association
    • Community consultant meetings – Plans for NGO to CBO transition

Counselling and Testing Services:

    • Demand generation for ICTC
    • Establishing rapport with ICTC team
    • Referral to ICTC / Coordination with ICTC Team Visit
    • Follow-up
    • Follow-up on the identified PLHIV
    • Prevention Messages to Non-Positives & follow-up (Window Period)

Capacity Building:

    • Orientation Program for the new NGO staff
    • Refresher training program for the existing ftaff
    • Exposure Visit
    • Training cum review meeting – Internal
    • Sharing of experience by the trained members in the staff meeting.
    • Technical Update
    • Identify opportunity and gaps and evolve plans

Networking and Leveraging:

    • Co-ordination with the district administration and other stake-holders
    • To resolve challenges and to sacle up initiatives
    • Mobilizing the services such as condom, STI medicines, treatment, IGP activities, counseling and testing etc.,
    • Networking with other NGOs involved in TI (with support of APAC) and NGOs involved in Care & Support.
    • Leveraging services fsrom ICTC, ART, HIV/TB Centre, Community care Centre, Drop-in-Centre, etc.,

Monitoring & Evaluation:

    • Data quality management
    • Avoiding duplication
    • Head count
    • Adhering APAC guidelines
    • MTR, MFR
    • Journey plans/ weekly & monthly plans
    • Weekly, monthly and quarterly review meetings
    • ESRM
    • Participatory Site Visits (PSV)
    • Field Observations, Community Understanding & Strengthening  (FOCUS)
    • Part5icipation in APAC meetings
    • Coordination meetings between NGOs at District Level
    • DPO & APC Technical Officers Visit
    • Training on MIS by APAC