Friday, February 28, 2014

Link Worker Scheme

The Government of India estimates that about 2.40 million Indians are living with HIV (1.93 ‐3.04 million) with an adult prevalence of 0.31% (2009). For the readers, there is a popular myth that HIV, AIDS is an urban disease. As per the HIV Sentinel Surveillance (HSS) of 2007, it was identified that 57% of the HIV positive persons in India are estimated to be living in rural areas.

Under the NACP III, Link Worker Scheme was designed for rural prevention and NACO implemented this programme with the financial support of Global fund through Lead NGOs. Link Worker Scheme was launched to saturate the reach of the HIV related services to the high risk groups based in the rural areas. The scheme aims at building a rural community model to address the complex needs of rural HIV prevention, care and support requirements. Under this scheme, a person who has been trained and has been made responsible to carry out specific activities is called a Cluster Link Worker. I visited field office of Humana People to People India (HPPI) at Lucknow on learning tour about Link Worker Scheme. There was formation of red ribbon club (RRC) in the villages. This was done due to dormant village health committee and uneasiness among village elders to take up issues related to sexual health. I observed that women from higher caste and men are reluctant to talk openly. Cluster Link Worker told me about the few cases that have been referred to STI services under this intervention. Information materials & commodities (condoms, needles/syringes) through collaborating with nearest government health facilities has been distributed among the youth in the community.

There are numerous NGOs and CBOs working on HIV/AIDS issues in India at the local, state, and national levels. The events are organized by NGOs are limited to shouting slogans and carrying placards depicting various messages related to HIV/AIDS. They also help in social marketing (SM) of condoms. The campaign uses targeted ads and community engagement opportunities to change the way man and women think about HIV/AIDS. The major reasons of AIDS can be contributed to Unsafe Sex and Low Condom Use. But it arises from the Low levels of literacy leading to myth and misconception. STIs very often go untreated due to both lack of information and health care facilities. Stigma towards people living with HIV is widespread among urban and rural community. There are sex workers hiding in plain sight.

The high risk group (HRG) among the population includes Female Sex Worker (FSW), Men Who Have Sex with Men (MSM) & Injecting Drug Use (IDU). Bridge Population is truck drivers, male and female migrant while vulnerable Population constitutes migrant spouse, HRG spouse, truckers spouse. Youth migrating for work and trafficked women forms a critical group because of their ‘mobility with HIV’. Migration for work lead them into new living and working conditions without support of family. Sexually active age and separation from regular partners for extended periods of time predispose them to paid sex or sex with non-regular partners. Movement is not a necessary element in the trafficking process, with the mechanisms of deployment, payment of advances and wages bear a striking similarity across the country. The various reasons of trafficking are a result of complex set of Gender discrimination, illiteracy, No sex education, violence against women, vulnerability and ignorance of girls is finally lack of opportunity.

The HIV positive population needs provision of safe spaces and support system to overcome shameful anxieties, fragile hopes and guilt. I saluted the guts of the social worker to work in the community on such a taboo issue. It takes moral courage to meet outcast and convince a socially rigid community. There is a lot of awareness now on HIV now than a decade ago and the attitudes about AIDS changing gradually. It's not because people suddenly understood the arguments that were made back by few social workers. With consistent awareness, masses get used to message, AIDS loses its disgust value. And, the new generation is just much more open.

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