An IPPF Innovation Fund project implemented by the Family Planning Association of India

Ms. Shyamla Devi, the Project Coordinator explains ‘This [project] has encouraged.. people living with HIV to see life beyond being a person living with HIV’.

Why is this work important?

In the Madurai district of Tamil Nadu, HIV/AIDS related services provided by Government are heavily concentrated in urban areas.

They are organised vertically - not linked to other sexual and reproductive health services.

Those people that do use the services often experience stigma and discrimination in their communities because of their HIV status.

Unsurprisingly, people living with HIV only seek health services as a last resort, once they are seriously ill. They are not receiving the preventative care that could help them to lead healthy and positive lives and delay their need to start using Anti-Retroviral Therapy (ART).

What is innovative about this project?

This project is improving the quality of life for people living with HIV in Madurai district.

A pioneering model has been developed that integrates a broad range of sexual and reproductive health and HIV information and services.

• More people from Madurai’s rural areas are using the sexual and reproductive health and HIV services that they need
• The project is mobilising and empowering communities to support people living with HIV and reduce the stigma and discrimination they face
• FPAI is effectively integrating its own sexual and reproductive health and HIV services
• HIV positive people are involved in all of the project activities, including as staff members

How is the strategy working?

The project is targetting its mobile clinics to communities with the most HIV positive clients and those that find it hardest to travel to Government facilities.

As many services as possible are provided on the doorstep, such as contraception and voluntary counselling and testing for HIV.

The mobile teams are also knowledgeable about the sexual and reproductive health and specialist services needed by HIV positive clients.

They provide information and referrals for a wide range of services including:

• antenatal care
• surgical contraception
• abortion
• CD4 cell count testing
• treatment for opportunistic infections 
• antiretroviral therapy

This referral system with FPAI’s static clinics, Government facilities and networks of people living with HIV provides an integrated service and avoids duplication.

In 2007, 6,500 services were provided by the mobile teams, increasing to around 10,000 in 2008.

The mobile clinics are popular because clients avoid travel costs and can use them early in the morning or in the evening, when they don’t have work commitments.

The service providers are non-judgemental and many of the outreach workers are themselves HIV positive.

The mobile services are not stigmatized because their sexual and reproductive health package meets the health needs of the whole community.

This has encouraged people living with HIV, drug users, sex workers and transgender people to use the services.

Street drama, group discussions, film shows, radio and adverts on auto rickshaws bring to life messages about the rights of people living with HIV. They tackle the fear that is at the heart of much stigma and discrimination.

Mr. Nelson, a project counsellor tells the story of a twelve year old girl, Vijayalaxmi, living with HIV from one of the project areas: ‘she said “I was sitting alone in the classroom and watching my class mates playing, because I was not allowed by my teachers to play with others because I have HIV. They thought they will get the infection from me”.

Now this little girl plays with other children. This change happened after the team conducted a series of sensitization programs for the school authorities.’

What next?

A Positive Prevention Kit of materials is being developed to be used by outreach workers in the community. This will provide information for people living with HIV about how to address the social and psychological challenges that come with knowledge of HIV status.

Workshops on these concepts with project staff have already had striking results. HIV positive staff reduced their ‘self stigma’ and gained the confidence to change their own lives.

Three of these staff have since decided that they could get married – something they didn’t believe was possible for a person living with HIV.

This is significant because, as outreach workers for the project, these individuals are role models in their community.

Want to find out more?
Contact
innovation@ippf.org
IPPF South Asia Regional Office
Family Planning Association of India (FPAI)