FHI/India HIV-AIDS Program Overview

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FHI/India HIV-AIDS Program: Family Health International

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INDIA IMPACT/India

Email: fhiimpact@... Kathleen Kay

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FHI India Program Overview

India is a country of more than one billion people, 17 officially

recognized languages and hundreds of ethnic and linguistic groups. It

is administratively divided into 28 states and seven union

territories (UTs). Sectors such as health, education and social

welfare are administered by the respective states and UTs. More than

a third of India's population lives below the poverty line. The

infant mortality rate has gradually fallen to 70 per 1000 live

births. Two-thirds of the population is literate.India was one of the

first countries to establish a national family planning program. For

more than 50 years, the government's primary focus in the area of

reproductive health was on reducing the rate of growth of the

population. Its emphasis has shifted recently to promote efforts

aimed at improving broader reproductive health outcomes and prevent

HIV transmission.

The first HIV case was reported in 1986 in Chennai, capital of the

state of Tamil Nadu in southern India, and in 1993, the National AIDS

Control Organization (NACO) was established. NACO estimates that as

of 2000, 3.86 million people in the country were living with HIV,

with an estimated total adult HIV infection rate of 0.7 percent. But

the epidemic in India is heterogeneous as each state is at a

different stage.

In many ways, the HIV epidemic in India comprises a number of

epidemics. According to NACO sentinel surveillance results, the

infection has surpassed one percent among antenatal clinic attendees

in six states. All the states, union territories and three large

cities have set up AIDS control societies to manage the HIV/AIDS

control programs. Many private donors and foundations also support

HIV prevention and care work in the country.Family Planning and

Reproductive HealthWorking with the World Association of Girl Guides

and Girl Scouts and the Bharat Scouts and Guides Association in

India, Family Health International (FHI) is educating Scouts and

Guides to provide reproductive health information to other young

adults through the Healthy Adolescent Project in India.

The project, supported by the and Lucile Packard Foundation,

gives adolescents information they need to make good decisions about

behavior affecting their health, while developing leadership skills.

Scouts and Guides earn a merit badge by becoming peer educators —

teaching what they have learned to other adolescents. The

participating youth are also introduced to local health services and

provide feedback to health providers on how to make their services

more adolescent-friendly.

FHI has worked in India on a variety of other projects as well–

including clinical trials to test the safety of newly developed

vaginal microbicides, studies on costing of health services, and

interventions designed to increase condom use in mixed HIV status

couples.HIV/AIDS Prevention and Care FHI's HIV/AIDS efforts in India

are aimed at enabling the collection and dissemination of high

quality data to support epidemiologically sound programming,

developing and documenting model programs for a range of high-risk

and vulnerable groups. The nature of the HIV epidemic in India

requires that programs are developed for specific groups based on the

prevalence of HIV, infrastructure and services in their particular

locale. Building the capacity of non-governmental organizations

(NGOs) at all levels is an important part of FHI's work in India.

This expands the human resource base and contributes to sustainable

programs. Interventions are focused on vulnerable populations who

have no social safety nets. Altogether some 25 research projects were

completed by mid-2001. Findings from these first-ever surveys were

disseminated at the state level and the information provides valuable

evidence for decision makers and program managers.

IMPACT ProjectThrough the IMPACT project FHI has developed a

framework for activities that complement and support USAID/India's

programmatic priorities and geographic focus and are consistent with

NACO's strategic plan.

FHI has supported research, capacity building and direct intervention

programs for a range of groups; provided ongoing technical assistance

to USAID's bilateral programs in Maharashtra and Tamil Nadu; and

supported five major research studies–an STI health care provider

study, a behavioral surveillance survey (BSS), mapping, a condom

supply and quality study, and a communications needs assessment–to

provide baseline information to USAID's bilateral AVERT project in

Maharashtra. To address the urgent need for capacity building, FHI is

helping to build the capacity of local NGOs through the formation of

a local resource group and provided support for professional staff

development for both NGOs and the state AIDS societies. The IMPACT

project has funded direct interventions with organizations to develop

interventions with MSM and trade unions. The project also funds six

agencies to develop and implement interventions for children who are

most vulnerable to HIV and those dealing with HIV within their

families.HIV Prevention Trials

FHI, as the Coordinating and Operations Center (CORE) of the HIV

Prevention Trials Network (HPTN), is working with U.S.-based

researchers and HIV Prevention Trials Units (HPTUs) in India. s

Hopkins University and the Fenway Community Health Center are

collaborating with HPTUs in Pune and Chennai to develop and implement

clinical trials and related studies of HIV prevention interventions

as part of the HPTN research agenda.

More information on this work can be found on the HPTN website.

DFID-Supported FHI HIV/AIDS Projects in IndiaThe United Kingdom's

Department for International Development (DFID) in 1998 awarded FHI a

contract to design a project for assessing the impact of sexual

health and HIV/STI prevention programs in states supported by DFID:

Kerala, Orissa, Andhra Pradesh, Gujarat and West Bengal.

The coverage area also included national highways on which DFID

supported a pan-Indian HIV prevention project–called the Healthy

Highways Project–aimed at long-distance truck drivers and others

working in the trucking industry most vulnerable to HIV infection and

their sexual partners.

The methodologies designed by FHI complemented the NACO-supported HIV

sentinel surveillance and consisted of HIV risk behavior surveillance

surveys (BSS), STI prevalence surveys and surveys of health care

providers on STI case management. FHI provided technical assistance

and/or managed and coordinated the implementation of the baseline

surveys. The BSS in the states and in the Healthy Highways Project

coverage area are designed to track trends in HIV/AIDS-related

knowledge, attitudes and behavior in sub-populations at particular

risk for HIV infection and contribute to the larger monitoring and

evaluation efforts of the State AIDS control societies.

The Health Care Provider Surveys in these states and the Healthy

Highways Project coverage area gathered measures and information on

how health care providers from various categories provided STI case

management. STI prevalence surveys among female sex workers and

truckers estimated the prevalence of selected STIs, including

syphilis, gonorrhea, trichomoniasis, genital chlamydial infection,

herpes simplex virus and HIV.

FHI expects in the near future to establish and run a sexual health

resource center with funding from DFID. This knowledge management

center, with open access to everyone, will work to build the capacity

of various stakeholders to better implement programs, facilitate the

provision of technical assistance for strategy and program

development, document and analyze sexual health, and disseminate

information to all stakeholders. The center's work will advance

DFID's strategy of supporting multisectoral approaches and

integrating comprehensive HIV/AIDS prevention and care strategies

into overall development strategies.

Elton AIDS Foundation — FHI Rapid Response FundThe Elton

AIDS Foundation-FHI Rapid Response Fund is intended to provide a

quick response mechanism for funding community-based HIV/AIDS

prevention and care activities through local NGOs or community-based

organizations (CBOs). NGOs implementing the project have been

identified based on several factors, including their location in a

high prevalence state. In particular, the fund aims to provide

educational interventions for the general public, interventions with

high-risk groups, youth, care and support and care for orphans and

vulnerable children.

Partners: FHI's key partners in India include state and national

governments, research and academic institutions, non-governmental

organizations and civil society institutions. These include: The ARMS

Diagnostics and Research Centre; Asian Information Marketing and

Social Research (AIMS Research) Ltd.; Association for Care and

Support (ACS); B.J Medical College; Bharat Scouts and Guides; Bhoruka

Public Welfare Trust (BPWT); Biocare Diagnostics and Biomedical

Research Centre; Blackstone Market Facts India Pvt. Ltd.; Centre for

Social Research and Development (CSRD); Community Health Awareness

and Natural Green Environment Society (CHANGES); Consultancy Group

for Research and Forecasting, University of Kerala (C-GRAF);

Consultant for Human Resources Empowerment and Support In Organising

Around Natural Resources (COHESION); Family Planning Association of

India (FPAI)/Kolkata Branch; India Rural Reconstruction and Disaster

Response Service (PREPARE); Jamnagar Medical College PSM Dept.; Jyoti

Sangh; M.P Shah Medical College and Guru Gobind Singh Hospital,

Jamnagar; Operation Research Group (ORG); Rangaraya Medical College;

Social Organisation for Mental Health Action (SOMA);

Sofres MODE (TNS MODE); Voluntary Organisation Indulged in Community

Enlightenment (VOICE). FHI has also collaborated with Kerala,

Gujarat, Andhra Pradesh, Orissa, West Bengal State AIDS Control

Societies, the West Bengal Sexual Health Project, State Management

Agencies in Andhra Pradesh and Kerala, and the Project Support Unit

in Gujarat.

Selected FHI Publications on IndiaKey FHI publications on India

appear below. For additional full-text articles, click here and enter

the key word " India " or search the bibliographic database of FHI

scientific journal article citations.·

Workshop report: Results of a Roundtable Session at the 12th

International Harm Reduction Conference in New Delhi April 2001,

Injecting Drug Users and HIV/AIDS: Information Needs and Research

Methods ·

Tamil Nadu, India, Behavioral Surveillance Surveys (BSS) ·Network:

Programs for Adolescents: Reproductive Health Merit Badge for Scouts

Making Prevention Work: 10. Crossing Borders: Reaching Mobile

Populations atRisk · Network: Some Cultures Tolerate Risky Male

Behavior · Women's Forum: Inclusive Prevention Efforts Fight

Stigma in Rural India · Impact on HIV: Preventing Trafficking in

Women and Children in Asia: Issues andOptions · Search for

Nonsurgical Sterilization Continues

Source: http://www.fhi.org/en/cntr/asia/india/indiaofc.html

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