Expansion with empowerment
In one of the largest expansions of non-government sexual health service provision in India, the Alliance launched 49 new sexual health clinics in the southern state of Andhra Pradesh in 2005. This was a 300 per cent increase on the previous year, improving the quality of services and treating nearly 20,000 people.
The clinics are a vital part of the Alliance’s contribution to Avahan (India AIDS Initiative) and a key component of the Alliance’s Frontiers Prevention Project. The project’s strategy is to work with population groups most likely to be affected by HIV, who are also key to slowing the epidemic’s spread.
The successful expansion of the clinics is down to their provision of a unique combination of community support and empowerment with a comprehensive range of services. These include the treatment of sexually transmitted infections, free condoms, counselling, and education. Clients get help to access the services from trained community outreach workers, who come from population groups key to the epidemic, such as men who have sex with men, sex workers, transgendered hidgra, and people living with HIV.
An exciting component of the clinics is the safe meeting spaces that have been developed nearby to allow members of these groups to meet and discuss key community issues. In-depth consultation with members of these groups ensures that the clinics stay in tune with client needs. For example, consultation had showed that a centre with ‘AIDS’ or ‘STI’ in its name could alienate the neighbourhood, so the clinics were named ‘Mythri’, meaning ‘friendship’ and ‘goodwill’ in Telugu, the language of the state.
The clinics’ expansion in 2005 is also based on knowledge acquired from assessments commissioned by the Alliance and partners in 2004, which measured the size of key population groups, gathered information on HIV-related needs and identified gaps in services.
Some 6,646 female sex workers and 6,661 men who have sex with men participated in the study in 40 sites throughout the state. The process enabled previously marginalised groups in the community to feel that they were being treated as equals whose needs and opinions counted, allowing them to take ownership and action.
The Alliance’s focused prevention programme in Andhra Pradesh has also produced wider benefits. Other organisations in India have used the resulting knowledge, good practice and resources for their work. In addition, the Alliance and its partners have been able to contribute significantly to policy and strategy development at the state, national and global level. For instance, focused prevention approaches and results in Andhra Pradesh help inform activities in other countries benefiting from the Alliance’s Frontiers Prevention Project. Similarly, programme lessons were part of the Alliance’s input into the planning of the new five-year National AIDS Control Programme in India.
