MEE NESTAM Strengthening Partnerships for Public Health
India HIV/AIDS Alliance Hyderabad
MEE NESTAM Strengthening Partnerships for Public Health First Printed - 2010 Second Printed - 2012 The photographs published in the document are the property of India HIV/AIDS Alliance and have been used with the consent of the persons.
India HIV/AIDS Alliance, Andhra Pradesh 2010 Sarovar Centre 5-9-22, Secretariat Road, Hyderabad 500 063, Andhra Pradesh, India Tel: +91-40-667781161, 66686261, 23231356, Fax: +91-40-66686262 Email:infoap@allianceindia.org
Supported by
HLFPPT
Partners for Better Health
APSACS DM&HS Campus,Sultan Bazar, Koti, Hyderabad-95, AP Phone No: 24657221 Fax: 24742833
Swagati Project HLFPPT 3-5-816, 3rd Floor Veenadhari, King Koti Road Phone No: 23298417
Heroes Project
Technical Support Unit HLFPPT 3-5-816, 4th Floor Veenadhari, King Koti Road Hyderguda, Hyderabad-29, AP Phone No: 23237691
Centre for Advocacy and Research
401, Meghna Gowrishankar Residency
Flat no 301, 4th Floor
Street No. 4, West Marredpalli
Door No- 6-3-1185/166
Secunderabad 500 026, Andhra Pradesh India
New Lines Blue Diamond Apartments
Website: www.heroesprojectindia.org
BS MAKTA, Begumpet, Hyderabad - 500 016 Ph : 040-23417091 / 93
Abbreviations
ABVA
AIDS Bhedbav Virodh Andolan
LCD
Liquid Crystal Display
AIDS
Acquired Immuno Deficiency Syndrome
LWS
Link Workers Scheme
ANC
Anti Natal Clinic
M&E
Monitoring and Evaluation
APSACS
Andhra Pradesh State AIDS Control Society
MSM
Men who have Sex with Men
ART
Anti Retroviral Therapy
NACP
National AIDS Control Programme
CBO
Community Based Organisation
NGO
Non Government Organisation
CCC
Community Care Centre
OI
Opportunistic Infections
CST
Care, Support and Treatment
PLHIV
People Living with HIV
FSW
Female Sex Worker
PPTCT
Prevention of Parent to Child Transmission
HIV
Human Immunodeficiency Virus
PRP
Police Resource Person
HLFPPT Hindustan Latex Family Planning Promotion Trust
RCH
Reproductive and Child Health
STD
Sexually Transmitted Disease
STI
Sexually Transmitted Infection
TB
Tuberculosis
TG
Transgender
TI
Targeted Intervention
TSU
Technical Support Unit
WCD
Women and Child Development
HRG
High Risk Group
IAS
Indian Administrative Services
ICTC
Integrated Counselling and Testing Centre
IDU
Injecting Drug Users
IEC
Information, Education and Communication
IPC
Indian Penal Code
ITPA
Immoral Trafficking Prevention Act
KP
Key Population
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Contents
Foreword
Acknowledgements
About the Module
1
Session I : Introduction and Objectives of the Workshop
5
Session II : Facilitation Skills
8
Session III : Introduction to HIV
12
Session IV : Components of the HIV Programme
17
Session V : Prevention of Immoral Trafficking Act (PITA)
21
Session VI : Role of Police in HIV Prevention
29
Session VII : Discussion, Clarifications and Post Test
35
Annexure Registration Form
39
Pre and Post Test Questionnaire
40
Frequently Asked Questions
43
Ice Breakers
49
HIV & AIDS Myths and Facts
51
List Of Swadhar Shelter Homes
52
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Foreword
T
his module is aimed at helping police personnel understand the issue of HIV and how the key populations (KP) are affected by it. The overall goal is to build, enhance and support efforts to facilitate effective interventions for key populations such as sex workers, men who have sex with men and injecting drug users. This will tremendously help all HIV & AIDS prevention and care programmes across Andhra Pradesh. Given that the police have a direct and critical role in interfacing with KPs, they are mandated protectors of the civil rights of all citizens, and are themselves vulnerable to HIV. The programmes engage with the police at various levels to build their capacity at maximum number of police stations across the 23 districts of the state. This module will not only familiarize the police with different aspects of HIV & AIDS but also enable them to understand how they can protect themselves and help in general prevention efforts within the state. This is especially important since the police and the armed forces personnel fall under a high-risk group that is prone to the HIV virus due to separation from their families for unnaturally long periods at a time (20-45 years) when they are sexually most active. The module is therefore not only intended to help police personnel understand how this training fits into their overall work but also to engage them to facilitate effective intervention programmes. The module is arranged in a sequential manner and sessions are inter-linked to each other. If the sessions are followed in the manner that is meant, participants will have a thorough understanding of the targeted intervention programmes in the state and help in identifying various issues and the way forward. We do believe that this document will be of great assistance and a provider of support to the police department to understand the sensitivity associated with targeted interventions and disseminate the learnings to the rest of the staff to enable a smooth, effective response to HIV.
C. Parthasarathi, IAS Project Director, APSACS
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Preface
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Acknowledgements
T
he Mee Nestam Module has been developed under the supervision and aegis of the Andhra Pradesh State AIDS Control Society (APSACS). This module is the result of many deliberations among the officials of APSACS, TSU, Alliance and Swagati. The endeavour was to ensure an effective module to strengthen partnerships for public health with the police. I thank all the officials for understanding the exigency of such efforts and converging to create this comprehensive module. It is now an established fact that the police play a critical role in facilitating the smooth conduct of the targeted interventions (TI) in the field. I thank all the participants from the police department who have kindly acknowledged the importance of the efforts in reducing the burden of HIV & AIDS. Setting aside their busy schedules, they have duly consented to be part of the trainings. Without their support and help these programmes would not have seen the light of the day. I would also like to extend our sincere thanks to all the master trainers drawn from police department, NGOs and the community. These members have consented to be a part of this important step in creating an enabling environment for the success of the TIs. These master trainers have agreed to undergo the two day intensive trainings followed by trainings at the district level. Their contributions in terms of time and effort are well recognised and we are grateful to them. I thank the PD, APSACS, Dr. R. V Chandravadan, IAS, who has been the key pillar of strength for innovative programmes in the state. His leadership over the last few years has been a real source of inspiration for the many agencies working in the field of HIV & AIDS. AP has witnessed many innovative practices during his tenure and this effort is one of the most essential aspects of the prevention programme. Alliance wish to thank Sri. C. Parthasarathi, I.A.S PD APSACS for his guidance and support to continue this Innovative Advocacy intiative of senstising police personnel of all cadra in the district of A.P. I thank the Avahan Programme Officer, Ms. Matangi Jayaram, for her continuous support. I would also like to extend my sincere thanks to Joint Director – TI Mr. T. Kailash Ditya for providing insights & direction during the development of this module. I would especially thank the advocacy team members of Alliance, Swagati and TSU for their relentless efforts to develop this module. I would especially like to mention Ms. P. S Renuka, Programme Manager - Advocacy and Ms. P. Shailaja, Director, Programme Support, India HIV/AIDS Alliance, who took the lead in developing this comprehensive module. I also would like to express my sincere thanks to Ms. Mondira Jaisimha, Senior Advocacy Director, Heroes Project and Mr. Narender Revelli, Programme Manager, CFAR. I hope the module will be effective in strengthening partnerships and preventing HIV among the police & the community across the 23 districts in the state.
Dr. P. Prabhakar Director-Regional Office India HIV/AIDS Alliance Hyderabad
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About the Module
This Module for the police in Andhra Pradesh has been designed to sensitize, train and build the capacity of the police towards a greater and more meaningful engagement in HIV & AIDS responses. The module offers a mix of key resources for training which can be used varyingly depending on the duration of the training. The training modules are supplemented with MS Power Point Presentations for facilitators.
This module contains the following sessions: Session I
Introduction and Objectives of the Workshop : Building rapport with the participants and setting ground rules for the programme
Session II
Facilitating Techniques : The session helps the facilitators to develop various skills to conduct training programmes
Session III
Introduction to HIV & AIDS : This provides participants with a comprehensive understanding of HIV & AIDS from a social perspective linked to the technical aspects of HIV transmission.
Session IV
Components of HIV Prevention Programme : This session helps participants understand the various components of the prevention programme with the target groups of FSW, MSM and IDU.
Session V
Introduction to Immoral Trafficking Prevention Act (ITPA) : This session deals with the basic details of ITPA and its application on the ground.
Session VI
Role of Police in Prevention Programmes : The interpretation of existing laws and how they should not be a hindrance to police to work for HIV prevention activities.
Session VII
Discussions, Clarifications and Post Test : This session is to consolidate the learnings from the workshop and clarify doubts, followed by a Vote of Thanks.
In addition to the sessions, the Toolkit also contains: Registration Form Pre and Post Test Questionnaires Frequently Asked Questions Ice Breakers and Games HIV & AIDS Myths and Facts ●
Registration Form: For all the sessions conducted at various police stations across the districts the Registration Form needs to be filled in by all the participants. The facilitators will be responsible to submit the duly filled in forms to Alliance.
●
Pre and Post Test Questionnaires: These questionnaires are meant to evaluate the workshop. A full day workshop will have both the pre and post workshop questionnaires, but for the half day workshop, the pre workshop questionnaires are optional and can be triangulated with Focus Group Discussions at the end of the workshop.
●
Frequently Asked Questions (FAQs): These FAQs are for reference and provide detailed information on various issues that surround HIV. Broad thematic areas include; prevention, testing, treatment, human rights, stigma, laws and policies and blood safety.
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â—?
HIV & AIDS Myths and Facts: The Annexures also contain HIV & AIDS Myths and Facts as additional resource material for the facilitators and the participants.
â—?
Ice Breakers and Games: Some interesting Ice breakers and games are attached. The facilitators need to be innovative and choose the right game depending upon the audience.
How to use the Module The module is a living module and needs to be used at the discretion and understanding of the situation by the trainer. Although the sessions are outlined in the module, it is still left to the trainer to understand the training needs of the participants. It is suggested that the trainer carry out a brief assessment just before the training. There may be situations where the trainees have already undergone sessions on HIV. The time given in the workshop is only indicative and the facilitator can select and choose the best fit as per the need. Sample workshop agendas for an 8-hour session and a 5-hour session are given here. The sessions cover the basics of HIV and focuses on the opportunities that the police force has to address HIV in their work situations. This should be the introduction to the workshop. Introduce HIV as an issue, talk about the vulnerabilities of certain groups, and talk about the various components of the HIV programmes and the role that NGOs play in the prevention of HIV and the support that they require with this work. Lastly, talk about the role of the police to help manage the challenges of HIV as best as they can but within the framework of the law.
Use of the Module Each session has a clear set of instructions on how the session is to be conducted. It is recommended that the trainer reads the module completely. If there are any queries, references are provided for the trainer for clarifications. You can also contact the organisations listed here for help with the sessions. It is advisable to try and understand the audience before you start training. But if that is not possible, try to judge the level of knowledge by asking the participants a few questions and gauging their knowledge, issues and areas of interest. This is important as the module focuses on various vulnerable populations like Sex Workers, MSM and IDUs. To the extent possible, it is advisable to engage NGO and community representatives as additional resources while delivering the training. Because the police have a hierarchical institutional structure, it is also advisable to invite a senior police person to lead the discussion on the role of the police too. This will also ensure that the participants pay attention. In preparing for the sessions it is important that the facilitators read and familiarize themselves with the modules and work closely with other resource persons to better prepare as a team for the session keeping in mind the overall objective of each session.
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State (ToT) Agenda / Session Plan
Day-1 Please display the AIDS Clock on the LCD screen Welcome and Registration 15 mins
Inaugural speech by PD
15 mins
Orientation talk by JDTI
Tea Break Session I:
30 mins
Orientation to workshop/Setting ground rules/Ice breaking
Session II:
75 mins
Basic of HIV/AIDS
45 mins
Talk by the community member and Interactive session with community member
Lunch Break Session III:
45 mins
HIV/AIDS programme in AP
60 mins
Components of HIV/AIDS
Tea Break Session IV:
90 mins
Facilitation Techniques
15 mins
Wrap up of Day-1
30 mins
Recap of the Day-1
60 mins
ITPA
Day-2 Session I:
Tea Break Session II:
60 mins
Role of Police in HIV Prevention
60 mins
Case study and group discussion
Lunch Break
Session III:
60 mins
Case study and group discussion
45 mins
Plan Presentation by participants
Tea Break Session IV:
3
30 mins
Discussions and clarifications
30 mins
Post test and Vote of thanks
30 mins
Travel reimbursement and other administration requirements
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District Session Plan / Agenda
One Day – 8 hour Session Please display the AIDS Clock on the LCD screen Welcome and Registration Session I:
45 mins
Introduction and Objectives of the Workshop
15 mins
Conduct Pre Test
Tea Break Session II: Session III:
60 mins
Introduction to HIV & AIDS
60 mins
Components of the HIV programme
45 mins
Talk by the community member (Optional- to reduce time)
Lunch Break Session IV:
90 mins
Prevention of Immoral Trafficking Act (ITPA)
Session V:
90 mins
Role of Police in HIV Prevention
Tea Break Session VI:
45 mins
Question and Answer Session
30 mins
Conclusion and Post-Workshop Questionnaire
Half Day – 5 hour Session Welcome and Registration Session I: Session II:
15 mins
Introduction and Objectives of the Workshop
15 mins
Conduct Pre Test
45 mins
Introduction to HIV & AIDS
Tea Break Session III:
45 mins
Components of the HIV Programme
15 mins
Talk by the community member (Optional - to reduce time)
Lunch Break Session IV:
60 mins
Prevention of Immoral Trafficking Act (ITPA)
Session V:
60 mins
Role of Police in HIV Prevention
Tea Break Session VI:
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30 mins
Question and Answer session
15 mins
Conclusion and Post-Workshop Questionnaire
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Session I
Introduction and Objectives of the Workshop Introduction In this session the facilitator shall introduce the participants to the purpose and objective of the workshop. The introduction session shall also throw light on the session flow of the day and set ground rules for all the participants. The session will help the participants understand the background of the workshop and help them understand their roles with HIV & AIDS programmes in India and Andhra Pradesh. Facilitators shall initiate the discussion with the introduction and slowly walk the participants through the purpose of the workshop. By the end of the session, the facilitator shall help the participants feel comfortable enough to ask relevant questions.
Objectives: Develop good inter group rapport
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Identify and recall the objectives of the day long workshop
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Relate to the role of police in HIV intervention
30
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Facilitators to introduce self and welcome the participants to the workshop.
●
Session to start with “Name Thy Neighbour” Game (please refer to the games section in the Annexure 4)
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Set the Ground Rules
●
Facilitator shall give an overview of the day's agenda and the expectation from the participants, and also talk about the purpose of the workshop
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Fa c i l i t a t o r w i l l d i s t r i b u t e p r e t e s t questionnaires forall the participants and collect the duly filled in forms
Note for facilitator
Training Material
The facilitator shall ensure that before beginning the second session, all the participants finish the pre-test and clearly understand the objectives of the session. It is important that all the participants are on the same page.
Presentation with LCD projector and microphone
5
minutes
Session Flow
By the end of the session participants will be able to: ●
Recommended time
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Content and Outline Introduction: The facilitator shall introduce him/herself to all the participants and welcome them to the workshop. “Name Thy Neighbour” Game: The facilitator shall introduce the game and explain the process to all the participants. The detailed steps of the game are explained in Annexure 4 Set the Ground Rules: The facilitator shall clearly explain the rules of the workshop and will encourage the participants through a participatory method to help set the ground rules. All of the rules as mutually agreed shall be written on a chart and put on display in the training hall for the rest of the day.
Some of the commonly practiced ground rules are: ●
Switch off mobiles or keep them in silent mode
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Avoid cross discussions, discuss with the faculty or the entire group
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Raise your hand when you want to speak and wait for your turn
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All the participants should make themselves available throughout the workshop
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Time Management and other such rules as applicable
The facilitator shall give an overview of the day's agenda and also encourage the participants to list their expectations through a participatory approach. The expectations should be put on the chart and displayed. The facilitator should go through the list of expectations and categorise them into two sections – the ones which shall be dealt with in the forthcoming sessions and the ones which qualify to be in the “parking lot”. The expectations and questions in the parking lot should be addressed by the facilitators' team at the end of the day.
Parking Lot: A specific space created to “park” all the doubts/ questions which cannot be addressed immediately or are not relevant to the session. The participants should be encouraged to ask queries/ doubts and such issues to be put on a chart paper. It is important to address all of the questions in the parking lot prior to the conclusion of the workshop.
Purpose of the Workshop: The purpose of the workshop is to build and enhance support in the state to create an effective interventions for key populations (KPs) such as sex workers, men who have sex with men and injecting drug users. Given that the police have a direct and critical role in interfacing with KPs, are mandated protectors of the civil rights of all citizens, and are themselves vulnerable to HIV, this training programme engages with the police at various levels to build their capacity across the 23 districts in the state.
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This workshop is a preparatory phase to set the tone for all the implementation partners and APSACS to work in close coordination with the police and find avenues for joint efforts and collaborations for a sustained response towards HIV prevention. Objective of the Workshop: The key objective of the workshop is to orient the police on strategies and programmes of NACP III and the targeted interventions in particular. It will also help them understand the importance of police department in prevention programmes. This will eventually lead to an integrated, inclusive, multi-sectoral approach that will broaden the scope to build ownership of HIV & AIDS programme interventions and related issues by various agencies. The Specific Objectives are: ●
To explain NACP III - its goal, rationale and objectives – for the police to gain the right perspectives
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To develop the right perspective about convergence issues related to HIV & AIDS with various departments, with examples
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To identify and build local resources for conducting similar kinds of workshops within departments at various levels
___________________________________________________________________________________________________________________________________________________________1 Some of the expectations/ questions of the participants might not be relevant to either HIV & AIDS or for the purpose of the workshop. The facilitator shall explain to the participants that such issues are beyond the scope of the workshop and hence cannot be addressed immediately. Nevertheless, if the participant pursues further, they may be asked to write to the authorities (Alliance/ Swagati/ TSU) directly and get necessary clarifications.
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Session II
Facilitating Techniques (ToT) Introduction The session will help all the facilitators or trainers to acquire some basic skills and techniques to facilitate learning and sharing in an effective manner. These skills also help people feel comfortable with a participatory approach and encourage people to share information, ideas, concerns and knowledge.
Objectives: By the end of the session participants will have:
Recommended time
60
minutes
Session Flow ●
Facilitator to give the overview of Session II
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Understood the essence of module
●
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Recognised the importance of participatory approach
Facilitator to give a brief on particpatory approach
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Facilitator to provide various skills and techniques
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Understood various skills and techniques and instructions of module
Training Material LCD projector and microphone
Note: This section is designed exclusively for the ToTs 3-day training programme and the same does not appear at the district level one-day training programme. Mee Nestam
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Content and Outline Facilitation Skills Facilitators need to build a broad base of knowledge, skills and attitudes.
Tips for Facilitators Be well prepared ●
Plan each of the sessions before the training so that you are well prepared Ensure you have all the materials you need – toolkit, handouts, flipchart paper, markers, cards etc.
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Arrive early so that you are ready to welcome the participants when they arrive
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Prepare the room ●
Remove tables to make room more informal
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Set up the meeting space in a semi-circle – check that everyone can see you and the flipchart / board / screen
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Some sessions - where you are sharing - can be done sitting in a full circle
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Put flipchart sheets on the front wall
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Set up a separate table for markers, tape, handouts, cards etc.
Make trainees feel comfortable ●
Break the ice and put participants at ease at the start of the workshop
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Learn participants' names, be informal, use games, songs or buzz groups
Find out what the learners really need to learn ●
What do they really need to know or do?
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What are some of the problems they are facing in their work?
●
What new attitudes or knowledge would really make a difference to their work?
Ask questions and lead discussion ●
Ask clear, simple, open questions that allow people to give their opinions
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Fish for contributions – use your hands and body to encourage participants
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Wait for responses – give people time to think and come up with an answer
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Encourage everyone to talk – buzz groups get everyone talking
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Keep asking, “Who would like to add to that?”
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If there is no response, rephrase the question
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Show that you are listening and are interested
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Praise responses to encourage participation
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Rephrase responses to check that you and other participants understand
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Redirect to involve others – “He said….What do others think?”
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Summarise and check agreement before moving to the next question or topic
Use small groups to build participation ●
Give a clear explanation of the group task, time and reporting method
●
If the task is difficult, write instructions on a flipchart so that everyone is clear
●
Vary the size of groups for different sessions – pairs, threes, fours and fives
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Keep changing the groups so participants work with different people
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When participants move into groups, go around checking that they understand the task
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Use 'round robin' to make reporting back more interesting and efficient
Keep presentations short and simple ●
Give a presentation only when you are sure people don't know the topic
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Write out the main points in key words on a flipchart and then explain them
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Speak slowly, clearly and loud enough
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Look at people; maintain eye contact and use your hands and body to emphasise points
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Keep it short and simple – no more than ten minutes. Only explain the basics
Keep changing your methods ●
Use different methods for different topics to keep things interesting
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Use your creativity – a story or case study can be turned into role play or reporting back
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Use different sizes of groups – don't buzz all the time: try threes or fours
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Change the space – you can go outside and hold sessions under the trees
Check the energy level ●
Observe body language – do participants look bored or sleepy?
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Ask, “How are you feeling? Is it time for a break?”
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Change the topic, take a break or play a wake-up game
Watch the timing and pacing
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Be time conscious – decide how much time you need for each session
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Remember, small group work takes more time than you expect. You will also need to allocate time for completion/reportingback
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Don't go too fast – let the group help you set an appropriate pace
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Give groups enough time to do their work – don't rush them
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Do small group work in the afternoon when the energy levels drop
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Don't forget to take breaks to relax, get tea and talk informally
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Finish on time! Don't drag things on forever at the end of the day
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Evaluate throughout the workshop ●
Evaluate each ongoing activity - not just at the end of the workshop
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Organise a short evaluation at the end of each day or the following morning to encourage participants to review what was learned
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Assess what was learned and how the learning was done
Team facilitation ●
Plan and run the workshop with another facilitator and debrief afterwards
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Take turns in the lead facilitation role and as the flipchart recorder
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Support each other – if one of you runs into trouble, help each other
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Session III
Introduction to HIV & AIDS
Introduction The session will start with interactive discussion to understand the basics of HIV & AIDS, routes of transmission and how one can prevent HIV. The facilitator should take the lead and build the discussion with a presentation or lecture on the identification programmes. The discussions will provide a background of the programme and will lead to in-depth discussions on the changing phase of the programmes due to the of first HIV case in India and indicate its significance with the national HIV & AIDS shift in programme needs.
Recommended time
60
minutes
The session will also cover the transition phase of NACP I, NACP II and NACP III with an emphasis on the rationale and background for the shift in programme strategy. The participants shall also be trained on basic concepts of the epidemic in India and Andhra Pradesh. By end of the session, participants shall be equipped with basic knowledge on HIV & AIDS, NACP, fuelling factors for the spread of HIV and the state's response in HIV prevention.
Objectives:
Session Flow
By the end of the session participants will have: ●
Understood the basics of HIV & AIDS
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Understood the background of NACP and its changing phases
●
Recognised the fuelling factors of HIV
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Understood Andhra Pradesh's response to HIV & AIDS
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Facilitator to give the overview of the Session II
●
Discussion on the basics of HIV & AIDS in India
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Fuelling factors for spread of HIV in Andhra Pradesh
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An overview of NACP programmes in India
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A brief on the state's response to HIV & AIDS
Note for facilitator
Training Material
At end of this session, the facilitator shall quickly ask a few basic questions to the participants to reconfirm the learnings. It is also important to reinforce the key topics - routes of HIV transmission, how HIV does not spread.
Short questionnaire on basics of HIV & AIDS, presentation, LCD projector and microphone
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Content and outline Basic information on HIV HIV is a national epidemic. Approximately 2.31 million Indians are living with HIV - the highest number in Asia - next only to South Africa. An estimated 88.7 per cent of all infections are in the age group of15-49, indicating that HIV & AIDS still threatens the cream of society, those in the prime of their working life. HIV & AIDS disproportionately affects children and young people by infecting huge numbers, by affecting the families adversely and by damaging the country's economic and development prospects. In many countries, HIV & AIDS has already worsened poverty, eroded economic growth, spawned human rights abuses and erased many development gains. All this notwithstanding, it is imperative for us to understand that “HIV is completely preventable”. HIV stands for: H : Human – does not infect any other animal or living being I : Immunodeficiency - Causes the defence system in the body to become weak and hence susceptible to infections V : Virus – a type of germ AIDS stands for: A I D S
: : : :
Acquired – got and not caught; cannot be caught like the common cold Immuno - pertaining to the immune or defence system of the body Deficiency – weakness, deficit, lack Syndrome - a collection of signs and symptoms
It is acquired from somebody as an infection and not genetically inherited. Infection with HIV over a period of time leads to AIDS. It is the late stage of HIV infection and can take more than 8–10 years to develop. A person living with HIV can live without symptoms for many years. HIV is found in body fluids such as blood, semen, cervical and vaginal fluids, breast milk, and tissues containing blood. A person infected with HIV is said to be HIV positive or PLHIV (Person Living with HIV). As the disease progresses, the person becomes weak, loses weight and becomes susceptible to a number of common infections also called opportunistic infections (OIs). Only when the infection has progressed to the late stages it is called AIDS. AIDS is therefore a disease syndrome caused by the HIV infection.
How is HIV transmitted? 1.
Sexual route: Through unprotected penetrative sexual intercourse (vaginal, anal or oral) with an HIV infected partner. This is the predominant mode of HIV transmission (87%) in India.
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Source : National AIDS Control Organisation
2.
Infected blood and blood products: Transfusion of blood and blood products which are infected with HIV is one of the most efficient means of transmission of HIV infection. The recipient of a single unit of HIV-infected blood has 90-95% possibility of acquiring the infection. In India, HIV transmissions through blood transfusions account for 1.1% of the total infection load.
3.
Needles and syringes: HIV can also be transmitted through the use of blood smeared needles, syringes, blades, knives, surgical instruments and other piercing instruments that have been used on an HIV infected person that are left un-cleaned or un-sterilized. Sharing of needles and syringes among Injecting Drug Users (IDUs) carries a 1-10% risk of getting infected as IDUs often end up giving themselves mini blood transfusions
4.
Parent-to-Child transmission: This is an overwhelming source of HIV infection in new born and young children. In the absence of preventive intervention, the probability that an HIV positive woman's baby will become infected ranges from 25% to 35% in India. Nearly 5.9% of HIV infections in India are due to this route. However, with the right treatment at the right time, the chances of transmission from the HIV positive pregnant women to her child can be brought down to as low as 0-2%.
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HIV virus does NOT spread ●
By shaking hands with an infected person
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Travelling in the same auto, taxi or bus
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Eating from the same plate
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Drinking from the same glass
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Hugging and kissing
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Mosquitoes and other insects
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Using toilets and urinals used by infected persons
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Through sneezing or coughing
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Working with an infected person
Fuelling factors for HIV spread in AP High prevalence of STIs among general population (6-7%) and High Risk Groups (26 %) High non regular sex partners and low condom usage (25%) with non regular partners Existence of traditional/non-traditional sex networks and trafficking of girls into sex trade Long length of Railway lines / National Highways with increasing tourism and hotel industry Industrialisation and existence of busy commercial activities leading to high in-migration
Background of HIV & AIDS Programmes in India The first confirmed case of HIV in India was detected in Chennai, Tamil Nadu, in 1986. The National AIDS Control Programme (NACP) was started in 1987 and focused mainly on surveillance in perceived high-risk areas, blood screening, and health education. A semi-autonomous body, the National AIDS Control Organisation (NACO), was established under the Ministry of Health and Family Welfare to implement this programme. The 1st phase of the NACP lasted from 1992 -1999. It focused on initiating a national commitment, increasing awareness and addressing blood safety. The second phase of the NACP began in 1999 and ended in March 2006 during which India continued to expand the programmes at the state level. Greater emphasis was placed on Targeted Interventions (TI) i.e. interventions aimed at high-risk groups, preventive interventions among the general population and the involvement of NGOs and other sectors and line departments, such as education, transport and police. The transition from NACP I to NACP II and now to NACP III has been a gradual and more comprehensive response. While for NACP I the main focus was on safe blood and general prevention, NACP II established the State AIDS Control Societies (SACS) and started working with NGOs. Now with NACP III, the Government aims to further decentralize to the district level and also build further on those partnerships with civil society organisations and most importantly work towards greater active involvement of the target groups themselves in the programmes.
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A Stigmatized Epidemic Stigma, apathy and denial about HIV & AIDS are widespread at every level of Indian society. Stigma breeds fear and ignorance, demonizes those infected with the disease, and encourages high-risk populations to hide from society, often eliminating opportunities for prevention services and support. Women who are infected by their husbands are often abandoned. Sex workers and drug users are harassed, ostracized, and disempowered, driving them further underground. This leads to limited access to information, condoms, health clinics, and other services that can help prevent HIV transmission.
The State's Response Andhra Pradesh State AIDS Control Society (APSACS) was formed in 1998 and registered under Societies Registration Act to respond to the HIV epidemic, manage the programme's priorities and address the issues that arise during implementation. It is under the Ministry of Health and Family Welfare, Govt of Andhra Pradesh. In the last decade of programme implementation, APSACS has undergone various phases of learning and has demonstrated significant successes. Particularly in the last 4 years, the programmes have undergone significant expansion, scale-up of facilities and thrust on quality to ensure coverage saturation of relevant sub-populations with the appropriate programmes and interventions. APSACS has managed to stabilize the HIV prevalence, significantly expand care and support for those infected or affected and combat fear and rejection of people living with HIV.
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Session IV
Component of HIV PreventionProgramme Introduction The session will help the participants understand the various components in the HIV & AIDS programme and the services delivered at different levels. The session also focuses on component wise major beneficiaries and the stakeholders involved in the programmes.
Objectives:
Recommended time
60
minutes
Session Flow
By the end of the session participants will be able to: ●
Facilitator to provide an overview of Session IV
●
Recall and list different components of HIV & AIDS programme
●
Discussion about various HRG in HIV & AIDS programmes
●
Develop an understanding of the different
●
●
HRGs (Female Sex Workers, Men who have Sex with Men and Injecting Drug Users)
Provide an overview of service delivery by various components
●
Develop in-depth knowledge about the
●
components of targeted interventions
Note for facilitator
Training Material
At end of the session the facilitator shall emphasis “Remember, training is dynamic and cannot be restricted to certain structured parameters. It is the innovation of the individual/group according to time, person and place which in the end will have the greatest impact”.
Presentation with LCD projector and microphone
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Content and Outline Components of the HIV & AIDS Programmes Understanding the dynamic of the HIV epidemic in India, the programme components are designed to meet the requirements of HRG and bridge population. The programmes interventions are divided in two broad categories: â—?
Prevention services
â—?
Care, Support and Treatment services
While the component of Information, Education and Communication (IEC) covers mainstreaming activities and cuts across all the components. The detail programmes components in the HIV & AIDS programme are: l
Targeted Intervention o High risk group (FSW, MSM and IDU) o Bridge Population o Link Workers Scheme
l
Basic Services o ICTC/PPTCT o HIV-TB referrals o STI management
l
Care support and treatment o PRE ART o ART o CCC
l
IEC and Mainstreaming
l
Blood Safety
Overview of Service Delivery Targeted Intervention (TI): The Targeted Intervention Programme aims to achieve saturated coverage among key population groups called HRGs like female sex workers (FSW), men who have sex with men (MSM) and injecting drug users (IDUs). The programme also addresses the needs of the bridge population groups like truckers and migrants. The approach of the TI programme is to saturate coverage of HRGs, through community led interventions and district-wide programming in its focused prevention interventions.
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Few definitions of high risk groups covered under the targeted intervention Female Sex Workers (FSWs): Females identified to have been paid for sex in cash or kind by their non regular sex partners in the past 12 months, residing or soliciting or having sex or can be networked within the geographical area. Men who have Sex with Men (MSMs): Males who have had oral or anal sex with another male in the past 12 months and can be identified at places of aggregation for cruising, soliciting, having sex, hanging out or can be networked within the geographical area. Injecting Drug Users (IDUs): People identified to have injected drugs in the past 12 months for intoxication without medical advice and buy drugs or inject or hang out or reside or can be networked within the geographical area.
At the end of the sub session, the participants shall understand the situation of HRGs and develop empathy towards them, not sympathy.
Experience sharing by a member of a high risk group The facilitator shall call a member of an HRG from the respective district TI NGO to facilitate a talk about the life of an HRG, and ask them to explain the programme component of TI. The talk should be for not more than 10 minutes followed by some open discussion.
Pre talk preparation by facilitator For HRG: The person going to talk shall be well prepared in advance to focus on the lifestyle of the HRG, the situations that compel them towards such behaviour and the benefits they get from the programme components. They shall NOT discuss or talk about the problems they face from the police in this session (this will deviate the topic). For participants: The participants shall be sensitized not to ask personal questions, and must not try to track the network through investigative questions, and shall not accuse the person. The services provided under the TI programme consist of (a)
Behaviour change communication
(b) STI services (through static and mobile clinics) (c)
Condom promotion
(d) Referral to HIV services The TI programmes in the state are implemented through NGOs and CBOs. During the initial stages of the programmes the implementation was exclusively done by NGOs while with introduction of NACP III the shift from NGO led intervention to CBO involvement for implementation is now being emphasised.
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Link Workers Scheme (LWS) is a new intervention that covers 6 districts in the state, with an emphasis on scaling up to all the A category districts in the state. LWS covers the general and HRG population in rural and remote areas. Basic Services: The component of basic services includes services for ICTC, PPTCT, HIV-TB referrals and STI management. With increased awareness the focus on expanding counselling, testing and syndromic diagnosis and management of STI to the district and sub district level is now ensured. ICTC: As an entry point for HIV diagnosis, they cater to all the non-ANC cases in government health facilities. The centres provide counselling and testing facility for HIV and subsequently the positive cases are referred to TB and ART centres. PPTCT: Provides facility of counselling and testing for ANC cases, which cover the majority of pregnant mothers and ensure the prevention of transmission of the infection from parent to child. For better follow up of the testing protocols, a team of outreach workers are part of the service that ensure testing of all pregnant women for HIV and also follow up with positive pregnant mothers for safe deliveries. HIV-TB: The cross referrals from ICTC to TB programme are ensured to provide timely treatment to the patient. Since TB is the most common opportunistic infection among the HIV positive, all the positive cases from ICTC with symptoms of TB are referred to the TB centre and TB patients are referred for ICTC for testing and referral to ART. STI Management: The state has 85 designated STI clinics in government health facilities with trained staff and equipment. The services ensure that the population who are from the productive age group, and found to be at risk, are tested and treated for STI. Timely treatment for STIs contributes to the prevention of HIV through sexual transmission. Care, Support and Treatment: Massive scaling up of CST services is being planned during NACP III. Every district is currently provided with an ART centre and a CCC to treat OIs among people living with HIV. In the year 2009, ART services were being further improved through link ART centres that reach out to people even at the sub district level. IEC and Mainstreaming: The IEC component has a major role to play and cuts across all the components and provides support for the communication needs for the various segments of the population on different issues. IEC drives the optimum utilisation of services and reduces the issues related to stigma and discrimination. Blood Safety: The blood safety component aims to reduce transmission of HIV infection through blood and blood products to less than 0.3% and ensure the availability of safe blood and blood products. Safe blood is ensured through the assessment of blood requirement in the district, increasing voluntary blood donations and strengthening blood banks. NACP III aims to develop in-built systems to ensure the quality of blood related services, injection safety and hospital acquired infections. Blood banks, storage units and blood donation camps are important initiatives under this component that are located both within the Govt sector as well as the NGO and private sectors. ______________________________________________________________________________________________________________________________________________________________ * Category A: More than 1% ANC prevalence in district in any of the sites in the last 3 years. Category B: Less than 1% ANC prevalence in all the sites during last 3 years with more than 5% prevalence in any HRG site
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Session V
Introduction to Immoral Trafficking Prevention Act (ITPA) Introduction The session will help the participants get a clear and complete understanding about the Immoral Trafficking Prevention Act, 1956. Through discussion, case scenario discussions and mini lectures explaining the clauses in the ITPA, the facilitator will enable participants to understand the provisions of the law and interpret the law in an easily comprehensible way to create the right balance in the session by generating participation, interest and illustration by example.
Objectives:
Recommended time
90
minutes
Session Flow
By the end of the session participants will be able to: ●
Facilitator to provide an overview of ITPA
●
Understand and conceptualise ITPA
●
Discuss various definitions
●
Understand their own responses in various situations
●
Group activity through case study discussions and presentations
●
Develop in-depth knowledge about legal issues pertaining to high risk groups
Recommendation : A legal expert should conduct this session.
Note for facilitator
Training Material
The facilitator shall ensure that the participants don't get in to the theoretical part of ITPA, but they shall try to explain the purpose of the act and its relevance on the ground. Special emphasis shall be on the lower grade staff of the department (head constables and below) who are in direct interface with HRGs.
Presentation with LCD projector, microphone and chart paper
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Content and Outline Introduction to ITPA The primary objective of ITPA is the suppression of both traffic in persons and sexual exploitation of others. The ITPA declares the acts of exploitation and abuse of others as an offence/crime, and includes, trafficking, running a brothel, sexual abuse and other related activities by pimps and living off another's sex work. Through the amendments to the original Acts, the penal provisions have been made more stringent in order to ensure effective enforcement of these provisions. Note: The facilitator should mention the background to the ITPA by mentioning the International Convention on the issue of trafficking, provisions under the Article in the Indian Constitution, which relates to the issue of trafficking, definition of the term ¨prostitution¨ and highlight the different meanings of the term “prostitution.” When speaking about Sections 3, 4, 5, 6, 7 and 8 of ITPA, give more thrust on Section 8(b) of ITPA, (at this point in the presentation stress upon why sex workers are on the streets to solicit, and link this with the issue of trafficking. Explain about the power structures involved such as middlemen, goondas, pimps, and the other people who are involved in the trafficking racket). Explain the Fundamental Rights of sex workers to legal aid. Connection between Immoral Traffic Prevention Act, 1956 and HIV & AIDS: There seems to be a lot of exploitation and abuse of people in sex work, due to which a lot of them are forced to get involved in unsafe sex. This has made sex workers one of the worst victims of many sexually transmitted infections including HIV& AIDS. Immoral Traffic Prevention Act, 1956 (ITPA), purports to prohibit human trafficking and exploitation of people towards prostitution. The right usage of powers under the Act should effectively control the exploitation and human trafficking for prostitution. However, the Act has been misinterpreted and misused to arrest and harass women in sex work. This results in driving sex workers underground with a consequent rise in unsafe sex. The police have varied powers under ITPA through which the acts of human trafficking and sexual exploitation can be controlled effectively. Knowing about the objectives and the working of ITPA shall equip the police enough to tackle the issue appropriately and prevent its misuse. Does the ITPA prohibit prostitution?: Prostitution by the definition means sexual exploitation or abuse of persons for commercial purpose. Prostitution hence is an offence, as it is ´sexual exploitation or abuse´. The activities that amount to exploitation and abuse of another for prostitution are made illegal. Section 4 of the Act awards punishment to persons living on the another's earnings from prostitution. Hence, it is an offence to live on the prostitution of another.
Clarification: Prostitution, as per its Definition in ITPA is not voluntary sex work; and voluntary sex work is not prohibited under the Law in ITPA. Can a sex worker be arrested as per the definition of ´prostitution´? As under Section 2 (f) of the ITPA, prostitution is defined. NOWHERE in the Act is 'voluntary sex work' punishable. Hence, a sex worker cannot
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be arrested just for being a sex worker. When there is exploitation or abuse of another involved, the exploiter needs to be arrested and not the sex worker. If a trafficked person for prostitution or the sex worker in a brothel is arrested under the definition of ´prostitution´ it would amount to criminalization of the victims of sexual exploitation and abuse. Can Section 8 (b) of the ITPA be applied to a sex worker standing on the road?: Section 8 (b) of the ITPA does not apply to any one, even if the person is known to be a sex worker, for merely standing on the road. It amounts to an offence only if solicitation for the purpose of prostitution is prevalent and offends public decency. Does a peer educator carrying condoms become an offender under Law? No. There is no law that prohibits anybody from carrying condoms with them. A peer educator cannot be arrested for carrying condoms. Where does it say in ITPA that sex work is legal?: The ITPA prohibits exploitation for prostitution. In furtherance to this, all those activities surrounding prostitution like human trafficking, running brothels, soliciting and exploitation for the prostitution of another are made illegal. The Law states very clearly what is illegal, and nowhere in the Act is sex work made illegal. If it is voluntary sex work, the sex worker is not an offender under the Law of ITPA. If the sex worker is forced to do sex work, then the person exploiting, is the offender under the Law and not the sex worker (who is exploited). ¨Sex work¨ (prostitution) per se is not an offence but the surrounding activities like brothel keeping, pimps living on the earnings of prostitution (sex worker) e.g. are illegal.
Section 377 – The fight against the law criminalizing homosexuality The law in question is Section 377 of the Indian Penal Code (IPC) which states as follows Whoever voluntarily has carnal intercourse against the order of nature with any man, woman or animal shall be punished with imprisonment for life or for a term which may extend to ten years and shall also be liable for fine.
Impact Private acts among consenting adults such as anal or oral sex were rendered unlawful. This also impacted consenting homosexual relationships. It drives communities of MSMs underground and makes them vulnerable to police action and excesses. The law criminalized health interventions among men who have sex with men – distribution of condoms and other health interventions amongst MSM were liable for prosecution under the law. The law was at cross roads with NACO's (Ministry of Health and Family Welfare, Government of India) initiatives to provide services to MSMs under the TI strategy.
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Questioning the legality of the law In 2001, Naz Foundation (India) Trust, filed a writ petition in the High Court of Delhi challenging the validity of Section 377, IPC . In 2004, the High Court of Delhi dismissed the petition stating that Naz Foundation did not have any locus standi to participate in the case as it had not been prosecuted under the said law. A Special Leave Petition was filed in the Supreme Court of India against the decision. In 2006, the Supreme Court ruled that the High Court should hear the case on merits and the same should not be dismissed on the grounds that it had been. The case was remanded back to the High Court of Delhi for a decision
Arguments presented Naz Foundation a.
Law violates Right to Privacy and Dignity guaranteed under Article 21 of the Constitution of India (Right to Life). Private or intimate acts such as consensual, sexual relations or sexual preference is the core of the concept of “private space” and are an inalienable component of the Right to Life. “Privacy” includes an individual's sexual orientation and conduct in so far as such conduct does not. Hence Section 377 abridges the right of privacy and dignity under Article 21. Right to Health – The impugned law drives homosexual activity underground thereby jeopardizing HIV & AIDS prevention efforts and, thus, rendering gay men and MSM increasingly vulnerable to contracting HIV & AIDS.
b.
Section 377 clubs together dissimilar sexual acts as “penile – non –vaginal intercourse” irrespective of age, consent and harm. The law is arbitrary, unreasonable and disproportionately targets MSMs. It violates the fundamental rights guaranteed under Article 14 (Equality and Equal Protection of Law).
c.
Law violates an individual's right not be discriminated on grounds guaranteed under Article 15 Constitution of India. (Right to Equality and Equal Protection of Law) – No individual may be discriminated on ground of…. Sex etc. The term “sex” used in Article 15 can include sexual orientation and hence equality based on sexual orientation is a guaranteed fundamental right in the Constitution. Criminalizing homosexual behaviour and activity under Section 377 IPC is based on sexual orientation and violates Article 15
d.
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The law violates the fundamental right of freedom of express guaranteed under Article 19 as it curtails an individual's freedom to express or make a statement about his sexual preference and receive or exchange information on sexuality.
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Ministry of Home Affairs a.
It has been generally invoked in cases of child sexual abuse and for complementing the gaps in rape laws. Penal clause has especially been used in cases of assault where bodily harm is intended or caused.
b.
Homosexuality is unlawful and such acts cannot be made legitimate because of the element of consent of both parties.
c.
Though sexual acts of consenting adults is covered under private and family life, interference by public authorities in the interest of public safety and protection of health as well as morals is permissible.
Ministry of Health and Family Welfare a.
Groups at risk of HIV & AIDS such as MSMs are mostly reluctant to reveal same sex behavior due to the fear of law enforcement agencies, keeping a large section invisible and unreachable and thereby pushing the cases of infection underground making it very difficult for the public health workers to even access them.
b.
Enforcement of Section 377 IPC against homosexual groups renders risky sexual practices to go unnoticed and unaddressed in as much as the fear of harassment by law enforcement agencies leads to sex being hurried, particularly because these groups lack 'safe place', utilize public places for their indulgence and do not have the option to consider or negotiate safer sex practices.
c.
Hidden nature of such groups constantly inhibits/impedes interventions under the National AIDS Control Programme aimed at prevention.
d.
Enabling environment is required where the people involved in behaviour that poses a HIV risk are encouraged not to conceal information so that they can be provided total access to the medical services and other prevention efforts.
Judgment “Inclusiveness” is an underlying theme of the Indian Constitution. Those perceived by the majority as 'deviants' or different are not excluded on those grounds. Section 377 IPC in so far as it criminalizes consensual sexual acts of adults in private violates Article 21, 14 and 15 of the Constitution. The Section still forbids non consensual sex, including situations where either person is below 18 years.
Implications of the Judgment Recognition of the right to sexuality of MSM communities – protects sexuality from State interference. Enables MSMs to freely access services and information without fear of police action / excess. Enables service providers to reach out to communities of MSMs with health and other services without fear of police reprisal or legal hurdles. Paves way for seeking enforcements of rights of sexual minorities in other spheres and legal recognition of discrimination against sexual minorities.
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Current Status Nineteen petitions have challenged the judgment in the Supreme Court and they have been clubbed together for hearing. Supreme Court has however refused to grant a stay to the Delhi High Court Judgment pending its decision. Hence the ruling of the Delhi High Court continues to be in force. The order is technically applicable only in Delhi but it has persuasive value – it has set a precedent and can be cited in courts across India. However once the Supreme Court hears the appeals and gives its decision, its ruling will become the law of the country.
Section 377 of Indian Penal Code “The Delhi High Court has held that consensual sex between adults in private is not criminal. The matter has gone to the Supreme Court of India in appeal. Whatever decision the Supreme Court gives will be applicable all over India. The Government of India is waiting for the decision of the Supreme Court. Having said that, it is important to mention that the Government of India is now supporting the judgment of the Delhi High Court – that section 377 is unconstitutional in respect of consensual sex between adults in private. It is thus supporting decriminalization. This is unlike when the matter was being argued in the Delhi High Court, when there was a division in the Government ranks, the Home Ministry opposing the decriminalization and Health Ministry supporting it. The Government has not appealed against the judgment.” — Mr. Anand Grover, Director of the Lawyers Collective (India) and UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
The Narcotic Drugs and Psychotropic Substances Act, 1985 The Narcotic Drugs and Psychotropic Substances Act, 1985, defines drugs / narcotics substances in section 2 (xiv): coca leaf, cannabis (hemp), opium / poppy straw and includes all manufactured goods. l
Cannabis (S.2 (iii))- charas or hashish, ganja, any mixture of these
l
Coca (S. 2 (v)): cocaine
l
Opium (S.2 (xvi)): poppy plant - morphine - heroin
Or defined in S. 2 (xxiii): means any substance, natural or synthetic, or any natural material or any salt or preparation of such substance or material specified as list of PS in the Schedule.
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Mandrax or Methaqualone
l
LSD
l
Diazepam
l
Ecstacy
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Cultivating, producing, manufacturing, possessing, selling, purchasing, transporting, using, exporting, importing are deemed offensive. The lesser offence is for personal consumption except for scientific or medical purposes. Attempt to commit offences, abetment, criminal conspiracy, and allowing premises to be used for the commission of offences - punishment as provided for the offence.
Exceptions: When possession of drugs is not an offence: ●
Addict registered with the State govt may possess opium on medical advice for personal consumption (Sec 10 (a)(vi))
●
Research Institutions or Hospitals may possess a reasonable qty for scientific/medical requirements (Rule 66)
●
Individual may possess a hundred dosage units for personal medical use (Rule 66)
Exceptions: When supply of drugs for personal use is not an offence: ●
Government may supply drugs to addicts, for medical necessity (Sec 7(2)(f), Sec 71)
●
State govts may permit possession of opium by a 'registered addict' for personal consumption, if medically prescribed (Sec 10 (a)(ii))
●
Authorised pharmacists may supply drugs to foreigners with a medical prescription (Rule 67 A)
Procedure S.52 (1): Persons arrested to be informed of his grounds of arrest. S.52 (2): Every person arrested to be forwarded to the Magistrate without delay. S.53A: Statements made and signed before any officer u/s 53, shall be relevant for the purposes of prosecution in cases specified in S.53A(a). S.67: Power to call for information, require any person to produce or deliver any document, examine any person acquainted with the facts and circumstances of the case. S.37: All offences are cognizable and non-bailable under the Act.
Bail can be granted when: 1. Only after the public prosecutor has been given opportunity to oppose the application. 2. The court is satisfied that there are reasonable grounds to believe that the accused is not guilty of an offence and that he is not likely to commit an offence while on bail. The above rigor is relaxed in cases of small and in between quantity.
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An addict is a person with dependence on any ND or PS S.39: When any addict is found guilty u/s 27 or for offences relating to small quantity, the court may, after taking into consideration age, character, antecedents, physical and mental condition, with addict's consent, direct he be released for medical de-toxification or de-addictions per procedure laid down in this section. S. 64A: Immunity from prosecution for addicts and persons found with small quantity provided they volunteer for de-addiction treatment and undergo complete treatment for de-addiction but must complete the treatment
Group work activity for discussing different scenario The facilitator shall divide the participants in to 4 small groups and ensure that every group has the balance of the officials from different levels. It is always suggestible to have one senior officer in every group. Through discussion, case scenario discussions and mini lectures explaining the clauses in ITPA the facilitator can enable participants to understand the provisions of the law and to interpret the law in an easily comprehensible way to create the right balance in the session by generating participation and interest and illustration by example. This session also looks at the use and misuse of ITPA. And hence it is suggested to have a legal expert who can justify the cases. This shall be learned by the master trainers to demonstrate the similar explanation at other levels of workshop. Scenario One: You have conducted a hotel raid and you find 2 women “indulging” in sex work. The two women mention that “they were sold into sex work and hence they were practising sex work” What will you do? ● If you have an approach to deal with this scenario, please suggest it in a step-by-step manner ● Scenario Two: You spot a woman who is standing at a place that is known for solicitation for sex work as well as sex work. You have seen this woman standing there 3 or 4 times before too. What will you do? ● If you have an approach to deal with this scenario, please suggest it in a step-by-step manner ● Scenario Three: You see a woman who is carrying condoms and distributing it to some clients. On some other days you have also found the same woman soliciting clients elsewhere. What will you do? ● If you have an approach to deal with this scenario, please suggest in a step-by-step manner ● Scenario Four: You have gone into a lodge to make enquiries and find 2 women, one of whom is 17 years old and the other 20. They make a statement that the lodge owner has brought them there to do sex work. What will you do? ● If you have an approach to deal with this scenario, please suggest it in a step-by-step manner ●
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Session VI
Role of Police in Prevention Programmes
Recommended time
Introduction Considering the minimal role of the police department in the HIV prevention and control programme, there is a definite demand for their involvement at a higher level that will go a long way in preventing the spread of HIV. Their position as protectors of law and order can be used as a plus point in speeding up the process of HIV prevention. Hence, this session will focus on the different roles that police personnel can play in the control of HIV.
90
minutes
The session will help the participants to understand the role of police in the prevention programmes especially the targeted interventions. Since the police have a critical role to play in creating an enabling environment for KPs to access their rights especially those related to HIV prevention/care, this session's goals are to sensitize participants to understand legislation pertaining to KPs, with a focus on how their interpretation of these laws further drive KPs underground, making them more at risk/vulnerable to HIV and isolates them from accessing services. The present session will focus on how an enabling environment needs to be created for the key populations to address the issues that make them vulnerable to HIV.
Objectives: By the end of the session participants will be able to:
Session Flow Facilitator to provide an overview of Session VI and recap Session V
●
To understand the vulnerability of uniformed personnel to HIV & AIDS
●
●
Define their role in creating and enabling environment for NGOs to work with the key populations unhindered within the framework of the law
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Discuss how the police are at the risk of HIV
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Discuss the role of police in prevention
●
Group activity to share the perspective about various situations
Note : It is recommended that a Senior Police Officer conduct this session.
Note for facilitator Conclude the session with a statement that the police force is the backbone for the success of this project. If there is a decrease in police violence, that would be considered as a first step towards the success of this vulnerability reduction project.
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Training Material Presentation with LCD projector and microphone
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Content and Outline Brief the NGO spokesperson/police resource person on the objectives of the session. Discuss with them the purpose and how they will take up the session. You need to also share with them the session plan and discuss how it will fit into the debriefing that they will do and the information that they will share with the participants. Your role in this session will also be to ensure that it is taken in a positive way and does not end up in a “blame game” between the HRGs and the Police. Also ensure that learning takes place in terms of what the police can do in creating an environment where the NGO workers can carry out their activities with the key populations in an unhindered manner. Please check prior to the session, whether the focus is on sex work, MSMs or IDUs. Depending on the priority of the KP in the area, the issues related to that particular group will be given more time in the presentation.
Understanding the Vulnerability of Uniformed Personnel to HIV & AIDS It is difficult to imagine our life without the uniformed forces. The police help us live a peaceful, comfortable, safe and secure life. The police work virtually 24-hours-a-day relentlessly, often in difficult and risky conditions. Uniformed personnel stay away from home for long periods of time on several occasions. The lack of the normal support of family plus peer pressure leads to high risk behaviours, such as casual sex and commercial sex (paying sex workers), not using condoms, and injecting drugs like heroin. The need to relieve stress, loneliness and boredom can lead to risky behaviour. The use of alcohol and other drugs can contribute to excessive risk taking behaviour. “R & R” (rest and relaxation), or leave, post-training and post-deployment periods are especially dangerous for individuals to get infected with STIs including HIV, because of the need to relieve stress. Police operations involving raids in red light areas and while looking for drugs constantly expose them to the risk. Forces, particularly the police, in their dealings with road accidents, come in contact with blood, which may be infectious. High incidence of accidents among members of the uniformed forces and injuries sustained while performing duties, which may require blood transfusions which also puts them at risk.
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Implication on the Armed Forces: A random study in 1997 had stated that the incidence rate of HIV& AIDS was less than 0.5 per 1,000. The armed forces personnel fall under a high-risk group that is prone to the HIV virus due to separation from their families for unnaturally long periods, at a time (20-45 years) when they are sexually most active. The official figure for the prevalence of HIV among Indian armed forces is still only 0.08 per cent. This is very low in comparison to the acknowledged prevalence rate among adults in the Indian public, which is at 0.9 per cent. According to Lieutenant-General Yogendra Singh, director general of the Armed Forces Medical Services (AFMS) the infection rate lower than in civilians. However, UNAIDS director Ulf Kristofferson said that the prevalence rate among troops could be much higher. Recent statistics show in fact that every day at least one member of the Indian armed forces is detected with HIV i.e. 30 to 40 HIV cases among the personnel every month. Currently there are 6,180 HIV& AIDS patients among their ranks. In 2007, 323 personnel of army, navy and air force were detected with HIV. In 2006, health authorities had found 409 HIV positive cases among the armed forces. The Armed Forces had reported 461 cases of HIV in 2005 and 475 in 2004. Therefore prevention is the focus. Free condoms will now be made freely available to Indian troops under military orders. The United Nations will offer substantial help to India by footing the bill. The defence ministry signed a partnership agreement with UNAIDS to mitigate the impact of HIV& AIDS on India's 1.3million-strong military. The signing of the agreement was an act of unusual candour on the part of the government, and its first public acknowledgement of the fact that its soldiers are vulnerable to HIV.
Role of Police in Prevention Programmes The role of police in the prevention of HIV is perceived in two folds, one to protect themselves from the risk of HIV and two, support the targeted interventions in the state and create an enabling environment for successful results.
How Police Personal can protect themselves from HIV ●
Know more about HIV & AIDS/STIs: Information and skills required to make informed choices and to protect oneself from HIV
●
Self risk perception is the first step to make changes in risk behaviours: Perception about individual risk from the HIV infection helps in being conscious of the risk behaviours that put the individual, spouse, other partners and unborn babies at risk
●
Modify risky behaviour: Effort should be taken to modify risky behaviours gradually; choices/decisions need to be made responsibly. Wherever possible, maintain mutual fidelity between partners, otherwise correct and consistent use of condoms should be practised. Avoid drinking and drug use before having sex
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●
Seek early and complete treatment for STIs: STIs need to be treated early. Presence of STIs increases the risk of HIV infection ten-fold. It is important to get treated for STIs from qualified medical practitioners. Partners also need to be notified for treatment to avoid recurrence of STIs
●
Avail voluntary, confidential testing and 44 counselling (VCTC / ICTC): Those who wish to get their HIV test done should avail of the pre and post test counselling facilities provided by the government / NGOs in the vicinity. Remember, an HIV test is not mandatory; it is a purely voluntary decision
●
Always follow precautionary measures (Universal Precautions): Always follow universal precautions while dealing with blood at the hospitals, accident sites, murders, and any other situation. Remember to use gloves and masks during such police operations
How the Police can help Targeted Interventions create an Enabling Environment ●
Participate in community activities that would generate interaction and strengthen the relationship between the police and the community
●
Facilitate the HIV Prevention programmes being implemented by the NGOs with the marginalized groups. (female sex workers, MSM, drug users) through advocacy with the local government
●
Network with NGOs, CBOs for effective handling of individuals referred to the police who need help Be aware of the rights of PLHIV and respect them
●
Proper handling of HIV & AIDS related concerns in the community such as confidentiality, prevention, discrimination of suspected or known HIV positive individuals, termination from work on the basis of HIV status, carrying condoms, death and burial of PLHIV
●
All personnel of police stations should be supportive to HIV related programme activities Discourage arrests purely for carrying condoms
●
Stop harassment of sex workers and use of violence
●
Sign ID cards of the peer educators wherever applicable
●
Appoint point person in the office of the Police Commissioner/SP to resolve day-to-day issues.
●
Allow NGOs to hold police station wise sensitization programmes
●
Share the knowledge of and address the vulnerability of police officials
●
Incorporate HIV & AIDS and sex work related sensitization programmes in the police training modules It is big challenge to work with sex workers where they are not organized. NGOs build a rapport with sex workers with great difficulty. At times when the workers of the NGO interact with the sex workers, police try to arrest them. This makes the sex workers think that NGO workers are informing the police about them and they then do not co-operate in the programmes
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Overall Support to the Programmes ●
To know and understand the ITPA Act in its real sense and understand the definition of the word “prostitution”. The police need to punish people who are involved in trafficking and exploitation of women and discharge their duties with no bias by understanding the various problems and reasons for a woman to end up in this profession. Every sex worker is a human being first and has every right to exist with dignity and hence we need to accept and respect persons as they are and give no room for physical and verbal abuse to sex workers/MSMs or their clients in public spaces or in-house
●
To produce sex workers, if caught soliciting, before a Magistrate within 24 hours of arrest, give permission to make a telephone call to intimate their family or lawyer without taking undue advantage of them (physically or monetarily)
●
To support their peer educators while they are doing HIV prevention and control work. Often, Peer Educators get arrested while performing their duties with respect to HIV prevention work, e.g. distributing condoms, educating clients etc. The Peer Educators are issued ID cards by the District Magistrate / Superintendent of Police / Police Commissioner or the NGO working in HIV prevention in the district. They should be allowed to do their prevention work and should not be arrested while performing this role
●
To refer any person identified as having an STI or HIV or AIDS to service organisations
●
To protect sex workers from violence and harassment by rowdies
●
To provide justice to women when abused (such as gang rape etc.)
Group Activity to Build Perspective Divide the participants into 4 small groups. Give each group a case study as given below. Ask the group to discuss what they would do in that particular case by answering the questions set in the case study and put it down as a presentation. Give them chart papers and markers to do this and 10 minutes to complete their work. After 10 minutes, invite the groups to make a 5 minute presentation on the steps that they have arrived at to the panel. Ask the NGO Representative / community member and the Police resource person to sit on the panel discussion and give their views on the presentations. The facilitator should ensure that each of these presentations is summed up by consolidating important points and issues emerging from the presentation.
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Case 1: You have conducted a hotel raid, and you find two women “indulging” in sex work. The two women mention that “they were sold into sex work and hence they were practising sex work” 1. What is your reaction to this scene? Who would you consider guilty? 2. In normal circumstances what would happen to the women? 3. What is the reaction of the hotel owner in such cases? 4. What should be the legal stand of the police in this case? Case 2: You see a woman who is carrying condoms and is distributing it to some clients. You have also seen this woman distributing condoms to other women elsewhere. You also know that she is a sex worker. 1. What is your first reaction to this scene? 2. Can the woman be taken in custody as guilty? Of what? 3. What is the legal stand that the police require to take in such cases? 4. How different will the reaction of sensitized police personnel be? Case 3: You are on duty and while walking your beat, you see a young man carrying a bag loitering near the community park. You ask his name and on checking him find that he is carrying condoms in his bag and a diary with list of names. 1. What is your first reaction to this? 2. Who do you think this man is? 3. Under what section can you pick up and book this man as guilty? 4. As a police officer what is your role? Case 4: You have raided an office following a tip-off about homosexual and pornographic activities being conducted in the office. When your team raids the office, you find a lot of literature and pictures, which you feel are obscene. You also find some wooden penis models. There are 15 to 20 men sitting in the room and are apparently in the middle of a meeting. 1. What is your reaction to this scene? What do you conclude is happening? 2. If arrests are to be made, under what sections do you think they should go? 3. What do you need to know about the situation to judge if it is an offence? 4. What do you think is your role is as a sensitized police officer?
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Session VII
Discussions, Clarifications and Post Test Introduction The session will help the participants clarify their doubts and initiate open discussions pertaining to the session and the overall workshop. The session will also attempt to address the points written on the parking lot. Knowledge of content and attitudinal change that will become more pronounced by the end of the session and will be captured through post test.
Objectives: By the end of the session participants will be able to: ●
Clarify their doubts on HIV prevention in vulnerable populations
●
Clarify their role in HIV prevention
●
Assess the post workshop change in the knowledge levels
30
minutes
Session Flow ●
Facilitator to take feedback from the participants on the workshop
●
Re visit the parking lot for clarification of questions
●
Provide post test questionnaire to the participants
●
Take the questions that you have grouped. You need to have your resource persons seated with you
●
Answer relevant questions without getting into discussions. Remember this is only a clarification exercise
●
Do try to take the attitude questions and also analyse questions to bring out the attitudes they carry if you think there is a learning from such an exercise for the group
●
If there are any questions that the resource persons need to answer, invite them to do so
●
When all the questions have been taken, thank the participants and resource persons
Training Material Presentation with LCD projector, chart paper, post test questionnaire and microphone.
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Content and Outline This is the last part of the workshop - the workshop wrap up. Thank all the participants, resource persons and various people associated with helping you in the workshop, Then ask a few participants to give their views at the end of workshop. Ask all participants if they would like to formalize their commitment to the task of HIV prevention in vulnerable populations by taking a pledge from all the participants. The pledge may be in the form of the slogan of the local police force, for e.g. in Maharashtra it is “Sad rakshanaya, Khal Nigrahnaya” – always protect the good and destroy/overcome the evil. (Refer sample pledge) Or link it to the pledge taken by the Police Force when they join the services. You may also want to prepare a pledge for the occasion, for example:
“In the presence of God, the Power that I hold Supreme and with my colleagues as my witnesses, I pledge to help those who will approach me for help to prevent HIV. I pledge to help fight the myths related to HIV. I pledge to make people around me aware of the infection and how to protect themselves from it… I pledge to fight the stigma and discrimination that society heaps on those less fortunate than myself. So help me God”
You can end the workshop on this note of hope!
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ANNEXURES
REGISTRATION FORM Sl. No.
39
Name of the Participant
Designation
Place
Signature
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Annexure 2
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Annexure 3 Frequently Asked Questions Q.
What is HIV?
A.
HIV (Human Immunodeficiency Virus) is the virus that causes AIDS. This virus is passed from one person to another through blood-to-blood and sexual contact. In addition, infected pregnant women can pass HIV to their babies during pregnancy or delivery, as well as through breast-feeding. People with HIV have what is called an HIV infection. Most of these people will develop AIDS because of their HIV infection.
These body fluids have been proven to spread HIV: ●
Blood
●
Semen
●
Vaginal fluid
●
Breast milk
●
Other body fluids containing blood
Q.
What is AIDS? What causes AIDS?
A.
AIDS stands for Acquired Immuno Deficiency Syndrome. This condition is said to occur when being infected by HIV the body loses its ability to fight off infections. A person infected by HIV may live for years without getting AIDS. A positive HIV test result does not mean that a person has AIDS.
Q.
What happens when I have AIDS?
A.
When a person is infected with HIV, it weakens the immune system such that it cannot fight off certain infections. These types of infections are known as "opportunistic" infections because they take the opportunity a weakened immune system gives to cause illness. Many of the infections that cause problems or may be life-threatening for people with AIDS are usually controlled by a healthy immune system. The immune system of a person with AIDS is weakened to the point that medical intervention may be necessary to prevent or treat serious illness. So when HIV reaches a stage where the immune system cannot fight off infections, the person reaches a condition that we call AIDS.
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Q.
How do people become infected?
A.
This virus is spread through the blood, semen, and vaginal discharges of an HIV-infected person. People can get HIV when they come into contact with these fluids. This can happen by engaging in specific sexual and/or drug use practices. Also, an HIV-infected woman can pass the virus to her newborn during pregnancy and childbirth. Many people do not know they have this virus and therefore can unknowingly pass it to others. This is because they usually look and feel fine for many years after HIV infection occurs.
Q.
What are the possible advantages of testing a pregnant woman?
A.
If a pregnant woman has a positive test result there are now drugs that can reduce the risk of her passing HIV on to her baby in the womb or at birth. Delivery by elective Caesarean Section also reduces the risk of a baby becoming infected. It is usually best for babies to be breast-fed. However, if a mother has HIV, breast-feeding will increase the risk of her baby becoming infected. If a pregnant woman has a negative test result it could be very reassuring.
Q.
Can blood transfusions transmit HIV infection?
A.
Yes. If the blood is infected with HIV In many places blood is now screened for HIV before it is transfused. If you need a transfusion, ensure that screened blood is used.
Q.
Can injections transmit HIV infection?
A.
Yes. If the injecting equipment is contaminated with blood containing HIV. Avoid injections unless absolutely necessary. If you must have an injection, make sure the needle and syringe come straight from a sterile package or have been sterilized properly; a needle and syringe that has been cleaned and then boiled for 20 minutes is ready for reuse. Finally, if you inject drugs, of whatever kind, never use anyone else's injecting equipment.
Q.
What about working every day in close physical contact with an infected person?
A.
There are no risks involved. You may share the same telephone with other people in your office or work side by side in a crowded factory with HIV infected persons, even share the same cup of tea, but this will not expose you to the risk of contracting the infection. Being in contact with dirt and sweat will also not give you the infection.
Q.
Can I get HIV from kissing on the cheek?
A.
HIV is not casually transmitted, so kissing on the cheek is very safe. Even if the other person has the virus, your unbroken skin is a good barrier. No one has become infected from such ordinary social contact as dry kisses, hugs and handshakes.
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Q.
How effective are latex condoms in preventing HIV?
A.
Studies have shown that latex condoms are highly effective in preventing HIV transmission when used consistently and correctly.
Q.
What is STI?
A.
An STI (Sexually Transmitted Infection) is an infection that is transmitted through sexual contact. STIs can also be transmitted through blood and blood products or from a mother to her child. The infection can be found in both men and women. There are different types of STIs which are caused by bacteria or viruses. Some of the STIs can cause ulcers, open wounds or sores in the genital areas.
Q.
Does the presence of other sexually transmitted infection or diseases (STI /STD) facilitate HIV transmission?
A.
Yes. Every STI/STD causes some damage to the genital skin and mucous layer, which facilitates the entry of HIV into the body. The most dangerous are: Syphilis Chancroids Genital herpes Gonorrhea
Q.
Is there a vaccine for HIV or AIDS?
A.
While there is currently no vaccine for HIV or AIDS, research is under way.
Q.
How is HIV treated?
A.
Currently there is no way to get rid of the virus once a person is infected. However, new medicines can slow the damage that HIV causes to the immune system. Also, doctors are getting better at treating the illnesses that are caused by HIV infection. HIV is now considered to be a manageable, long-term illness.
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Q.
Do people living with HIV or AIDS have special rights or responsibilities?
A.
Since everyone is entitled to fundamental human rights without discrimination, people living with HIV or AIDS have the same rights as sero-negative people to education, employment, health, travel, marriage, procreation, privacy, social security, scientific benefits, asylum,etc.
Q.
Where can I get tested for HIV infection?
A.
Many places provide testing for HIV infection. Common testing locations include some private doctors, almost all government hospitals, Integrated Counselling and Testing Centre, private hospitals and sites specifically set up to provide HIV testing. It is important to seek testing at a place that also provides counselling about HIV & AIDS. Counselors can answer any questions you might have about risky behaviour and ways you can protect yourself and others in the future. In addition, they can help you understand the meaning of the test results and describe what AIDS-related resources are available in the local area.
Q.
What are the tests available for HIV?
A.
The ELISA (Enzyme Linked Immuno Sorbent Assay) is the standard screening test used to detect the presence of antibodies to HIV. The ELISA should be used with a confirmatory test such as the Western blot. Tests that detect other signs of HIV are available for special purposes, such as for additional testing of the blood supply and conducting research. Because some tests are expensive or require sophisticated equipment and specialized training, their use is limited.
Q.
What is Voluntary Counselling and Testing?
A.
As the HIV problem intensifies, the issues of care and support for affected individuals, and prevention of HIV transmission to those who are not affected, become even more critical. Voluntary counselling and testing (VCT) is now seen as a key entry point for a range of interventions in HIV prevention and care. It provides people with an opportunity to learn and accept their HIV sero-status in a confidential and enabling environment and to cope with the stress arising out of HIV infection. VCT should become an integral part of HIV prevention programmes.
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Q.
Is the blood issued by blood banks safe?
A.
Yes. As per the National Blood Safety Programme of NACO, it is mandatory for blood banks to test every unit of blood properly for grouping, cross matching and testing for HIV, Syphilis, Hepatitis B and C and Malaria before it is issued for transfusion. Facilities have been provided by NACO to all the government and charitable blood banks like Red Cross to carry out these tests.
Q.
How does HIV & AIDS stigma affect people's behaviour?
A.
Stigma can negatively affect preventive behaviour because it creates a silence around the issue or builds up a prejudice against perfectly positive behaviour. For example, the use of condoms is associated with sex workers. It can negatively affect those who need to seek healthcare. For example, the reluctance of patients to visit STI clinics incase confidentiality is not maintained. It can negatively affect the quality of care given by health care providers who could be biased against the care seeker. It increases the overall health costs because of denial of risk of infection, increased infection rate, avoidance of testing, treatment of infections at an advanced stage etc.
Q.
What are the vulnerable groups?
A.
Some people because of their work or their behaviour are more vulnerable to HIV. Some of these groups are: Female Sex Workers - FSW Men who have Sex with Men –MSM Injecting Drug Users - IDUs
Q.
What is the ITPA?
A.
The Immoral Trafficking Prevention Act, 1956 is an Act in which the Government has ratified an international convention for suppression of trafficking in persons and exploitation of the prostitution of others. The ITPA is the main statute dealing with sex work in India. It does not criminalize prostitution or sex workers per se, but mostly punishes acts facilitating prostitution like brothel keeping, living off earnings and procuring, even where sex work is not coerced.
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Q.
What is the Narcotic Drugs and Psychotropic Substances Act, 1985 (NDPS Act)?
A.
The NDPS Act bans the production, possession, consumption, sale, use, etc. of manufactured and psychotropic drugs and opium and its derivatives. This law criminalizes the possession of the tiniest quantity of drugs. The NDPS Act prescribes severe punishments by way of rigorous imprisonment and heavy fines. It also makes all offences under it cognizable and non-bailable and gives wide powers of search, seizure and arrest to the police. It makes a presumption of guilt against the possessor of any drugs or apparatus for the manufacture of any drugs. It also makes any attempt or abetment to commit an offence punishable.
Q.
How have the police helped in this?
A.
In some instances there has been strong support and involvement from the police for NEPs, outreach education and drug substitution. Police also participate in education and literacy and permit the circulation of explicit harm reduction literature. These changes in the law have created spaces for lawful interventions among IDUs that make it safer for them to consume drugs and help prevent the spread of HIV and AIDS.
Q.
What are the possible advantages of testing a pregnant woman?
A.
If a pregnant woman does test positive for HIV there are drugs that can reduce the risk of her passing HIV on to her baby in the womb or at birth. Delivery by elective Caesarean Section also reduces the risk of a baby becoming infected. While it is usually best for babies to be breast-fed, if the mother has HIV, breast-feeding will increase the risk of her baby becoming infected.
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Annexure 4 Ice Breakers Some ice breakers to get the participants comfortable with the group.
1. Name Thy Neighbour Purpose - To get the participants to get to know each other Size group - Any size Time - 10-15 minutes (Depending on how many participants are present. Estimate 1 minute per participant) Preparation: Prepare the participants to learn about their neighbour on key details about them also to share their details to the neighbours. (Name, Department, Designation, Place of work, their awareness levels about HIV etc) Allot time for quick interaction among themselves Introduce their neighbour with as many details as possible to all the other participants.
2. Three Questions Everyone in the group writes down 3 provoking questions they would like to ask the others in the group. Not the normal, “What's your name?” type questions but something like, "Where is the most interesting place you have ever travelled?" or "Name a topic you feel absolutely passionate about". Give them time to mingle, and to ask three different people in the group one of their three questions. Get back together and have each person stand and give their name. As they say their name, ask the group to mention what they know about this person.
3. The Pocket/Purse Everyone selects two items from their pocket or purse that has some personal significance to them. They introduce themselves and do a “show and tell” of the selected item and explain why it is important to them.
4. Circle of Friends This is a great greeting for a large group who will be attending a seminar for more than one day especially since the chances of meeting everyone in the room is almost impossible. Form two large circles one inside the other and have the people in the inside circle face the people in the outside circle (or simply form two lines facing each other), Ask the circles to take one step in the opposite directions, allowing them to meet each new person as the circle continues to move. If lines are formed, they simply keep the line moving, as they introduce themselves.
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5. The Quiet Game The instructor explains that this exercise needs self control. Members pair back to back. On the count of three, everyone must face their partner, look each other in the eyes, and then try to remain solemn and serious. No speaking! The first to smile or laugh must sit down. All who remain standing then take a new partner and the activity continues until only one person has not smiled or laughed. (Second round of playing can involve two teams competing to outlast each other.) If you get a pair at the end who keeps a straight face, the rest of the group can act as hecklers to distract them!
6. Hot Chocolate Objective 1.
To make people feel comfortable talking about sex and sexuality
2.
To encourage people to share their feelings and thoughts about sex and sexuality
3.
To create humour and laughter
Requirements 1.
Enough chocolate for everyone
2.
Butchers paper and Markers
3.
White board and Markers
Game: - How to facilitate 1.
Introduction (10 mins): - Welcome everyone and ask them to introduce themselves and to share a little about where they are from and what they do.
2.
Pass out chocolate, including yourself, and ask people to begin eating.
3.
Once everyone has started eating their chocolate, ask each person individually, 'what feelings do
4.
they have when they eat chocolate'. For example, does eating chocolate make you feel good? Why? Write responses on the white board.
5.
Now ask people to think about 'what sex makes them feel like'. For example, does sex make you feel good? Why? (5mins)
6.
Write these responses next to the chocolate responses.
7.
Draw out things like, why does eating chocolate and sex make us feel good?
8.
Ask questions like, what are the similar words that describe sex and chocolate (for example, taste good, feels good, makes me happy).
9.
Start to explore why some of these responses are and may be, similar? (5mins)
10. After everyone has shared his or her comments wrap up session by summarising what was discussed.
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Annexure 5 HIV & AIDS Myths and Facts Read the following statements and ask trainees whether true or false 1.
HIV (Human Immunodeficiency Virus) is the virus that eventually causes AIDS
2.
HIV is spread mainly through unsafe sex and sharing needles with an infected person
3.
A few people have contracted HIV from tears or saliva of a person with HIV
4.
Only adolescents are at risk of getting HIV because of their sexual activity and/or drug use
5.
The HIV antibody test is a test for AIDS
6.
A person can be infected with HIV and not know it
7.
You can tell if someone is infected with the HIV or has AIDS just by looking at them
8.
You can get HIV from shaking hands, hugging, kissing, eating at restaurants, sharing food, toilet seats, telephones, swimming pools or furniture
9.
Only Injecting Drug Users (IDUs), gay men and transgenders get HIV
10. HIV and AIDS are the same disease
Answers 1.
HIV (Human Immunodeficiency Virus) is the virus that eventually causes AIDS: True. Scientists have shown that HIV does cause AIDS
2.
HIV is spread mainly through unsafe sex and sharing ID needles with an infected person: True. Unsafe sex and sharing injecting drug equipment are the most common ways of catching HIV.
3.
A few people have contracted HIV from tears or saliva of a person with HIV: False. It would take more than a whole bucket of saliva or tears to pass on HIV
4.
Only adolescents are at risk of getting HIV because of their sexual activity and/or drug use: False. Everyone, no matter what sex, race, age or disability, are at risk of getting HIV if they do not take safe precautions The HIV antibody test is a test for AIDS: False.
5.
The HIV antibody test is an HIV test. There is no test for AIDS. It is the diseases that follow HIV that are called AIDS related infections. These could be any numbers of infections.
6.
A person can be infected with HIV and not know it: True. Some people may not show any symptoms and not know that they have become infected with HIV. This is why an HIV test is an important part of looking after our sexual health.
7.
You can tell if someone is infected with HIV just by looking at them: False. You can't tell if someone is HIV positive or living with AIDS by just looking at them.
8.
You can get HIV from shaking hands, hugging, kissing, eating in restaurants, sharing food, toilet seats, telephones, swimming pools or furniture: False. You cannot get HIV from any of the above.
9.
Only Injecting Drug Users (IDUs), gay men and transgenders get HIV: False. Everyone is at risk of HIV.
10. HIV & AIDS are the same disease: False. HIV & AIDS are not the same. HIV is a virus that causes the immune system to break down. When this happens, our body becomes open to many infections. When our body starts losing the ability to fight off these infections do we get AIDS. This syndrome is known as AIDS.
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Annexure 6 LIST OF SWADHAR SHELTER HOMES/ HELP LINES SANCTIONED BY GOI SL. District No.
Name of the organization
Location of the Project
No. of beneficiares
1
Anantapur
Praja Seva Samaj, H.No. 1-364-6-4 A, Post Box No. 10, R.S. Road, Kadiri, Anantapur Dist.-515591 Ph. No. 08494-222833, 222453
H. No.1-1189-99 NGO, Glong, Kadiri, Anantapur Dist.
50
2.
Anantapur
Ambedkar Harijan Samajam, (AHS), #D.No. 5/532, Industrial Estate, Kummarivandlapli, Kadiri, Ananthapur Dist. Ph. No. 08494-2264166
Plot No. S-9, Near Telephone Exchange, Industrial Estate, K. Kummaravonadala Palli Kadiri - 515594 Ananthapur Dist.
50+ Helpline
Cell No. 9440152829 / 9866687888 3.
Kadapa
Bharat Ratna Mahila Mandali, 4/369-J, Vivekanada Nagar, Cuddapah -516001 Ph. No. 091-8562-243117 Cell No. 9849050422
H. No.4/369-J to L, Vivekanada Nagar, Near, Hero Honda Show Room, Kadapa Dist. AP
50
4.
Kadapa
Rayalaseema Harijana Backward Minirities Seva Sangam, Pothkurupalli Cross Roads, Near Anjaneya Temple, Kadapa Main Rd., Rayachoti, Kadapa. Ph. 9848061373 (Mr. Ratnam) rhgbmssrso@gmail.com
Masapet, Raichoti Municipality and Mandal Kadapa Dist.
50
5.
Kurnool
Shanti Educational Society, H.No. 15/81, Shareen Nagar, Kurnool Dist.-518002. Ph. 235983 Cell No. 9849190019
No. 11/26, at Venkatadri Nagar Near, Sharoor Nagar, Kurnool-518002.
50
6.
Chittoor
Rashtriya Seva Samiti #9, Old Huzur Office building, Thirpathi, Chittoor-517501. Ph. 0877-2242404 rass_org@rediffmail.com Chittoor Dist.
R.S.S. ARKVA Anjaneyapuram, Kara Kambadi (Vil) Renigunta Mandal,
50+ Helpline
7.
East Godavari
Sree Harsha Educational Soc., D.No.1-226, Vedireswaram Rd, Ravulapalem Mandal, East Godavari Dist. Ph. 08855-257646 (O)
Plot No. 8-556, Plot No. B-288-9/11, Main Road, of NH-5 of Ravelapalem, East Godavari Dist.
50+ Helpline
8.
East Godavari
Sr. Kandukuri Veereshalingam Educational and Welfare Society, 29/1-7, Lepakshi Handi Crafts Emporium, Upstairs GNT Road, Rajamundry, East Godavari Dist. Ph. 2447016 / 2448016 5655655
D. No. 73-3-9/2 & Narayanapuram, Rajamundry, East Godavari Dist
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9.
53
West Godavri
Annie Owe Memorial Orphanage, D. No. 131, Near Vijaya Lakhsmi, Mini Threatre, Benarjeepeta, Eluru West Godavari Dist. Ph. 0881-2249282, 9908320943 & #13-99, Vidyanagar, Eluru-534007 aomosuseela@yahoo.com
D.No.10-120 10-121, Chantaparru Road, Eluru, Benerjepeta, West Godavari Dist.
50+ Helpline
10. Krishna
Vasavya Mahila Mandali, D. No.40-9/1-16, Vasavya Nagar, Benz Circle, Vijayawada, Krihna Dist Dist. Ph. 0833-2812232
Vemavaram K. Tadepalli Gram Panchayat, Vijayawada Rural Mandal Krishna Dist - 520012
100
11. Krishna
Gram Vikas, Saingar, Krishna Fax : 08761- 281566 gramvikas_mgo@yahoo.com
125, Nuzvid, Krishna Dist
50+ Helpline
12. Nellore
Community Association for Rural Development (CARD), Mannapolur, Sullurpet Mandal, Nellore Dist - 524121 Ph. 9440496765 / 0862-2341613 nathcard1@redifffmail.com
S.No.102B, Mannarpolur Village, Sullurpet Mandal Nellore Dist.
50+ Helpline
13. Nellore
Vasantha Lakshmi Charitable trust and Research Centre, 16-11/131, Kasturidevi Nagar, Pogathota, Nellore Dist - 524001 Ph. 0861-2326228, 2347276 Fax : 0861-2347277 vasanthalakshmi_vict@yahoo.com
D. No. 5-492, Osmansahebpeta, Nellore Town-1, Nellore Dist.
50
14. Prakasham
Dasari Adivaiah Memorial Ele. School Committee, Uluvapadu, Prakasham Dist-523292 Ph. 08599-234376 / 9010790965
Ulavapadu Village & Mandal,. Prakasham Dist. NH-5
50+ Helpline
15. Guntur
JMJ Social Service Society, Nallapadu, Guntur Dist. Ph. 08644-236137/ 222458 Cell : 9848073836 / 9441394798 jmjtelanl@rediffmail.com
D.No. 58-3, 58-4 at Angala-Kudutu Panchayat and D.No.58-3D, 58-4B at Angala-Kuduru, Opp. J.M.J. College for Women, Tenali, Guntur, AP
50+ Helpline
16. Guntur
BARK Educational Society, Akbar Pete Bapatla, Guntur Dist-522101 Ph. 08943-220660 Cell : 9440434310
H. No. 4-8-43 & 4-8-35A, Bapatla, Akbarpet, Guntur Dist.
50+ Helpline
17. Guntur
Kothapet Mahila Mandali, Pothuraju Vari Chowk, Kothapet, Guntur Dist - 522001 Ph. 0863-2212382 kmm_csw_gnt@yahoo.com
Venkatadripet, Nehru Nagar, 2nd Line, Guntur Dist
50
Mee Nestam
18. Visakha Patnam
Society for Education and Environment Development (SEED), D.No.45-52-5/2, Aravind Apartments, Abid Nagar, Akkayyaplam, Visakhapatnam Dist.
14-70 Simhadri Nagar Near, RTC Depot, Gopalapatnam, Vizag Dist.
50
19. Visakha Patnam
Priyadarshani Service Organization, D.No.45-53-9, Narasimhanagar, Akkayapalem, Visakhapatnam, Ph. 9848193466 / 9848275928 psc.csw.vskp@yahoo.com
D. No. 45-56-6/1, Narshimhanagar, Akkayyapalem, Visakhapatnam Dist.
50+ Helpline
20. Vizia Nagaram
Chaitanyabharathi, Plot No. 754, Gouthamingarvuda, Colony Near Phase-III, Junction, Contoment (PO), Vizianagaram Dist. Ph. 08922-231704 Cell : 9440343498
S. No.36, Ward No.35, Ambedkar Colony, Cantonment, izianagaram
100+ Helpline
21. Karimangar
Prakriti Environment Society, H.No.5-3-182, Ashok Nagar, Karimnagar, Ph. 0878-2240840 Fax : 040-23772776
H.No. 6-4-288, Bomma Kisthaiah Nagar, Bommakal, Road, Karimnagar Dist.
50
22. Khammam
Gram Vikas (GV) Hyderpet, Sathupally, Near B.C. Hostel, Khammam Dist-507303. Cell : 9393511537
Plot No.122, H.No. 3-138, Sathupally, Khammam
100+ Helpline
23. Khammam
Chaitanya Mahila Mandali, Mamilagudem, Khammam Dist. Ph. 9848183006
#10-2-36, Mamilagudem, Khammam Dist.
50+ Helpline
24. Warangal
Pragathi Seva Samithi, #2-5-578, KLN Reddy, Subedari, Hanumakonda, Waragal Dist Ph. 0870-2550659, 2540851 Fax : 0870-2540979 info@pragathisevasamithi.org
2-5-279, Nakkatagunta, Hanumakonda, Warangal Dist.
50+ Helpline
25. Adilabad
Society for Urban and Rural Enlightenment (SURE), Pulenagar, Bhainsa, Adilabad Dist. Ph. 08752-230056 Cell : 9849013297
H.No. 3-4-61/62#, Pulenagar, Bhainsa, Adilabad Dist.
50
26. Ranga Reddy
Development Organization for village Environment (DOVE), Adm. office 1-92/2/A, Prabhath Nagar Colony, Chaitanyapuri, Dilsukhnagar, Hyderabad. Ph. 24057624, Cell : 9440418424
4-7-2515, Manjara Pipeline Road, NGO Colony, Ranga Reddy Dist.
50
Mee Nestam
54
55
27. Ranga Reddy
Kasturba Gandhi National Memorial Trust, Mahila and Viksasa Kendra, Hydershakote, Via Langerhouse, Hyerabad-8, Ph. 040-27140986 / 27801688 Cell : 9391011282 kgnmthyd@yahoo.com
Kasturba Gandhi National Memorial Trust, Hydershahkote
50+ Helpline
28. Ranga Reddy
Human Resource Development Society (HRDS), 8-7-96/61, Plot No. 61, PRTU Colony, Vysalinagar, B.N. Reddy Nagar, Sagar Road, Hyderabad, Ranga Reddy Dist. Ph. 040-23754367
Plot No.58, PRTU Colony, Vaisali Nagar, B.N. Reddy Nagar, Hyderabad-500079 (consisting of 2 Floors)
50
29. Ranga Reddy
Hyerabad City Woem’s Welfare Council, H.No. 7-140/2, S.S. Nagar, Street No.8, Habsiguda, Ranga Reddy Dist. Ph. 23754367, 23045774
H.No.3-16-203/c/12, Venkat Reddy Nagar, Ramanthapur, Hyderabad-500013 AP
50+ Helpline
30. Ranga Reddy
Run by Government of Andhra Pradesh Location of project at Kukatpally
Kukatpally, Hyderabad Dist
200+40 Children
31. Hyderabad
Mahila Dakshata Samiti, H.No. 8-3-430/1/21, NSC, Employees Society, Yellareddyguda, Ameerpet, Hyderabad Ph. 040-23732366 (Anuradha-9246214934)
H.No. 8-3-430/1/21, Yellareddyguda, Ameerpet, Hyderabad AP
50
32. Nizamabad
Rural Infrastructure Development Organization (RIDO), Jadi Jamalpoor, Bodhan, Nizamabad Dist. Ph. 08467-2208864 Cell : 9440477017
R.I.D.O. Plot No. 157, Near Satyanarayana Swamy Temple Road, Boregam (P) Nizamabad Dist.
50+
33. Mahaboob Nagar
Navodaya Seva Sangam, 10-107, Netaji Road, Jadcherla, Mahaboobnagar, Ph. 08542-202200
Plot No. 104-105, and S.No. 74A, 74B, Balanagar, Mahaboobnagar Dist.
50+ Helpline
34. Nalgonda
Krushi Seva Samastha, Nalgonda Ph. 08683-237443
Hauzar Nagar Mandal Nalgonda Dist
50
Mee Nestam
Mee Nestam
56
Annexure 8
57
Mee Nestam