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Reaching Out to Help People Living with HIV and AIDS in India

Strengthening Services and Improving the Quality of Care

“The doctor was very loving and patient. It’s rare to get doctors like him. I have a lot of respect for him. He was not only my doctor, he was also my counselor—he helped me disclose my status to my wife. Thanks to him, I could coun­sel others who saw my side effects and were scared to start ART (antiretroviral therapy).” —HIV positive client

With the second highest number of people living with HIV and AIDS in the world after South Africa, India is facing one of its biggest public health challenges. India accounts for nearly 10% of the 40 million people living with HIV and AIDS globally and more than 60% of the 7.4 million such people in the Asia and Pacific region. These facts underscore the critical needs in India for prevention and treatment for millions living with the disease. The current HIV and AIDS treatment situation is disheartening. Many people living with HIV and AIDS need antiretro­viral therapy (ART), and for those currently receiving ART, treatment support and education are extremely limited. In 2004, UNAIDS estimated that of 770,000 Indians living with HIV and AIDS and needing treatment, only 35,000 were receiving ART. Weak supply systems, prohibitive costs, and lack of information about HIV treatments all contribute to this treatment gap. Even people who receive ART face ongoing challenges due to side effects, a dearth of treatment information in local languages, and/or lack of support on how to manage treatment regimens.

The good news is that a national effort is underway to address these issues. EngenderHealth’s India Office is part of a diverse consortium of local Indian non-governmental organizations (NGOs) working to improve the quality of care and support services for people taking ART. The project aims to increase the number of health providers who can provide high-quality HIV and AIDS care and support services, in accordance with the national treatment guidelines.

The project will reach 137,000 HIV positive people in the states hardest hit in India by HIV and AIDS: Andhra Pradesh, Karnataka, Tamil Nadu, Maharastra, Nagaland, and Manipur.

As a core member of the consortium, EngenderHealth is implementing an integrated training initiative that includes establishing two Continuing Education and Training Centers (CETCs); these will serve as model training centers for the consortium throughout the six states. The centers will also provide ongoing training and support to providers at all levels in the NGO sector.

As part of this initiative, EngenderHealth is developing three comprehensive training curricula in six languages. One is uniquely designed for peer educators who are HIV positive and who will use their treatment experiences and skills to educate other people living with HIV and AIDS. It includes guidance on how to conduct sessions with people living with HIV and AIDS and their caregivers, as well as presentations and hand­outs that can be used during informal group meetings or one-on-one sessions. In another manual, providers (doctors, nurses, and social workers) receive training on a broad range of skills to improve their attitudes and practices to ensure that their clients receive high-quality care. In addition to the training initiative, Engender­Health is helping its consortium partners to strengthen providers’ skills in delivering home-based and commu­nity-based care for people living with HIV and AIDS.

Together, the contributions of each member of the consortium are making a difference in improving the well-being of an often forgotten but rapidly growing population. Discussions are also underway in the Engen­derHealth India Office to link the HIV and AIDS program with their Men As Partners™ program, to expand the capacity of the HIV and AIDS network to address preven­tion more broadly by involving men.

Begun in 2005, the project will continue through 2010 and is made possible through a grant awarded by the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria. The NGO consortium comprises EngenderHealth, the Population Foundation of India, the Indian Network for People Living with HIV/AIDS, Freedom Foundation, and the Confederation of Indian Industries.

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