HIV/AIDS
SIAAP
SEX WORKERS FIGHTING AIDS
The year is 1988. Thirty female sex workers from the Southern Indian town of Chennai are thrown in jail because they are hiv positive. When the case comes to court two years later, there are more than 800 hiv positive sex workers in prison in the whole state of Tamil Nadu. The court eventually orders their release. 'The attitude of the authorities was typical of the panic and the lack of information about hiv & aids when aids first reached India,' says SIAAP director Indumathi Ravishankar looking back. In the meantime this attitude has taken a 180 degree turn.
The court case against the hiv positive sex workers was carefully monitored by Shyamala Nataraj, a journalist interested in the aids epidemic. She found that people living with hiv & aids were not or barely offered treatment and that nothing was being done to prevent others from being infected with hiv. To change this situation she set up SIAAP. Indumathi Ravishankar says: 'One of the first things we did was to set up an hiv & aids information point at a busy check post for trucks. Free condoms were also given out there.'
'In the years which followed we trained about 150 counsellors, all from the vulnerable groups which SIAAP works with: sex workers, homosexuals, people living with hiv and blind people. It was for that very reason that they were able to form a bridge between the target groups and the Voluntary counselling and Testing centres (VcTcs). After a number of years this programme was transferred to the government of Tamil Nadu. At this moment there are 730 VcTcs in Tamil Nadu. This approach obviously works. The percentage of people living with hiv in Tamil Nadu was at one point the highest in the whole of India: 1.25% (around 750,000 people). Now this has gone down to 0.3% due to death and fewer new infections. Among the groups which SIAAP works with, by the way, the infection degree is around 50%.'
SIAAP has invested a great deal of effort into mobilising sex workers, homosexuals and people living with hiv into so-called sangams. These are a type of self-help groups which have around fifty members each. 'The sangams have proved very effective in supporting people, providing information, referring people to regular health care and assisting members with all sorts of services,' says SIAAP director Indumathi Ravishankar. 'For instance, SIAAP is no longer responsible for providing information to health care providers, the sangams take care of that themselves now, often with great results.'
'In the Stanley Hospital in Chennai, for instance, a single large centre has been set up for counselling and tests. So now nobody knows whether you are there because you have cancer, diabetes or hiv. The health care workers have also been trained in such a way that they treat hiv positive sex workers with respect. One of their main tasks is to persuade people to allow themselves to be tested. This has become even more important because the Indian government recently decided that it would provide hiv patients with free ARV treatment. The sooner you start taking this medication after being infected, the better.
The sex workers’ sangams have been setting up small savings and credit associations over the past couple of years. 'In this way they can both save for the future and borrow money, for example, to pay for a good education for their children. More financial security, moreover, makes it easier for them to say ‘no’ if a customer wants to have sex without a condom. Meanwhile other people within thelocal community have also become eligible to join the savings and credit association. This means that representatives of the sangams are able to sit round the table with local leaders from the village or district. It is obvious that developments like that do not just greatly increase these people’s sense of self-esteem but also strengthen their position.'
Type of organisation
Service organization /non-profit
Sector
Hiv/aids
Country
India
Founded
1992
Hivos partner since
1992
Website
www.siaapindia.org
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