MSACS Targeted Intervention Trucker’s Project (IIYW)
Established on 01.05.2004
 
OVERVIEW
An estimated 2.4 million Indians are HIV positive, 83% of which are aged between 15-49 years (2009). India’s HIV epidemic is largely confined to a few industrialized states in the country’s south and west. Maharashtra is with its 420,000 affected people the second highest affected state, and accounts with the other southern states of Andra Pradesh (500,000), Karnataka (250,000), and Tamil Nadu (150,000) for 55% of India’s HIV infections.

The Indian HIV epidemic has not yet taken hold of its general population and is largely concentrated in a few high-risk groups, spreading first and foremost through unprotected sex between sex workers and their clients (such as migrants and long distance truck drivers), and through the use of contaminated injecting equipment when taking drugs. (Source: Worldbank, 2012)

HIV prevention in India:
  • National Level: National Aids Control Organisation (NACO) – In Control of Aids programmes across the country
  • State Level: Mahrashtra State Aids Control Society (MSACS) – funding agency
  • Local Level: Programmes are being implemented through local NGOs ie. IIYW receives grants from MSACS

Main target groups for HIV/AIDS programmes:
  • Female Sex Workers (FSW) – core target group
  • Migrants
  • Long-distance Truckers
  • Intravenous Drug Users (IDU)

Maharashtra has 8 projects focusing on the Trucker population delivered by 8 different NGOs. IIYW is the only NGO running a Trucker’s project in Nagpur.

Definition of ‘Long Distance Trucker’: Truckers who are travelling a minimum of 800kms one way / are absent from their home for more than 2 weeks.

Why long-distance truckers are a high risk group for HIV/AIDS:
  • Mobility (In 30% of cases this mobility results in multiple sex interactions with the local population as they travel.)
  • Living and working conditions
  • Sexually active age group (15-45)
  • Separation from regular partners for extended periods of time
  • Availability of cash in order to meet travel needs, makes truckers attractive customers to the sex industry
  • Inadequate access to STI treatment

During the course of their journey the drivers often experience a low self-esteem and powerlessness whilst dealing with the different constituencies. This fuels risky sexual behavior, because it is only in these situations that the drivers perceive that they regained control and fulfilled a macho image that is closely tied to their self-worth.

Statistically, 35% of Long-distance Truckers clients of sex workers, 2.2% are HIV positive, and 5-10% have at least one STI (Sexually Transmitted Infection).

The projects static clinic is situated at Pal Petrol Pump, Pardi Naka Nagpur, whilst mobile van extension clinic services are provided at 7 different sites on NH (National Highway) 6 and NH7. These high trucker points are Octroi Check Post No.10 Wadi, Octroi Check Post No.II Katol Road, Waddhamana, Khapari, Transport Nagar, and the parking area of Kalamana market. The area of operation is therefore a 30km stretch on NH6 and a 5km stretch on NH7 in Nagpur.

Overall, the project consists of 1 Project Manager, 3 Doctors, 2 Counselors, 14 Out Reach Workers (ORW) of which 1 is in charge of mid media training, 1 of Interpersonal Communication (IPC), 2 Nurses, and 2 Technicians.

AIM and OBJECTIVES

Aim:

To arrest the spread of STI and HIV/AIDS among long distance truckers.

Objectives:
  • To offer treatment for sexually transmitted infections (STI)
  • To raise awareness of STI and HIV/AIDS through mid-media, exhibitions, and street plays
  • To provide counseling
  • To offer socially marketed condoms (condoms provided at a no-profit basis in local shops)
  • To promote the use of condoms
  • To offer peer led dialogue based interpersonal communication (IPC)
  • To increase community mobilization and community participation
  • To provide HIV testing
  • To reduce the incidence of STIs among truckers through appropriate clinical intervention

Major strategies:
  • Broker’s strategy (catering high truckers points)
  • Synchronized mid media, IPC, and clinic services
  • Focusing on self esteem of truck drivers and their health seeking behavior
  • Behavior change communication strategy (including counseling and interpersonal communication sessions for high risk truckers)

ACHIEVEMENTS
1st April 2012 – 31st March 2013

Clinic footfall n/a
Awareness raising coverage through mid media IPC on STI and HIV/AIDS n/a
Total counseling 4865
STI treatments 1435
HIV Testing 2012
HIV Positive 21
Linked to ART 6


IIYW’s Truckers Project received 3 Gold Standard awards in 2007, 2008, and 2009 by TCIF (Transport Corporation of India Foundation). Additionally, it received Best NGO (TI) award for the year 2010-2011 on 1st Dec. 2011 on World Aids Day.

OUTCOMES
  • Truckers have gained comprehensive knowledge of STI HIV-AIDS.
  • The number of truckers using condoms with non-paid, non-spousal partners has increased.
  • Consistency in condom usage with paid sexual partners has been established

CHALLENGES
  • It is very difficult to link HIV Positive truckers to ART (antiretroviral treatment) Services because of their mobile nature.
  • Truck drivers suffer from a very low self-esteem. Thus our challenge is to boost their self esteem in order to encourage health seeking behavior.

FUTURE TARGETS
  • The target population has been increased from 30,000 to 35,000 long-distance truckers for the year 2013 to 2014.
  • The new check post in Khapri will be included in our work target. Our work area for 2013-2014 has been extended from the NH6 to include the NH7.

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