Speaking Out for Sexual Health of PLHIV and Key Populations

Bini Philips 17 October, 2014

Gujarat is one of the four states where Alliance India’s European Union‐supported Koshish programme was implemented for the past three years. Our Koshish partners in Gujarat intensively engaged with communities of people living with HIV (PLHIV) and key populations (KPs) through consultations to identify their sexual and reproductive health (SRH) needs. Among many, one of the key issues identified through these community consultations was the lack of availability of quality SRH counselling services for PLHIV and KPs in different service facilities and government hospitals.

Understanding the urgency, the Koshish team prioritised this as an important advocacy agenda and further worked to identify the actual gaps. Eventually the team zeroed down on the fact that the problem primarily stems from the lack of adequate knowledge among counsellors. As a measure to develop a solution, the partners first conducted a desk review of counsellor guidelines and training manuals developed by National AIDS Control Organisation (NACO). Additionally, they also did a survey to assess counsellors’ existing knowledge and identify training needs. The results were then shared with Gujarat State AIDS Control Society (GSACS) and with MS University and Gujarat Vidyapeeth, which implement the Saksham project with Global Fund support. Saksham aims to enhance the institutional capacities of counsellor training institutes to undertake capacity building and supervision of counsellors under the National AIDS Control Programme (NACP).

Realising the importance of the issue, GSACS immediately issued an office order to include a session on basics of SRH and rights in the ongoing state-level counsellor’s training funded by Global Fund. This session was facilitated by the Gujarat Koshish team and was attended by 45 counsellors from Integrated Counselling and Training Centres and Antiretroviral Treatment Centres. Our Koshish partners in Gujarat, CHETNA and the Gujarat State Network of Positive People (GSNP+) later interviewed female sex workers (FSWs) and men who have sex with men (MSM) who had accessed counselling services for feedback on the trained counsellors to gauge the effectiveness of the training. The findings indicated a marked improvement in the attitude of counsellors and the quality of service provision. Further, to sustain this innovation, the Koshish team shared feedback with GSACS recommending inclusion of a session on SRH counselling needs of PLHIV and KPs in the counsellor’s training on a regular basis.

Taking the recommendations on board, GSACS issued a circular to the state training institutes working with the Saksham project to include the suggested sessions in the trainings. The Gujarat Koshish team committed to extending facilitation support for these sessions by identified Technical Support Providers (TSPs) from the consultant pool created in Gujarat under this project. In the long run, this initiative will ensure structured and sustained inputs on SRH and rights for counsellors. By leveraging the role of counsellors who are a critical pillar in the service provision flowchart, Koshish was able to achieve a positive change in counsellor attitudes and behaviour and took important steps toward ensuring quality service provision in stigma-free environment for PLHIV and KPs.