HIV in Bihar and role and use of communication technologies in disease control measures

1. HIV in Bihar and role and use of communication technologies in disease control measures Dr Diwakar Tejaswi Consultant AIDS Physician & Medical Director Public Awareness for Healthful Approach for Living (PAHAL) & IHO www.pahalhealth.org www.ihousa.org

2. AIDS in Bihar • 50,000 PLWHA • > 1,30,000 estimated • Specific Issues: • Poverty • Migration • Pure health infrastructure • Miscommunication and misconceptions, Gap in services- Role of confidential communication and counselling in saving lives

3. Samvad Helpline with help of PAHAL and Rotary Pataliputra • Free Confidential Counseling services through mobile phone started on a pilot basis at L S Institute, Exhibition Road, Patna from May 12, 2012. • More than 630 calls made till date. • Examples of some calls-

4. Real People, Real Problems Hello, I am a software professional. I am worried about being HIV positive from a previous exposure. Can I start a family? Hello, Me and my wife are both HIV positive. No doctor is willing to perform MTP on my wife. What should I do? Hello, My daughter is getting married soon. How do I broach the topic of HIV testing to the boy’s side? Hello, I am 30 years old. My cousins are fighting with me over property. They threaten to inject me with HIV. Can they harm me? Hello, I am 15 years old. I have been forced into a sexual relationship. I am scared of getting HIV.? Hello, My son-in-law died of AIDS. My daughter got HIV from him. Her in-laws want to throw her out of the house. Help!

5. Why we started • There was gap in services- • - ART center counselors are overburdened • Social, cultural taboos prevent free discussion on sexuality and therefore on HIV • People don’t know how and where to access help • People don’t want to be seenasking • Ignorance leads to panic or indifference • In uses of all regional languages

6. We thought of solution • Solution - access to correct information and counseling • But, information must be easy to access and use • Hence, a phone based service • Phone is easy to use, no hesitancy to use from a public place like L S Instt. • Can get accurate information from experts • It’s anonymous • It’s there when you need it • It is free of cost

7. What Does this Helpline Do? Many benefits… • Provides accurate information, in time • promotes safer behavior • prevents knee-jerk reaction • gives comfort, confidence • Provide referrals to existing services for HIV in the location of the caller (Do YOU know where the nearest HIV counseling centre is?) • Crisis support: prevents suicides (proved examples) • Avenue for venting, provides psychological support

8. Why Is Samvad Necessary? • Phone is a good way to get people to seek help early • No other free helpline is being operated presently in Bihar – • Life changing impact of our counseling: testimonials from callers

9. Samvad HIV Helpline Samvad has succeeded - • Run by people with the right combination of skills • HIV expertise • Counseling skills • Management capabilities • Passion for making a difference • In operation since 2nd Oct,2005 to June 2012 – Maharashtra • Total Calls- 1,07,000 • In operation since May 2012 at L S Instt, Patna • Total Calls- 630

10. Principles of Samvad • Empathy, being non-judgmental • Providing up-to-date, accurate information • Privacy

11. Samvad Operations: Training • Counsellor Training • About 100 hours of class room training and 3 months practice • About HIV – thorough understanding of the disease • Counseling Skills – right attitude and skill in counseling • Phone Counseling - specific issues related to phone counseling • Mock Sessions • Buddy Training • About 3 months of training followed by 100% monitoring for 2 months

12. Samvad Operations: Software • FAQ database • Ensure that the latest and correct information is available • Provide support for converting the call into an opportunity to inform and educate • Reflect a common policy of the helpline towards questions • Demarcate the scope of the service especially with respect to allied issues

13. Samvad Operations: Networking • Networking • Build links with various service providers, NGOs • Establish Samvad as a credible partner in the fight against HIV/AIDS • Feedback loop on efficacy of referrals where feasible

14. Call Analysis • Typical caller situations • Caller believes exposure has happened and is anxious or in panic • Caller is HIV positive and struggling • Calls about prevention prior to likely exposure, in fear

15. Callers Age Group

16. CALL ANALYSIS ON HIV STATUS

17. CALL ANALYSIS OF PAHAL TILL JUNE 2012

18. We even Intervene

19. Example of Necessary Intervention A case of discrimination against PLH has come to light (this is real problem that has been solved by our telecounselor). We talk to the sarpanch of the village and make him aware of the legal rights of PLH and how discrimination is illegal and a criminal offence. After intervention he was issued BPL card.

20. New Communication technologies for effective control of HIV in this part of India is need of the hour. THANKS