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"Project
Sakhi" is one of the first peer based
intervention projects for prevention of
HIV/AIDS/STDs among the sex workers in
the North East India which has been implemented
by APS in Guwahati City in Assam . The
project supported by Assam State AIDS
Control Society has been started from
March 2000. Recognising the poor sexual
health status of sex workers in Guwahati
city ,the gateway to the North East India
and their low level of knowledge , present
belief systems, practices in prevention
and care of sexual health , it was observed
that it contributed to a situation where
STD/HIV could spread rapidly and as such
an intervention project felt necessary
was being implemented in the city.
Initially a baseline assessment was conducted
through a sample survey to look into the
issues of social demography, mapping,
behavioral practices among sex workers
, knowledge and attitude towards STD/AIDS
and assessed the prevalence of STDs among
them. There is widespread prevalence of
STD and a poor level of knowledge of STD/AIDS
among the sex workers . There is also
high volume of migration and being the
gateway of the North East a large number
of people enter and exit through this
busy capital city. A very large immigrant
population is also residing in various
pockets of the city. Some sex workers
in the city are young women from the neighbouring
States and also from the neighbouring
countries who cross over the porous borders
Some of the constraints in implementation
of the project is that Guwahati city do
not have any established Red Light area
and as such the sex worker population
are mostly a floating population operating
either on street level or residence based
while others operate as call girls and
from some private hostels of the city
Because of lack of a Red Light area in
the city the situation is much more complicated
and only through the network of peers
have they been effectively reached for
effective intervention through innovative
approaches. The peers are treated as friends
or 'Sakhis' who are looked upon as those
providing help and support and the genesis
of the project .
The principal components of Project Sakhi
are :- I) Behaviour Change Communication
ii) STD diagnosis and treatment iii) Condom
Programming and iv) creating an enabling
environment. Trained outreach and peers
have effectively conducted behaviour change
communication sessions and educated the
clients on various issues of HIV/AIDS.
Support from the community was evident
as with their support a field based health
centre was established to cater to the
health needs of the sex workers . The
project undertook activities for meeting
the needs of the sex workers and addressed
the issues related to education, literacy,
child care, education of children of sex
workers and provided them psychosocial
support.
A large number of sex workers were provided
STD treatment services under the project.
Condom use which were almost non existent
are gradually increasing and because of
the peers-"Sakhis" , their condom negotiating
skills with their clients have improved
. Living a life with very low esteem they
are gradually feeling much secure with
supporting "Sakhis" to whom they can turn
to with confidence anytime they feel the
need.
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