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`Our Vision: Shaping a New Reality (A Vision Document of the Positive Women Network)'
`AIDS Epidemic Update'
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`Balbir Pasha Phase 2'
NGOs working on HIV/AIDS
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Studies / Surveys
`Role of Nongovernmental Organisations in the Prevention and Care of HIV Disease in Women and Children: It Makes a Difference'
`Marriage, Monogamy and HIV: A Profile of HIV-infected Women in South India'
`Mother to Child Transmission of HIV: Situation in India and Programme Implications'
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Surveys / Studies
`Law, Ethics and HIV/AIDS in South Asia: A Study of the Legal and Social Environment of the Epidemic in Bangladesh, India, Nepal and Sri Lanka'
UNDP; The Institute of Law and Ethics in Medicine, NLSIU, India; Action Research Study on the Institutional Development of Human Rights in Bangladesh,
Produced : UNDP Regional Programme for HIV and Development, South and North East Asia, New Delhi, India; 2004; 44 pp.; Price: NA
Abstract :
This is a study of the legal and policy framework for HIV/AIDS, from a rights-based and gender perspective, in four South Asian countries - India, Bangladesh, Nepal and Sri Lanka. The study attempts to understand the practical impact of the epidemic on the lives of those affected and the extent to which the law or law enforcement practices are relevant. It also maps existing laws, judicial decisions and law enforcement practices relevant to PLWHA or to the spread and impact of the epidemic. The aim, ultimately, is to identify priorities for law and legal policy reform in the South Asian region.
The study found very little legislation in the South Asian region that refers specifically to HIV/AIDS. Even public health laws have not been amended to include HIV. As a result, there is much legislation that pre-dates HIV but now affects the rights of PLWHA.
All four countries have written Constitutions that recognise a range of fundamental rights - life, liberty and equal protection of law, among them. The Indian Supreme Court, in particular, has interpreted these Constitutional guarantees to include derivative rights - right to privacy, right to health and medical assistance, right to life with dignity and right to information, all of which are significant in the context of the HIV epidemic. However, the experience of invoking these rights for HIV+ persons has been disquieting.
The study also examines the lack of legal standards in public health and access to healthcare and the issue of privacy and confidentiality. As discussed above, in India - unlike Bangladesh and Nepal - the right to privacy is not explicitly guaranteed in the Constitution and has been judicially derived. However, none of these countries have adequately tested this right in the context of HIV. The right to privacy (and confidentiality) is also closely linked to the contentious issue of compulsory HIV testing. Again, with respect to discrimination in employment, the precise circumstances in which such discrimination will be unlawful have not been clearly defined. Perceived public health concerns could be relied upon to seek to justify discrimination against PLWHA in the workplace.
Similarly, despite the fact that all four countries have ratified CEDAW, there are still many legislative provisions throughout the region that discriminate against women. CEDAW guidelines on HIV/AIDS - avoid stigmatising women and female sex workers, support women?s efforts to get their partners to use condoms, empower women to make their own sexual choices - have gone largely unheeded in the region.
The study also examines the situation of sexual minorities, drug users, sex workers, migrant workers and prisoners. This section also looks at the role played by NGOs and CBOs, health professionals, hospital administrators and the media. The picture that emerges is deeply disturbing.
The text is well supported by highlights of best practices and examples of discrimination. The document ends with recommendations for HIV/AIDS law and policy in South Asia, stressing the need to develop legal policy guidelines through a process of consultation.
Website : www.youandaids.org
Country : India / South Asia
Supported by :
For more information: Contact WFS
`Will Balbir Pasha Get AIDS?: Case Study - An Innovative Approach to Reducing HIV/AIDS Prevalence Through Mass Media Communications in Mumbai, India'
Population Services International
Produced : Population Services International; May 2003; 15 pp.; Price:
Abstract :
PSI looks back at its wildly controversial and very successful ?Balbir Pasha? campaign, which was part of its behaviour change HIV/AIDS intervention programme ?Operation Lighthouse?. The campaign was based on the principle that people can learn by observing the behaviour of others (social learning theory of Albert Bandura). PSI and the advertising agency Lowe, therefore, created a fictional character called Balbir Pasha.
A preliminary study conducted by PSI indicated that the first campaign should be aimed at young men from the lower socio-economic strata. The campaign started with teasers that asked, ?Will Balbir Pasha get AIDS?? The next phase conveyed key messages on HIV/AIDS that would cause the target audience to question their own behaviour. This phase focussed on three key risk-factors for HIV: alcohol, risky sexual behaviour and the myth that people with AIDS necessarily look unwell. The last phase of the campaign encouraged people to call the AIDS helpline for information.
The campaign, which established Balbir Pasha as an icon, generated a huge amount of controversy. Women?s groups, in particular, registered protest against posters and ads that said, ?Balbir Pasha only goes to Manjula, but others go to Manjula too.? The criticism was that this line holds CSWs responsible for passing on AIDS to men, further stigmatising a profession that is already fighting existing stigma and attitudes. PSI?s response is that rather than stigmatising CSWs, it aims to protect them by motivating their male clients to use condoms.
Other criticisms were that the campaign only dealt with the heterosexual mode of transmission of HIV. IDUs and MSM were completely ignored. PSI?s response to this criticism is that any media campaign must be streamlined to address one particular target audience, with focussed messages that get through to that audience, in this case, young men from the lower socio-economic strata.
PSI had engaged an independent research agency (TNS MODE) to conduct an evaluation of the impact of the campaign. After the four-month campaign, 25 per cent of all respondents were able to recall Balbir Pasha spontaneously and connect it with AIDS. This is comparable with the brand recall value of commercial brands like Pepsi (28 per cent) or Colgate (18 per cent). The campaign also, significantly, had an impact on attitudinal change. Before the campaign, only 39 per cent of the respondents who visited CSWs perceived themselves at risk for HIV. After the campaign, 56 per cent perceived themselves at risk.
Why was the campaign so successful? The study answers this question: consumer insight based on in-depth study of target consumer; building of intrigue through teaser campaign; optimal media mix in train posters, billboards and audio-visual media; on-ground activity in the Saadhan helpline; infiltration in popular culture through use of the icon by independent art projects and advertisers; and cutting-edge frankness that allows the message to be conveyed in a hard-hitting manner.
Website : http://www.psi.org
Country : India
Supported by : USAID
For more information: Contact WFS
`When HIV-Prevention Messages and Gender Norms Clash: The Impact of Domestic Violence on Women's HIV Risk in Slums of Chennai, India'
Vivian F Go, Johnson Sethulakshmi, Margaret E Bentley et al
Produced : Department of Epidemiology, Johns Hopkins University, Maryland, USA; Y R Gaitonde Centre for AIDS Research and Education, Chennai, India; and Carolina; September 2003; 10 pp.; Price: NA
Abstract :
There is a direct linkage between marital violence and women?s ability to protect themselves from HIV/AIDS, this study finds. The research team conducted in-depth interviews and focus group discussions among men and women in two randomly selected slums of Chennai, India. Violence has been shown to increase women?s risk to HIV/STDs through three main routes: increased sexual risk-taking in women with a history of sexual abuse in childhood or adolescence; forced sex with an infected partner; and women?s inability to negotiate condom use.
Forty-eight interviews (23 women, 25 men) and 14 FGDs were conducted between October 1, 2000 and February 5, 2001. Focus groups consisted of three to seven same-gender adults from the community. Of the female groups, one was of unmarried participants and six were of married women; of the male groups, three were of unmarried men, two were of married men, and two groups consisted of both married and unmarried participants. The mean ages of men and women were 26 and 28 respectively. Eighty per cent of the women were married, compared to 38 per cent of the men, and 32 per cent of the women and 11 per cent of the men received no education.
Researchers found that while the traditional gender norms for men and women were widely accepted, the behavioural guidelines for men were not strictly enforced. According to the participants, physical and sexual domestic violence is widespread in the slums of Chennai. Factors such as unemployment, illiteracy and poor living conditions can exacerbate domestic violence by increasing marital stress.
Any talk about fidelity, marital sex and condoms between husband and wife are almost exclusively initiated and controlled by the husband. Further, wife-initiated condom negotiation raises suspicions of her infidelity. Efforts by women to practice self-protective behaviours place them at risk for domestic violence. Fear of partner retribution may, therefore, prevent women from negotiating condom use with a husband who, she suspects, may be infected with HIV/AIDS.
The study concludes that to reduce women?s immediate risk to HIV/STD infection, HIV messages promoting condom use and monogamy should also target men. At the same time, long-term, multipronged approaches are needed. Development of an effective microbicide may be critical in settings where domestic violence is pervasive, because women can then covertly protect themselves. Finally, interventions that provide women with the tools to elevate their economic status may psychologically and otherwise empower women to leave abusive relationships in response to violence. Unless violence is recognised and addressed, HIV prevention efforts targeting women in the slums of Chennai may be prove ineffective.
Website : http://www.yrgcare.org/
Country : India
Supported by :
For more information: Contact WFS
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