Project to improve the quality of life of HIV positive female sex workers by addressing the stigma :
This project is being implemented in 6 targeted interventions of Belguam and Baglakot districts. Project in one TI is funded by International Centre for Research on Women and in remaining by Sankalp project. The duration of the project is one year starting from April 2012 to March 2013.
The female sex workers with positive diagnosis of HIV may suffer from multiple stigmas in the society where sex work is considered as immoral and illegal. Positive Sex workers are particularly vulnerable to human rights violations, including violence. In many instances it was observed that they try to permanently move out from their places. This may affect their children where they drop out from the formal school education.They may suffer stigma and discrimination on multiple fronts due to their gender, caste, occupation and infection, which furthermore excludes them from realising their rights and entitlements.
Poor self worth or esteem causes these positive sex workers a great amount of mental blockage and negative attitude towards their life. Internalized stigma may undermine positive sex workers confidence to access care. Those suffering from depression are reluctant to avail post test care facilities.
Hence, the fear of disclosure linked to stigma and discrimination is a real problem for positive sex workers. They prefer to hide their HIV status from family members, permanent partner, other sex workers, neighbourhood and sex work community for fear of social ostracism. The quality of life of positive sex workers is compromised in the absence of disclosure, or instances of denial, since they consequently have poor access to health care, psycho-social services, and social entitlements through government schemes.
- To improve understanding of forms, manifestation of stigma and discrimination against positive sex workers
- To reduce anticipated and perceived stigma among sex workers and their families
- To reduce internalised stigma among positive sex workers and improve their resilience to cope with stigma
Strategies of the project
There is evidence to show that there is an increase in the number of positive people accessing services as also in the quantum of decentralised services available. But access to care and support is still a challenge for the female sex workers due to prevailing stigma. There are still lot of knowledge gap on various forms of stigma that exists, drivers and facilitators and manifestation of stigma on self, families and communities. Hence, one the strategy of the project is community engagement in unbundling the issues around stigma through a community based participatory process of exploration. This process will also help the various stakeholders (peers and family) in the community in owning the problem, finding joint solutions and developing a vision of future with reduced stigma.
Various structural drivers cause stigma and discrimination for positive sex workers. This is expressed through ‘power over’ the sex worker and their social exclusion. The sex workers indicated that most of these experiences are fuelled by the attitude and practices that prevail in the society and community in which they live. It is sometimes the self stigma and the stigma perceived by the sex worker that may affect her. There is a need to work with sex workers, their community and families of sex workers to reduce stigma. Hence, the strategy of Individual and group based education and reflection process will be adopted to reduce anticipated and perceived stigma among sex workers and their families. In addition the strategy of development of champions from the community and non community to advocate the rights of the positive sex workers will be used.
The positive sex workers experience both physical and social isolation. They internalize these experiences and consecutively feel guilty, ashamed and lose hope. This project provides support, individual counseling and safe space to discuss coping with stigma, building self esteem, disclosure of the HIV status to family, rights and responsibilities, assertiveness, future planning and death and dying. As the sex workers are anxious for their children, some sessions may include children so that the sex workers can plan for the future along with their children.
Another key strategy is capacity building that include capacity building of project staff and implementing NGO/ CBOs to understand issues of stigma and discrimination and on methods and process of conducting facilitated discussion and sessions with community stakeholders, family members and HIV positive sex workers.
Areas of implementation
The program is being implemented in villages of 6 Tis where there more are than 20 sex workers. 87 villages and 10 towns are being covered in this project.
- Staff recruitment is completed and they are in place.
- Finalized on the logical model of the project with technical support from ICRW.
- Finalized the M & E frame work and formats of the project and shared the same with ICRW.
- A detail 10 month action plan like a gantt chart prepared and shared with ICRW.
- Completed meeting with the TI partners and oriented the partners on the project.
- 4 days induction training for the project staff on stigma and discrimination is completed. More than 120 TI staff has been trained.
- Curriculum/modules for the group sessions with PSWs, sex workers and their families prepared and finalized.
- Participatory Assessment workshops with the female sex workers have completed.