Initiated by the International HIV/AIDS Alliance, with funding from the Bill and Melinda Gates Foundation, the Frontiers Prevention Programme (FPP) supported the delivery of a comprehensive package of interventions within specific geographic sites that were seen as potential high HIV-transmission areas in three low prevalence countries ( India, Ecuador, and Cambodia ). The programme aimed to reduce HIV incidence within the population of selected geographical sites, by reducing risk behavior and STI prevalence among key populations, understood as members of groups' key to HIV/AIDS epidemic dynamics. A comprehensive package with five key set of interventions were under this programme. They are:
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Individually focused health promotion;
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Provision of sexual health services and commodities, and AIDS care;
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Community mobilization;
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Structural and environmental interventions to create an enabling environment;
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Capacity strengthening of local NGOs
Alliance for AIDS Action (AAA), formerly India HIV/AIDS Alliance, Andhra Pradesh, provided strategic and programmatic leadership for implementation of the programme in partnership with local NGOs to supplement community led social capital building initiatives with STI services and condom promotion. The programme was initiated and driven by the community and created opportunities for service delivery and empowerment. The project gave a platform to the community for their voices to be heard by upholding values of Reliance, Respect and Recognition (3 R's). The FPP programme came to an end in December 2007.
Avahan
In addition to the FPP programme the Alliance for AIDS Action also spearheads a similar programme-the India AIDS Initiative-Avahan (IAI-Avahan) programme across the Rayalseema and Telangana regions of Andhra Pradesh. The prevention programme targeted at Key Population (KP) groups, such as Female sex workers, Men who have sex with men (MSM), People living with HIV & AIDS (PLHIV) and Injecting Drug Users (IDUs), is supported by the BMGF. Alliance, AP, currently is working with 37 implementing NGOs across 140 sites in 14 districts. The coverage of Key Population from 56,942 in 2006 to 73670 in 2007, the program so far has covered 42,663 sex workers 24,079 MSM, 657 IDU and 7,521
The program also treated 49345 episodes of STI (an increase of 78% over cumulative of 2006) and distributed 27484829 condoms (an increase of 16% in 2007) through 94 community based clinics, 70 CBOs and 103 drop-in centers. A state level sex workers network and three district level organizations of sex workers, MSM and PLHA have also been strengthened during the reporting period.
Alliance for AIDS Action developed a new strategy to address the challenges faced by key populations in advocating against police harassment, stigma, discrimination and access to social services. The Core Advocacy Group concept is a model for involving community members at all levels, building their skills and empowering them to take action, with key population leadership at the core.
AAA also uses innovative methods like Magnet Theatre and Shadow teams to raise the awareness among community members about their rights and creating an enabling environment to access the already existing services.
START AP
This is an innovative project in partnership with APSACS and District hospital at Karimnagar for providing quality Anti Retroviral Therapy (ART) services to Persons Living with HIV/AIDS (PLHIVs). The project aims to link existing prevention programme in the district with treatment services, support and coordinate community mobilization of marginalized populations and general populations to ART services. It further aims to build capacities of support groups and peer - counselors and build linkages between Mythri Centre, ART Centre and Positive Networks. It will also support and collaborate with APSACS and ART Centre on the development of Project Operational guidelines, Provide international technical assistance to the programme and support monitoring and evaluation for ART related services.
As far as community mobilisation is concerned there are 1033 PLHIV registered and 50 CLHIV in the Programme in the three NGOS, GNNS , REACH and SEWS in Karimnagar district so far. There are about 44 support groups formed with the PLHIV in the project. The support groups meet once in every month among themselves. There are also registered PLHIV CBO in each of the NGOs.
In 2007, there were about 412 referrals from the NGOs to VCCTC/ ART Centre/ CD4 tests, Karimnagar out of whom 385 have got CD4 Count Tests done. Among the PLHA in the Projects, 168 adults and 13 children are on ART. Since the start of the START AP project, nearly 600 PLHIV have been treated for Opportunistic Infections through the Mythri Clinics in the three NGO in Karimnagar District.
Chaha Project
Alliance for AIDS Action is one of the sub recipients of Global Fund Round 6. The overall goal of the programme is to reduce HIV-related morbidity/mortality in adults and children and address the impact of HIV on children. The objective of CHAHA is to improve care-and-support services to children living with HIV/AIDS (CLHIV) and children affected by HIV/AIDS (CAA) and enable interventions which keep them with their parents or extended families.
Till September 2008 the total number of children registered below 18 years of age who benefited from the care and support package is 586 children.
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Health/ medical care: This includes primary health care, immunisation, early identification of HIV status for children and treatment and follow-up for ART. Four children were referred to the ART centre in quarter-II. The formal linkages with the ART centers have been established, the formal linkages with ICTC, TB, ART, Govt. Hospitals and FPP Mythri clinics are built in all three districts. The referrals for Opportunistic Infections have been done since the beginning of the project. All the three NGOs have own Mythri clinics.
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Educational support: This consists of enrolment in formal and non-formal schools, support in school supplies, private tuitions, skill or vocational training for children more than 14 years. Under this education support programme, children are supported by payment of school fees, uniforms. In both the first and second quarters, 29 children were provided with education support by the NGOs.
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Psychosocial support: Under this children are counselled on different aspects - supportive, bereavement and spiritual. The outreach staff visits the families and provides the psychosocial support by conducting structured sessions by the counsellors. There are one-to-one sessions and one-to-group sessions held for caregivers and children.
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Income generation support: Through this family members are given some assistance for taking up income-generation activities About 19 families were identified for the income generation programme. The families came up with different proposals for which financial aid was provided.
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Supplementary Nutrition Support: Nutritional support does not mean merely extending supplementary nutrition, it includes nutrition demonstration, counselling, nutritional supplements to CLHA/CAA. Under this programme, various kinds of food items are provided to the families and children, like dal, ragi powder, groundnut oil, sesame seeds (til) with jaggery and wheat rava. In the period between October and December 2007, 58 children received supplementary nutrition - about 45 CAAs and 13 CLHIVs from all the three NGOs.
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Counselling: The outreach staff and counsellors have been conducting structured community counseling sessions conducted with the families and children.
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Household support: In emergency situations, this assistance could include any form - food, travel to hospital, funeral, diagnosis expenses, medicine expenses, cloth or coat, ration etc, depending on the need of the family. Most of the families were provided with ration. About 93 families were given basic household support by the NGOs.
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Foster care: This denotes financial/material support to care giver of CAA/CLHA for taking care. Three children were identified and provided foster care support in the last two quarters.
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Children support group: Group formed with a purpose of providing counselling and support within the group members. The members of the support group should be children living with and/or affected by HIV/AIDS and below 18 years of age. The main objective of this group is to discuss issues related to living with HIV, providing compassionate counselling and support to its members. In last quarter two children support groups were formed by two NGOs.
