DMSW Project

A
STUDY ON THE
PROBLEM OF SERVICE DELIVERY
OF THE PEOPLE LIVING WITH
HIV/AIDS OF FOUR BLOCKS OF
INDORE DISTRICT
A Study Conducted in Four Blocks of Indore District
(Indore, Mahu,Hatod and Depalpur)
This Dissertations is submitted for the partial

fulfillment of
Master in Social Work
(Final Year)
At
Mahatma Gandhi Chitrakoot Gramoday

Vishwavidyalaya
Satna (M.P.)
Research Superviso:-
Submitted
By:Dr. P.C. Mohapatra

Singh Sisodiya
Mr.Hemant
Director, COATS, Indore

13/0762610809
Distance Education Center
Roll.No:-
DEVI RUDRAPRIYA SHIKSHA PRASAR

SAMITI. CHHATARPUR
CERTIFICATE
This is certify that Mr.Hemant Singh Sisodiya student of
Master Degree in Social Work from Mahatma Gandhi Chitrakoot
Gramodaya Vishwavidhyalaya
Satna (M.P.) was working under my
supervision and guidance for herDissertationst work for the course

MRDP -001 her project work entitled "A study on the problem
of service delivery of the people living with HIV/AIDS of four
blocks of Indore district" which she is submitting, is her genuine
and original work.
Place :
Date :
Indore
Dr. P.C. Mohapatra

Project Supervisor
DECLARATION
I hereby declare that the desertion entitled as "A Study on
the Problem of Service Delivery of the People Living with
HIV/AIDS of Four Blocks of Indore District" submitted by me for
the partial fulfillment of Master Degree in Social Work to
Mahatma Gandhi Chitrakoot Gramodaya Vishwavidhyalaya is my
own original work has not been submitted earlier either to

Mahatma Gandhi Chitrakoot Gramodaya Vishwavidhyalaya or
to any other institution for the fulfillment of the requirement for any
other course of the study. I also declare that no chapter of this
manuscript in whole or in part is lifted and incorporated in this
report from any earlier work done by me or others.
Place : Indore
Singh Sisodiya)
Date
:
(Hemant
II
Acknowledgement
I express my gratefulness to P.C. Mohapatro, Director of
COATS, Indore under whose supervision and guidance I have been
able to complete this work.
I epitomize my deepest sense of gratitude for his valuable
guidance, keen interest innovative ideas and persistence endeavour
throughout
the
course
for
investigation
and
supervising
for
preparation of the manuscript.

I do express my indebtedness and heartfelt gratitude to the
Reader in Tribal Studies and Retd. Reader in Economics, Jagabandhu
Samal for his cooperation throughout the investigation.
I feel elevated in expressing my profound gratitude to SOVA
an NGO for their valuable suggestion and for sharing information
related to HIV/AIDS and guidance throughout my investigation.
I wish to express my deep sense of love and affection and
thankful to Mr. Santosh Kumar Pnada (Nikhil Communication, Indore,
Madhya Pradesh) who has helped me to design the project in
computer.
Last I bow my head before the almighty, whose blissful
blessings always stands as able company in every walk of life.
Place :
Indore
III
Date : 5th July 2015

Sisodiya)
(Mr.Hemant
Singh
IV
Abbreviation
STI
Sexually Transmitted Infection
HIV
Human Immune deficiency Virus
AIDS
Acquired Immune Deficiency Syndrome
BPL
Below Poverty Line
APL
Above Poverty Line
NREGA :
National Rural Employment Guarantee Act
SOVA
South Orissa Voluntary Action
NGO
Non Government Organization
MPSAC :
Madhya Pradesh State Aids Control Society
NACO
National Aids Control Society
VCCTC :
Voluntary Counseling and Confidential Testing Center
ICTC
Integrated Counseling and Testing Centre
INP+
Indian Network for Positive People
PLHIV
People Living with HIV AIDS
Contents
Certificate
Declaration
Acknowledgement
Abbreviation
Contents
Tables
Map of Madhya Pradesh
Map of Indore Block
Map of the Study Area (4 Blocks)
I
II
III
IV
V
VII
VIII
IX
X
Chapter - One INTRODUCTION

Introduction
National HIV/AIDS Figure
Situational Analysis
Origin of HIV
How does HIV causes AIDS
Symptom of HIV
Prevention of HIV
Role of NGO in HIV Control
Government Responsibility
1
2
3
5
5
8
9
11
12
Chapter - Two RESEARCH DESIGN

Problem Statement
Hypothesis
Universe of Study
Methodology of Study
Indore District Profile
14
14
14
15
15
Chapter
Three
- SITUATIONAL ANALYSIS REGARDING HIV/AIDS

Situational
Analysis
Regarding
HIV/AIDS
Age wise Distribution of PLHIV
Education Level of PLHIV
Profession of PLHIV
Chapter
Four
- PROBLEMS OF THE PEOPLE LIVING WITH

HIV/AIDS
Problem of the People Living with
HIV/AIDS
Profession Category Caste wise of
PLHIV
20
23
24
25
27
28
VI
Other Problem of PLHIV

ARV Drugs
Case Studies
30
32
33
Chapter - Five HIV/AIDS HAS NO CURE

HIV/AIDS Has No Cure
State Level Strengthening
Network of PLHIV
Role of NGO in Indore District
37
Chapter - Six
SUGGESTIONS AND FINDINGS OF THE

STUDY
Suggestion and Findings of Study
Some Ways to Reduce Risk and
Vulnerability to HIV Infection
Summary of the Study
42
Questionnaire
Bibliography
Reference
Project Proposal
Chapterisation
A
E
G
H
L
VII
Tables
TABLE
NO.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
TABLE TITLE
PAGE
State wise Cases of AIDS Case

Risk Transaction
Modes of Transmission
Age Group Highlights of the District
Demograhy
Agriculture Profile
Road Networking
Educational Profile
Age Wise Distribution of PLHIV
Socio Economic Status of the Affected
People
Education Level of PLHIV
Case Distribution of PLHIV
Profession Categories of the PLHIV
Number of the Death in PLHIV
Suffering of PLHIV - Infections
Suffering of PLHIV - Medicine
Socio-Economic Status of PLHIV
Distribution of PLHIV
Profession Categories and Caste Wise
Mode of Transmission of HIV (Virus)
among the sample
1
2
3
16
17
17
18
18
23
23
24
24
25
26
26
26
27
27
28
28
VIII
Map of Madhya Pradesh
IX
Map of Indore District
Map of Study Area

(Four Blocks of Indore District)
XI
Chapter - One
Chapter - One
INTRODUCTION
HIV/AIDS The Problem and Analysis

AIDS (acquired immune deficiency syndrome) which one of the most
dreaded pandemic of human society and this has spread every corner of the
world .and this is stumbling block for every developmental issue for the human
civilization. The pandemic is surrounded by myths, misconception and ignorance.
In India the pandemic is first detected in the year of 1986 at Chennai and is now
the serious public health issue. NACO estimates that there were 5.21 million
Indians living with HIV at the end of 2005. It means 0.91 of our population has
HIV/AIDS
AIDS is a Serious Pandemic
AIDS affects the people in maximum percentage when he is at the
productive age of nation, community and as well as to his family. AIDS so far is
not curable and since HIV is transmitted predominantly through sexual contact,
and with sexual practices being essentially a private domain, these issues are
difficult to address.
When people are infected with HIV they do not die of HIV or aids. These
people die due to the affects that the HIV has on the body. With the immune
system down, the body becomes susceptible to many infections, from the
common cold to cancer. So here people die due to the any common element of
opportunistic infections not for aids. Table 1.1 given below indicates the state
wise number of cases suffering from AIDS.
Table 1.1 : State wise Number of AIDS Cases
Sl No
1
2
3
4
5
6
7
8
State or Union Territory

Andhra Pradesh
Arunachala Pradesh
Andaman and nichibar Islands
Bihar
Chattisgada
Delhi
Daman and diu
Dadar and nagar haveli
Aids Cases
15099
13
37
155
1934
2759
1
0
Sl No
9
10
11
12
13
14
15
16
17
18
19
20
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
State or Union Territory

Goa
Gujrat
Haryana
Himachala Pradesh
Jharkhand
Jammu and Kashmir
Karnataka
Kerela
Lakshadweep
Madhya Pradesh
Maharastra
Madhya Pradesh
Nagaland
Manipur
Mizoram meghalaya
Podicherry
Punjab
Rajastan
Sikkim
Tamilnadu
Tripura
Uttarnchal
Utterpradesh
West Bengal
Ahamadabad municipal
Chennai M C
Mumbai M C
Total
Aids Cases
657
6873
655
302
258
2
4345
1769
0
1729
14325
641
736
2946
106
302
454
1153
8
52036
5
79
1751
2397
726
0
10362
124995
Source : www.nacoindia.com
Table 1.2 : Risk/Transmission Categories

Sl No
1
2
3
4
5
Modes of Transmission
Sexual
Perinatal transmission
Blood and blood products
Injecting drug users
Other not specified
Total
No. of Cases
106669
4755
2563
2930
8075
124995
Percentage
85.34
3.80
2.05
2.34
6.46
100.00
Age group
0 to 14 years
15 to 29 years
30 to 49 years
> 50years
Total
Male
3313
23905
54204
6823
88245
Female
2283
15876
16701
1890
36750
Total
5596
39781
70905
8713
124995
Source : www.nacoindia.com
Table No. 1.2 gives the information about the modes of transmission and
the number of affected persons under each age group. The table indicated that
there a total of 110686 cases which belong to the age group of 15 to 50 years.
This indicated that the economically productive group of people is the most
affected people. This table also highlights that 85.34 % of the people are having
this virus through sexual transmission and the others fare less in number
Situational Analysis
Now India occupies the second position of HIV infection rate after South
Africa although the overall prevalence remains low. Some stated experience a
generalized epidemic with various transmitted from high risk group into the
general population. A major challenge is to strengthen and decentralize the
program in the state and district levels to enhance commitment, coverage and
effectiveness
Women are More Vulnerable than Men
It has been proved that women are more vulnerable to HIV infection
because of biological and social reasons. A woman has three times more risk to
infection of HIV. If women are infected with STI she is 13 times more prone to
HIV infection.
It is therefore most important to note that every woman has
access to information about HIV/AIDS to protect herself.

AIDS Infect Children Too
A layman may be astonished to find that a child is infected with HIV but it
is absolutely true that a child is also infected with HIV from their parents.
Parents means especially from mother. A child may be infected with HIV during
pregnancy and birth.
HIV is a virus that causes AIDS.
This virus passes from one person to
another through blood to blood and sexual contact.
In addition, can infected
pregnant women can pass HIV to their babies during pregnancy or delivery, as
well through breast feeding, people with HIV have what is called HIV infection;
most of these people will develop AIDS as a result of their HIV infection.
HIV (Human Immune Deficiency Virus)
It is a retro virus that causes AIDS. There are four numbers of modes of
Transmission first one is unprotected sexual contact second using of unsterlised
injection, third receiving of HIV blood and last one is transfer through blood
mother to child. Most of these people will develop aids as a result of their HIV
infection.
Following are the body fluid where the virus can exist
BLOOD
SEMEN
VAGINAL FLUID
BREAST MILK
OTHER BODY FLUID CONTAINING BLOOD
These are additional body fluids that may transmit the virus to those
health care workers who may come into contact with Cerebrospinal fluid
surrounding the brain, the spinal cord Synovial fluid surroundings bone joints and
Amniotic fluid surrounding a fetus.
ORIGIN OF HIV
Scientists have different theories about the origin of HIV, but none have
been proved as cent percent correct. The earliest known case of HIV was from a
blood sample collected in 1959 from a man in Kinshasha, democratic republic of
Congo (how this person was infected with HIV that has not been proved).
Genetic analysis of this blood sample suggests that HIV 1 may have estimated
from
single
virus
in
that
late
1940s
of
nearly
1950
(Source
www.nacoindia.com)
We do know that the virus has existed in the United States since at least
the mid to late 1970 from 1979-1981 rare types of pneumonias, cancer and
other illnesses were being reported by doctors in Los Angels found New York
among a number of gay male patients. These were conditions not usually found
in people whose healthy immune systems
In
1982 public
health
officials
began
to use
the
term
acquired
immunodeficiency syndrome or AIDS to describe the occurrences of opportunistic

infections, Kaposis sarcoma and Pneeumocystis Carnii Pneumonia in previously
healthy men formal tracking (surveillance) of AIDS cases began that year in the
United States.
One of the main causes of AIDS is virus that scientists isolated in 1983.
The virus was at first named HTLV-III/LAV (Human T-Cell Lymph Tropic Virus TypeIII/Lymphadenopathy
associated
virus
by
and
International
Scientific
Committee. This name was later changed to HIV.

HOW DOES HIV CAUSES AIDS
HIV destroys a certain kind of blood cell CD4 T C (Helper Cell) which is
crucial to the normal functioning of the human immune system. In fact loss of
these cell in people with HIV is and extremely powerful predictor of the
development of AIDS. Studies of thousands of people have revealed that most
people infected with HIV carry the virus for years before enough damage is done
of the immune system for aids to develop.
However, recently developed
sensitive tests have shown a strong connection between the amount of HIV in
the blood and the decline in CD4 T Cell numbers and the development of AIDS.
Reducing the amount of virus in the body anti HIV drugs can slow this immune
destruction.
FOUR STAGES OF HIV INFECTION
Stage 1 Primary HIV Infection
This is the most important cause after infection. The only symptom during
the stage is an illness, commonly mistaken for the flu window period (the window
period is the time it takes for person who has been infected with HIV to react to
the virus by creating HIV antibodies). This is called seroconversion during the
window period, people infected with HIV have no antibodies in their blood that
can be detected by and HIV test, even though the person may already have high
levels of HIV in their blood sexual fluids or breast milk anti bodies generally
appear within three months after infection with HIV but may take up to six
months in some person.
Stage 2
Asymptomatic period while the viruses in this stage, very few symptoms
are experienced. The most common is swollen glands. This is significant because
while no outward signs are felt, the HIV virus is very active in this area here it
kills many helper t cell and spawns large amount of new viruses. Most HIV in the
test tries to measures the viruses that are put aside this area and it may became
instrumental in the next set of anti HIV treatments
Stage 3
This stage is known as symptomatic HIV infection the virus has begun to
defeat the immune system. The virus finally wins the battle against the immune
system for one or more of three reasons are that the HIV caused damage to the
lymph odes where most of its activity takes place. Another is that it destroys
more t cells than the body builds. That possibility is that strain of HIV is created
that is more dangerous to the body either way several years of stalemate
between the Body and the virus are over from here the infection soon precedes
to stage 4.
Stage 4 is AIDS
In this stage, the body immune system has been incapacitated, a

opportunistic infection has a clear path to attack the victim and so they must be
careful not to catch another disease at this point, HIV has done all the damage
that it can do and the body is in very hazardous position.
Time taken for HIV to causes AIDS
Since 1992 scientists have estimated that about half the people with HIV
will develop AIDS within 10 years after becoming infected. This time varies
greatly from person to person and can depend on many factors including a
person's health status and their health related behaviour.
Today there are medical treatments that can slow down the rate at which
HIV weakens the immune system. There are other treatments but they do not
cure AIDS itself.
AS WITH OTHER DISEASES EARLY DETECTION OFFERS MORE
OPTIONS FOR TREATMENT AND PREVENTIVE HEALTH CARE.

MODES OF TRANSMISSION OF HIV
Already it has been discussed that there are four numbers of roots for HIV
transmission.
Unprotected Sex
When we say unprotected sex that is the sex without using of condom
though there are varieties of sexual orientation but the following are the main
root cause of infection of HIV
Vaginal Sex
Vaginal sex means the male sexual organ penis enters inside the women
sexual organ vagina and that penetrates without condom and this is one of the
reasons for transmission of virus.
Anal Sex
This sex a male enters his sexual organ inside the anus of an individual
without condom and penetrates without condom this is the greatest cause of
transmission of HIV.
Oral Sex
Where there is connectivity between mouth and sexual organ this sex is
known as oral sex but this sexual orientation has less chance of HIV
transmission.
Sharing of Needles
Sharing of needles is one of the important reasons for HIV infection people
shares needles during ill health, taking drugs and creating body art that is
peering. These are the risk behavior for receiving unsterilized injection.
Transfusion of Blood
HIV can also be transmitted by the transfusion, of infected blood or blood
product.
Mother to Child
A mother can transmit HIV to her baby during conceive during delivery
and during breast feeding. The percentage of transmission of HIV from mother
to child is 40%.
Symptom of HIV
The only way to determine for sure whether you are infected is to be
tested for HIV infection. You cannot rely on symptoms to know whether or not
you are infected with HIV. Many people who are infected with HIV do not have
any symptoms at all for many years
The following may be warning signs of infection with HIV
Rapid weight loss
Dry cough
Recurring fever or profuse night sweats
Profound and unexplained fatigue
Swollen lymph glands in the armpits. Groin. Or neck
Diarrhea that lasts more than a week
White sports or unusual blemishes on the tongue, in the

mouth or in the throat
Pneumonia
Red, brown, pink or purplish blotches on or under the skin or
inside the mouth nose or eyelids
Memory loss, depression, and other neurological disorders
However, no one should assume they are infected if they are

infected if they have any of these symptoms each of these symptoms
can be related to other illness.
Again, the only way to determine whether you are infected is to be tested
for HIV infection.
Misconception about HIV
Ordinary
social contact, for example shaking hand, hugging.
Travelin
g in the same bus eating from the same utensil.
By
kissing.
By
mosquito or any other insect or animal bite.
It is not
water borne.
It is not
air borne.
Prevention part of HIV

There is a simple principle of prevention of HIV that is principle of A B C
here.
A stands for Abstinence
B stands for Be faithful
C stands for Consistence use of condom
Secondly there should be use of new syringes or needles each time
otherwise that should be sterilize for 20 minutes
Thirdly during transfusion of blood the must be tested for HIV
Fourthly though there are 30% chances for HIV from mother to child but
this could be reduces almost 0% by proper counseling and taking medicine but
one should remember that here the HIV will be negative to the child not to the
mother .
Sexually Transmitted Disease Facilitate HIV Transmission
Every STD causes some damage to the genital skin and mucous layer,
which facilitates the entry of HIV into the body. The most dangerous are
Syphilis
Cancroids
Genital herpes
Gonorrhea
Testing Facilities for HIV

One can get tested provided by NACO (National Aids Control Organization)
OSAC (Madhya Pradesh State Aids Control Society)
And there are establishment of VCCTC (Voluntary Counseling and
Confidential Testing Center) at every district of India.
Co-infection HIV and TB
Tuberculosis kills nearly 3 million people globally of whim nearly 50% are
Asians. The rapid spread of HIV in the region has further complicated the already
serious situation. Not only is TB the commonest lire threatening opportunistic
infection among patients living with aids but the incidence of TB has now begun
to increase, particularly in areas where HIV seroprevalance is high multi drug
resistant TB is also quite common in many areas.
Treatment for HIV/AIDS

All the currently licensed anti retroviral drugs. Namely AZT DDI DDC have
effects which last only for a limited duration. In addition these drugs are very
expensive and have severe adverse reactions while the virus tends to develop
resistance rather quickly with single drug therapy. The emphasis is now on giving
a combination of drugs including newer drugs called protease inhibitors, but this
makes treatment even more expensive.
WHOs present policy does not recommend anti viral drugs but instead
advocates strengthening of clinical management for HIV associated opportunistic
infections such as tuberculosis and diarrhea. Better care programmes have been
shown to prolong survival and improve the quality of life of people living with
HIV/AIDS .
PEOPLE
LIVING
WITH
RESPONSIBILITIES
Since
everyone
is
HIV/AIDS
entitled
to
HAVE
SPECIAL
fundamental
human
RIGHTS
rights
AND
without
discrimination, people living with HIV/AIDS have the same rights as Seronegative
people to education, employment, health, travel, marriage, procreation. Privacy,
social security, scientific benefits etc. seronegative and seropositive people share
responsibility for avoiding HIV infection and re-infection. But many people
including women, children and teenagers, not negotiate safer sex because of
their low status in society or lack of personal power. Therefore men whether
knowingly infected or unaware of their HIV status, have a special responsibility of
not putting others fat risk.
Role of NGO in AIDS Control
NGO have an important and special role to play. The close interpersonal
interaction that NGO have with people in the communities they work is
extremely useful for implementing the behavior interventions necessary for
HIV/aids prevention and care NGOs are also not under the same political
constraints as government programmes are. They therefore have greater
flexibility and the capacity to accommodate changing programmes and public

needs and can innovate and implement new initiatives more easily
Governments Responsibility
Government is responsible for ensuring that enough resources are
allocated to AIDS prevention and care programmes, that all individuals and
groups in society have access to these programmes, and that law. Policies and
practices do not discriminate against people living with HIV/AIDS.
Governments
of development countries have a moral responsibility to share the aids burden of

developing countries.
Chapter - Two
Chapter
Two
RESEARCH DESIGN
Statement of the Problem

AIDS is considered as the greatest pandemic in the globe. This is the major
health concern for the world. It is not just a health issue it is cross cutting issue
that affects every element of human development. It has also posed a major
problem in the Asian countries.
HIV and aids is now becoming a killer disease and spreading very rapidly
in Indore district of Madhya Pradesh. While offering curative care to
aids
patients seems to be a distant reality in the absence of vaccine evolving

strategies to control it, an immediate and effective response is required from
every educated individual of this country, this study introduces to social
determination to prevent and control it. For this an immediate effective response
is required from every educated individual of this country. This study introduces
to social determents of behavior patterns and practices that facilitate HIV
transmission and social dimensions of HIV and aids prevention.
This dissertation tries to understand the various problems of HIV and aids
patients of backward tribal dominated areas like Indore district
Objectives
The study is undertaken with the following objectives
1. To know the socio economic back ground of the people infected with
HIV/AIDS
2. To know the incidence of aids related complicated among the PLHIV
3. To access the knowledge and awareness level about HIV/AIDS of PLHIV
and their family member
4. To study the discrimination back ground towards PLHIV
5. To study the socio psychological and counseling problems of HIV
infected person
6. To evaluate the initiative implemented by Govt. and NGO for creating
awareness and controlling further spread of the pandemic
Hypothesis
The following hypothesis are proposed to e tested in course of the study
The sexually active and economically productive age group (14 45) age
group account for the major HIV/AIDS cases in Indore district.
The high risk group also belongs to SC and ST or socio economically
backward population
The measures taken by government and non government organizations
are not adequate to solve the problem.
Universe
The universe of the present study include Indore district of Madhya
Pradesh for four blocks these it is a back word district with heavy concentration
of ST ad SC and other weaker sections of the society .
Nearly 50% of the people of the district belong to ST and 14% SC (2001
census) in addition to ST and SC there are also other backward people living in
the district who are economically poor and socially backward 78.65% of the
people in the undivided district live below poverty line ( as per human
development report )
Due to poverty and unemployment people generally migrate outside
districts and states in search of employment. Migration of people in and out of
Indore is one of the causes of spread of HIV/AIDS in Indore. The main cause of
spread of HIV is sexual contact transmission from mother to child.
There are
some causes due to use of unsterilized syringes also. Transmission of blood

transfusion is also one of the causes but it is very rare.
Patients registered in the district headquarters hospital will be the main
focus of the study. The scholar intends to study of the cases of Indore 17% to
20% of the PLHIV on the basis of a random sample.
Methodology of The Study
Both primacy and secondary sources of information will be taken into
account secondary sources include information from various books, journals,
newspapers and the internet. Data from NACO, Madhya Pradesh state aids
control society and district head quarter hospital and ICTC of Indore will also be
collected for this purpose. Primary sources include data collected through
personal survey interviews and case studies
Tools of Data Collection
The main tool of data collection will be an interview schedule which will be
administered to the patients of area. The interview schedule consists of simple
questionnaire relating to the household particulars, kind of job in which one is
engaged, the level of income and the like. In addition to this case studies shall
also be used as a tool for data collection. Direct observation method shall also be
used for getting required information
Data Analysis
Data shall be coded, verified and analyzed using statistical methods and
processed on computer. Simple average will taken while analyzing the data Bar
and pie graphics are drawn to highlight each coded data.
Limitations
As an individual scholar with limited time and resources at my disposal it
is difficult to cover the whole area on a census method. The scholar has taken
adequate measures to choose the sample which represent the entire universe.
INDORE DISTRICT PROFILE
Geographical Statics
Indore district undivided was created on 1st November 1956. The present
Indore district has a population of 11,80,637 as per 2001 census.
constitute 52% of the total population.
Latitude
170 to 40 - 27 North
Longitude
810 24 - 84 degree 2 east
Altitude of Dist. Hq.
2900 ft from the sealevel
Geographical area
8379 sq km
Pradesh )
Table 2.1 : Highlights of the District
0
Sub divisions
02
Males
1
0
2
0
3
0
4
0
5
0
6
0
7
0
8
0
9
1
0
1
1
Tahasil
14
C d block
14
Towns
05
Municipalities
NAC
Police station
20
Gram panchayat
226
Villages
a) Inhabitant
b) Uninhabitant
199
8
191
6
82
02
Fire stations
Assembly
constituencies
04
Source: www.indore.nic.in
The above table gives information about the tahsils, Blocks, Gram
panchayat. Total villages etc Indore district is a tribal dominated district. As per
the 2001 census 49.62% of the districts population belong to the scheduled
tribes. The important tribes are parajas. Gadabas. Kandhas. Kotias. Bhumiyas.
Shouras. Bhatras and pentias etc
Table 2.2 : Demography
Total population
11,80,6
37
Total male population
5,90,74
3
Total female population
5,89,89
4
Percentage of literacy
35.72%
Percentage
of
male 47.20%
literacy
Percentage
female 24.26%
literacy
Literates (male)
2,31,05
5
1,18,98
9
Total literates
3,50,04
4
S
T
population 49.62%
( percentage )
SC
population 13.41%
( percentage )
Total house holds
2,84,87
6
Below poverty line ( BPL 84%
)
Literate female
Source: Census of India-2001
The tribal constitute 49.62% to the total rural population of the district, the
tribals are generally backward both socially and economically. Poverty, illiteracy,
ignorance and above all simplicity are the major factors which make their
economy mostly marginal. Womens contribution to the economic growth of the
tribal society is quite substantial. Nearly 88.48% of the people in Indore region
live in the villages Indore has an average literacy rate of 35.72%, lower than the
national average of 54.50%, male literacy is 63.24% and female literacy is
45.15%. In Indore 12% of the population is under 6 yeas of age.
Table 2.3 : Agriculture profile
Total cultivated land
Irrigated area ( kharif )
Irrigated area ( rabi )
Area under paddy
Area under pulses
Area under oil seeds
Area under minor millets/coarse
cereals
3,01,000
Ha
78,
000Ha
46,000
Ha
1,13,000
Ha
25,630
Ha
12,610
Ha
1,05,00H
a
The main occupation of the people of Indore district is agriculture and as

daily wage labour. Tribals in particular depend upon cultivation and collection of
forest products for their living. They also go for wage work to supplement their
earnings. Women perform a major part in agricultural operations like manuring,

weeding. Transplanting, harvesting, threshing etc. they also lend a helping hand
in other small and cottage crafts like rope and basket making etc.
Table 2.4 : Road Networking
Road
Kilomete
r
high 157
National
way
State high ways
Road
and
building
RWD
P.S road
G p road
Forest road
195
430
1023.80
860
4973
210
The National Highway 43 is passing through Indore district from

Vishakhapatnam in Andhra Pradesh to Jagadalpur in Chhattisgarh. Recently it has
been found that some of the villages are connected with cement concrete roads,
the programme like NFFWP and NREGA etc. initiated by the Govt. of India.
Indore people frequently visit the nearby town either for labour work, marketing,
and visit to the district hospitals for different purposes. Development of road
communication brings in a lot of migrant labor and truckers to and from Indore
district.
Table 2.5 : Educational Profile
Type of school
Numbers
school
Primary
1911
Upper primary
230
UGME
236
High school
109
Colleges
18
C.T school
1
Technical school
1
B ed college
1
Central school
1
School for the blind
1
School for the deaf and 1
dump
of
The above table gives a picture about the schools and colleges in Indore
district. Education holds the key to the socio economic and cultural development
of the society but the tribal female literacy in Madhya Pradesh has continued to
remain at the lowest level. The rate of literacy is only 35.72% as against the
state average of 63.61%. The rural literacy rate in general was 27.30%, which
consisted 39.16% males and 15.61% females (Census India 2001).
Chapter - Three
Chapter
Three
SITUATIONAL ANALYSISL REGARDING

HIV/AIDS
In India it is estimated that there are 2,45,000 HIV population.
The
surveillance rate of percentage has crossed to 0.7%. Approximately 70% of total

infected population in Madhya Pradesh are in the economically productive age
group. 80% of mode of transmission is through sexual routes. The major factors
for spreading HIV in Madhya Pradesh are migration in research of work in and out
migration. Low literacy, poverty, growing urbanization, inject able drug users,
unsafe sex practices (both homo and heterosexual and ignorance about the
modes of transmission of HIV/AIDS
In the context of HIV transmission, Madhya Pradesh is one of the moderate
prevalence states in India, but in close proximity if we analyze in rural setting the
prevalence of STI/RTI and HIV is more because of pre martial sex. Early marriage,
migration and illiteracy are the concern factors which are contributing to the
spread of HIV/AIDS in the state as per the report of the state AIDS control society.
The Madhya Pradesh HIV situation is at a crossroads. As per the report of the
state AIDS control society, Madhya Pradesh in 2002-2005 the total blood samples
screened was 54,857, out of which the total no of HIV cases were 3981 (2650
Males and 1331 Females) and the number of aids cases were found to be 725
and the number of deaths due to aids was 543 (Source : OSAC).
Indore has the 3rd highest incidence of HIV/AIDS among the district of
Madhya Pradesh, because passing of the NH 43 in two boarder states Andhra
Pradesh and Chhattisgarh, there has been an increase in the prevalence of
HIV/IDS and STI among the truckers, migrant workers in the district.
It was
reported on 1st December 2005 by the state aids cell that Indore is the high
prevalence district in HIV/AIDS and STI among the truckers, migrant workers in
the district. It was also reported on 1 st December 2005 by the state aids cell,
that Indore is the high prevalence district in HIV/AIDS in Madhya Pradesh
particularly in the rural setting. As per the VCCTC, INDORE IT WAS REPORTED
THAT OUT OF 2145 cases tested HIV 311 cases were found HIV positive. Out of
them 23 children were infected and more than 50 children were affected. Mostly
women and children are more vulnerable because of aids increased vulnerability
of the district of Indore. It is absolutely important to provide the basic prevention

and care and support package to reduce the incidence of HIV/AIDS and STD.
OTHER REASONS FOR VULNERABILITY
There is a high rate of commercial sex worker migrating from Andhra
Pradesh which is said to be the second high prevalence state on HIV/AIDS in the
country. The high risk people like the truck drivers, youth and migrant labours
are the victim because of the UN safe sex practices with the female sex workers.
Another contributing factor is the existence of NH-43 connecting three states i.e.
Andhra Pradesh, Madhya Pradesh and Chhattisgarh. More than 500 trucks pass
every day through this high way. There are about 34 major spots in between
Indore to Kotpad in Indore district and from Borigumma to Nabarangpur district
where the truckers take food and refreshments. These truckers during halting
and resting time seek to have sex with female sex workers.
Females mostly
lacking alternate sources of livelihood generally prefer to trade their body and
indulge in unprotected sexual activities that subsequently leave them vulnerable
to aids.
High incidence of TB and malnutrition are other important reasons for
HIV/AIDS which is making HIV easy access to their body.
Poverty is one of the major causes making people prone to the HIV
infection. As the people do not find other alternate livelihood sources they are
forced to involve in the commercial sex which make them vulnerable to HIV/AIDS
and at the same time pass the virus to others and so on.
Cultural traditions in the tribal areas are another contributing factor for
HIV/AIDS. The people in rural areas celebrate many festivals and functions in
different seasons.
The important festivals are Push Parab, Chaitra Parab,
Dasashara, Bali Yatra, Nuakhai Parab celebrated round the year.
During the
social functions the Nata (folk entertainment) and information media takes place.
These Natas play a very important role in the outlet of emotions and tensions of
the people and a tool of entertainment for them. This also plays a vital role in
giving many people opportunities to have sex with others.
This gives rise to
21
unprotected sexual behavior, which contributes to the vulnerability to the STI

and also HIV.
In the rural and tribal society women and adolescents (school drop outs)
have the supportive economic structures, they contribute labor and income to
their families. Men and women in their youth work together freely. Sometimes
the women are exploited by the contractors, traders and middlemen working in
their areas.
The people of the district have low health seeking behaviour. The people
generally do not have the practice to go to a doctor while they are sick rather,
they go to witchcrafts traditional healer for alternate cure.
Women and children are more vulnerable to HIV/AIDS because of the
infection, unequal power relations and the low status of women.
The limited
access to human, Financial and economic assets weaken the ability to women to
protect themselves and negotiate for safer sex.
Stigma towards people infected with HIV/AIDS is widespread. The
misconception that aids only affects men who have sex with men, sex workers,
and drug users strengthens and perpetuates existing discrimination. The most
affected groups are often marginalized. They have little or no access to legal
protection of their basic human rights. Creating an enabling environment that
increases knowledge and encourages behavior change thus extremely important
to the fight against AIDS. These factors play a very important role in the out let
of emotions and tensions of the people.
AIDS
If we will distribute the PLHIV in district of Indore 62% are male and 38%
are female (113 out of 296) and 62% are male (183 out of 296)
Table 3.1 : Age Wise Distribution of PLHIV
Age group
Nos
PLHIV
of
MALE
FEMALE
22
< 14 years
26
18
08
15 to
years
24
42
26
16
25 to
years
49
226
143
83
> 50 years
11
Total
305
194
111
Source : ICTC, Indore
The table reveals that maximum number 226 of PLHIV are found in the
age group 25 to 49 years, distantly followed by the age group 15 to 24 and less
than 14 years.
This shows that the adolescents (13.77%) and young adults (74.1%) are
the most vulnerable to HIV.
Nearly 8.52% of the children up to 14 years are
found to be affected by this killer disease.

Table 3.2 : Socio Economic Status of the affected people
Socio
status
APL
BPL
economic
Nos
PLHIV
172
133
of
The data collected further reveals that 57 % of the affected people belong
to above poverty line 43% are below poverty line categories in the district under
study. The APL people are necessary rich or well to do people. A majority of
them come under poor categories and they just are above poverty line.
23
EDUCATION LEVEL OF PLHIV

It is found from the data collected that 26% of the affected people belong
to uneducated category who are either illiterate people or can only put their
signature but they are not able to read and write. Again out of the detected
cases 143 person (46.88%) are those who have completed primary or read upto
Class IX.
Table 3.3 : Education Level of PLHIV
Educational
status
Illiterate
Literate
can
sign
Upto Class V
Class V to IX
Class X
Class XII
Diploma
Graduate
Post graduate
Total
Nos of
PLHIV
72
65
31
64
48
11
2
11
1
305
This indicates that with higher level of education can help in the reduce
the number of HIV cases considerable and illiteracy will result in quicker spread
of HIV in the area.
Table 3.4 : Caste Distribution of PLHIV
Caste
Gener
al
OBC
SC
ST
Total
Number of
PLHIV
149
19
71
61
305
24
This table shows that HIV is seen in all castes. General class has the
maximum number of HIV. According to the study nearly 48.85% belong to the
general category.
It is followed by (SC
71 (23.28%) cases and ST 61 (20%)
cases ).
PROFESSION CATEGORIES OF THE PLHIV
The table below presents distribution of cases according to their
professional activity in Indore district.
Table 3.5 : Profession Categories of the PLHIV
Profession
Driver
Private jobs
Business
Daily labour
Govt . lob
Agriculture
House wife
Widow
Children
Un
employed
Total
Number of
PLHIV
53
36
34
34
17
10
73
2
22
20
305
The table shows that out of the 305 cases maximum PLHIV are housewives
(73) followed by drivers (53), those who are in business and who work as daily
wage laborers reported equal number of cases each ( 34 and 34 ) respectively in
private jobs. Even 22 cases are children below 14 years who are suffering from
PLHIV.
Numbers of death of PLHIVs
The Table 3.6 represents the number of deaths of PLHIVs ( 14% ) in of the
total number of PLHIVs. Most of the deaths are in the age group of 25 to 55
years.
Table 3.6 : Number of death of PLHIVs
25
Total
PLHIV
306
number
of
Total
number
deaths
63
of
26
Table 3.7 : Number of PLHIVs suffering from opportunistic infections

and
medicines given
Total
number
of
PLHIV
Opportunistic
infection
Medicine given for O
Is
30
6
29
6
23
2
Table 3.8 : HIV and tuberculosis co infection

Total number of PLHIV
Total number of tuberculosis
cases
30
6
32
27
Chapter - Four
Chapter
Four
PROBLEMS OF THE PEOPLE LIVING

WITH HIV/AIDS
PROBLEMS OF THE PEOPLE LIVING WITH HIV/AIDS

Due to constraints of time and resources the scholar has only taken care of
the HIV/AIDS sample on which the study has been made. Since the status of the
people living with HIV/AIDS have to be kept confidential and it is difficult to meet
many of the affected people, only 63 people were interviewed in various network
meeting of positive people.
Out of the sample only 10% were interviewed in their villages. The rest of
the people were interviewed in network meeting s. the infected people belong to
the four blocks of district Indore. A questioner was given to each PLHIV to know
about channels of infection, treatment by family members, treatment by hospital
staff etc.
After the collection of the data the tabulation of data was made. Their sex
wise distribution was studied to know about the vulnerable population and the
modes of transmission of HIV.
Their socio economic background was also
tabulated.
Table 4.1 : Table showing socio economic status of PLHIVs in the sample
Socioeconomic
status
Above
poverty
line
Below poverty line
Number
PLHIV
21
of
42
The data collected reveals that 33.33% of the affected people to be

sample belong to above poverty line and 66.67% are below poverty line (BPL)
categories.
All the APL people are not necessarily rich or well to do people.
Majority of the affected people belong to poor families, who work for their living
either as daily laborers or migrant workers
Table 4.2 : Distribution of PLHIV (sample) persons according to their
caste and sex
Caste
ST
Mal
e
18
Femal
e
08
Tota
l
26
SC
Other
s
Total
9
6
5
4
14
10
33
17
50
Table 4.2 represents the distribution of PLHIV (sample) persons according
to their caste and sex.
This study conducted by ICTC reveals that out of 50
sample cases 26 cases (52%) belong to S.T., 14 cases (28%) belong to S.C. and
10 cases (20%) belong to general caste. Another important finding of the study
is that the male outnumber the females in the table.
Table 4.3 : Profession categories and caste wise distribution of PLHIV in
the sample
Profession
Drivers
Self employed
Daily labourers
Govt jobs
Agriculture
Dependant
Un employed
Total
SC
12
8
8
2
11
8
6
55
Caste Categories
ST
10
6
4
2
6
3
4
35
Total
Others
6
4
3
2
3
6
3
27
28
18
15
6
20
17
13
117
The above table explains the professional and caste wise distribution of
PLHIV in sample taken. The table shows that HIV is seen in all castes. out of the
infected cases 20% belongs to general categories 52% ST and 28% belong to
SC . most of them are daily labourers and self employed .18% are drivers and
20% are dependant ( house wives and children ) . Only two of them are Govt
employees
Table 4.4 : Mode of transmission of HIV virus among the sample
Sl no
1
2
3
4
Modes of transmission
Pre and extra marital unsafe sexual practices
Through infected partner
Unsterlised syringes and needles equipments
Through blood transfusion
Male
42
12
5
0
Female
08
14
3
0
Total
50
26
8
0
28
Parent to child
Grand Total
10
69
4
29
14
98
Source : Lepra India and EXTA, Indore
Table 4.4 represents the mode of transmission of HIV virus among a

sample of 98 persons. The table reveals that in respect of 50 persons (51%) pre
and extra marital unsafe sexual practices have been responsible for AIDS, in 26
cases (26.53%) it through the infected partner, in 8 cases (8.16%) it is due to the
use of unsterilized synergies and needless equipments and in 14 cases (14.29%)
it is due to the transmission of virus from parent to child.
Awareness about condom
Out of the sample three couples who were found both have positive HIV
did not feel the necessity of use of condoms at all. In five cases only one of the
couple was found to be having HIV positive. There was usage of condom but in
some cases they did not resort to having sex at all. All of them had knowledge
about condoms but they were reluctant to use it.
PLHIV AND INSTITUTIONAL HELP
Out of the sample taken it was reported that 80% of them had visited
hospitals. 90% had visited ICTC for their testing and the rest were tested in
private clinics. Among 60% in the sample the pre and post test counseling was
very poor. After being tested only 20% had been admitted for treatment. In most
of the admitted cases there was breach in confidentiality as all the hospital staff
knew about the status of the admitted person.
10% of the cases, who were admitted in hospitals for long standing illness
like fever, diarrhea, weight loss etc, were discharged immediately after they were
tested 80% of the patients in the sample opined that most of the doctors were
sympathetic but a few of them were very rude who referred them to their
hospital on the pretext that there was no treatment for the disease. Among those
who were admitted for treatment were refused intravenous drug (saline) by the
nurses out of the fear of getting infected them selves. When the nurses reported
to the doctor said they did not have gloves. The affected people were discharged
and sent to their villages immediately
29
Out of the sample not a single affected person got free treatment , free Xray and investigation, the only medicines given to them free of cost were for the
Opportunistic Infection (OI) when ever available. Only 70% of the sample got
these medicines. The medicines purchased for OI from outside were not
reimbursed till date. ART (Anti Retro Viral drug) are not available in the govt.
hospital. The study reveals that doctors prescribing ART medicine to the PLHIV
only those who are economically sound that is (1%) could purchase drugs from
local chemists.
Only 2% who were referred to ART center Vishakhapatnam
received medicines.
Socio economic and psychological problems faced by PLHIV
The opinion of PLHIV sample regarding their accommodations are as
follows the treatment by family members found close relatives has been
sympathetic in 60% of the cases but in some cases especially females (14%) of
cases they have been kept in separate rooms one family (mother with two
positive children) has taken shelter in new hope shelter home at Muniguda
( Rayagada district ) the treatment received from villagers has been different in
different places. In about 60% of the case of the villagers are sympathetic
towards the PLHIV and also help them. In about 10% of the cases the villagers
are
not sympathetic
towards PLHIV.
In
some
villages they are
very
discriminative, so much so that the PLHIV does not dare to nurture out in the
village for bringing anything. They depend on what is brought to them by their
close relatives and family members.
Out of the sample 60% of the PLHIV have lost their jobs due to ill health.
10% of the PLHIV have been supported by the local NGO (SOVA, EKTA, LEPRA
INDIA) the organization provides sewing machines to the PLHIV, it also
encourages poultry, goatery and kitchen garden as per the skills of the PLHIV.
None of them have turned to begging till now.
Other problems of the people living with HIV/AIDS
The PLHIV are subjected to various psychological and economic problems.
The interview has brought some interesting and shocking opinion which is
narrated below. There is a lot of stigma involved in waiting outside a testing
30
center which is testing only HIV. People who come to hospital for testing have to
wait outside the VCCTC in the hospital and are looked at suspiciously but others
both male and females are usually asked to wait for their test in a single room
with a small curtain separating them and there is no privacy in hospital premises.
Most of the cases tested are referred from within hospital or from the TB
ward and their HIV status in wards does not remain confidential. Almost all the
staffs know about the status. Although consent for HIV testing is taken on paper
by taking thumb impression of the concerned persons but what is written is not
clearly explained to them
Counseling at VCCTC centers and in hospital
It is alleged that the Pre-Test and Post-Test counseling is not of good
standards. Patients invariably go into depression and do not know where to go,
whom to approach and what is their future.
This gives rise to too much
psychological pressure on the patients who feel helpless in the community.
If
test result is negative there is no problem but if an admitted patient on testing is

found to be positive the patients find themselves helpless as they are not
explained whom to approach for any kind of help or support. Due to frustration,
stigma and discrimination and non-disclosure by health authority their status and
hence, in most of the cases PLHIV are deprived of any kind of support from the
government.
Although the government has various welfare schemes for the poor like
Madhubabu Pension Scheme, Travel Concession on train, Antodaya Anna Yojana,
they do not demand for it and hence they do not receive them.
Out of the sample, 80% of the cases were not staged properly and no
proper special follow up card was given and neither proper guidance nor
counseling of the case was done similarly no proper advice on diet and
precautions to be taken was given in few cases death due to HIV/AIDS was not
registered
ARV DRUGS
ARV drugs are available free of cost in three centers of Madhya Pradesh
one is at Bhubaneswar second one is at Berhampur third one is recently opened
31
at Indore on 26th January 2009, this is supported by BILT Seva Paper Mill. The
other nearest ART center for Indore people is Vishakhapatnam there is no proper
referral system in place for ART center especially the one in Vishakhapatnam.
Out of the 15 cases of PLHIV referred to ART at Vishakhapatnam only 9 patients
are receiving ART now.
Majority
of
the
PLHIV
cannot
afford
to
travel
to
ART
center,
Vishakhapatnam. The PLHIV are very poor and cannot afford to travel to
Vishakhapatnam. The PLHIV are very poor and cannot afford to travel to
Vishakhapatnam and stay about five days on the first visit and then go for follow
up every month.
The orphan and the semi orphan are not cared for improper food, clothing
and medicine will result in early deaths.
Only 10% of the PLHIV have
rehabilitated by the local NGOs as per the study, children are not getting ARV
therapy.
CASE STUDY 1
ROHINI ( name changed ) a young widow aged about 35 is living with
three girl semi orphan children. Now her profession is preparing leaf plate and
selling it. Rohini had a wonderful and happy family. Her husband was an interstate driver who was transporting fishes from Andhra Pradesh to Madhya Pradesh
every day. Due to pressure he had habituated with alcohol and after some days
he had regular sexual behavior with commercial sex worker and infected with
HIV.
But it is the most fortunate part of Rohini life that Rohini and her three
children were not infected with HIV. It was impossible to her adolescent child but
it was possible for Rohini. Now Rohinis life became very hard after death of two
year of her husband. Her health condition has decreased because of family
burden and tension. She sold many domestic appliances like almirah, utensils,
wood bed etc for survival of her family and children her brother and the family
member of father in laws house are not responding to the pain and grief of
Rohini. They are telling it is your headache, you maintain it, we are also poor to
feed to your children lack of money Rohinis house has broken it was not
repainted due to heavy rain one wall side of the house has dropped down so the
32
local NGO SOVA has supported to up keep her house and given a Sewing
Machine with training fees to earn something by tailoring.
CASE STUDY 2
Dhanmati a widow tribal lady aged about 27 years is staying with her only
son aged about 3 in a tribal village five kilometer away from the Indore district
head quarter town.
Her current profession is doing daily labor and cooking
country wine. She lost her husband since five year. Her only son also infected
with HIV. Dhanmati is illiterate. There is a saying in English that "ignorance is a
bliss". Tribal people are ignorant about the consequences of HIV. So stigma and
discriminations has not touched to the life of Dhanmati. Her villagers and family
member are so cooperative towards Dhanmati because she is absolutely
independent earning her own. The local NGO SOVA supported her with two pairs
of goat but unfortunately the two goats died suddenly. Now she has two to four
goats. SOVA is supporting her drug cost. Her confident level has increased after
repeated counseling. Now she is sending her child to school.
CASE STUDY 3
Raghuram (name changed) a converted Christian tribal origin was very
poor fellow. He was leading his life as a daily labor and was living with his wife
and two children. Once diamond ore was discovered in his locality people rushed
secretly to collect diamond ore stone. Some people were died because of land
slide while collecting diamond ore stone by boring.
Raghuram also collected
diamond ore and went to Andhra Pradesh for its trade. Day by day his financial
condition improved and he made his own shelter and purchased a motor cycle, a
colour TV and many domestic home appliances.
With improved financial
condition, he got married to two women in his locality. Now he has three wives
and five children. After year Raghuram became weak and got infected with HIV.
He went to hospital at Andhra Pradesh and tested HIV positive and he came back
to his homeland and was suffering with some opportunistic infection. One day
he become serious his family members took him to Andhra Pradesh and finally
he died there. Now his three wives and five children are having no source of
33
income came to Indore hospital for testing HIV. The result was declared with one
is HIV positive out of eight members that is his first wife.
CASE STUDY 4
Sangeeta an adolescent girl is now studying at intermediate in Science
stream. She scored first division in high school certificate examination. Her aim
is to become a pilot because she is very much interested to fly in aeroplane.
When aeroplane and helicopter flies over her head she dreams to became pilot.
But now she is living with HIV since two years. She does not know about her HIV
status except her parents and brother and sisters. When she was in standard
eight, she fell down from upstairs from her house. One teeth of her teeth broken
she required blood.
One of her relative had donated blood to her.
After this
blood transfusion she became weak day by day she fell in sick with different
symptoms like weight loss, chronic cough, prolonged fever and some times
headache. She visited repeatedly to hospital, finally doctor advised her parents
to test HIV.
They did it and the result found was HIV positive.
It was
unbelievable and unacceptable to her parents. However, they recalled that she
received blood from one of their relative.
This might be the reason for her
infection of HIV. After frequent visit to hospital she asked to her parent why she
is getting ill repeatedly and many times.
Her parents said because God has
given you a small organ inside your body which is of a big size so you have to
visit doctor as long as you are alive.
34
CASE STUDY 5
Personal Detail
Sunil (name changed) a young man aged 27 years, belongs to general
category and stays in Jeypore. He was working as an accountant in an office. He
was earning Rs 3000/- per month.
Family Background
Sunil stays with his parents and sister at Jeypore. Seven years ago he was
studying in Andhra Pradesh, where in the company of friends, he had premarital
sex with sex workers. Last year, he developed fever and was treated by doctors
in Jeypore and later referred to Vishakhapatnam where he was admitted in
nursing home and tested HIV reactive, his CD4 count were 50 only.
He was
prescribed ARV drugs and since then he was spending more than half his salary
on ARV drugs.
A few months ago he noticed hoardings of SOVA in Indore and he
approached SOVA, in SOVA he was counseled on hygiene, diet and given
opportunistic infections drug and also referred to ART centre, Vishakhapatnam.
At Vishakhapatnam he did not get ART medicine and he was very much
depressed and he even wrote e-mails to NACO. He returned to SOVA and he was
asked if he could attend a 6 week training program on "LEADERSHIP AND
MANAGERIAL
PROFICIENCY"
PLHIV
in
Xavier
Institute
of
Management,
Bhubaneswar in collaboration with UNDP. He took some time and later decided
that he should attend the course.
Current Situation
After attending the said course, he is now a changed man. He gave up his
job and decided to work with SOVA dedicating his career to the care and support
of PLHIV of Indore. Recently he had been to ART center Vishakhapatnam and
now is getting his ARV drugs there. He has also helped other PLHIV to ARV drugs
from ART center, Vishakhapatnam. Since then he has been actively participating
in HIV and AIDS awareness programme and counseling of PLHIV and helping in
the formation of the network of Indore people living with HIV (NKP+).
35
Conclusion
Now Sunil is leading a normal and healthy life and has dedicated his life in
the service of PLHIV.
He has been elected as Secretary of Network of Indore
people living with HIV (NKP +). He now attends a number or meetings of INP+
and OSACS.
CASE STUDY - 7
Laxman a young man of 35 years is living with his wife and a two year old
daughter. He belongs to kotpad. He is a daily wage labor. His daily wages is Rs.
25/- per day
Family Background
Laxman stays with his wife and his two year old daughter. He frequently
indulged in premarital sex. He had married four times, the present wife is the
fourth one from whom he has a girl child of two years old. He was suffering from
fever and cough for quite some time and then diagnosed to be suffering from TB
fever and cough for quite some time and then diagnosed to be suffering from TB,
due to irregular treatment, he did not improve and when he was tested for HIV in
Raipur. He was found to reactive, wife also suffered from opportunistic infection,
child was also suffering from cough.
Due to negligence and indulgence in
premarital sex and his multi partner sexual behavior he had got infected with HIV
and he later transmitted the virus to his wife. Laxman had spend a lot of money
on his treatment and his family, he had also sold his land for the treatment, he
used to visit Chhattisgarh for his treatment , he spent all his money on travel and
medicines and now he had no money for his food.
36
Current Situation
When counselor from SOVA came to know about this family at Kotpad, she
visited them and brought them to TB Hospital in Indore and got him tested for
HIV from VCCTC and also got them investigated for TB.
TB treatment was
started for Laxman but wife and child were not suffering from TB counselor told
them that proper hygiene should be maintained and they should eat good
nutritious food like Ragi, Vegetables Dal, Milk and Eggs and boiled water. They
were given nutritional support for necessary grocery items for few months by
SOVA they were also given medicine for opportunistic infections.
SOVA gave them four goats and three pairs of hen for their livelihood
support. Presently the condition of daughter is not very good as she is suffering
from TB is also having oral thrush.
Conclusion
Laxman is leading a very tough life and his financial condition is not good.
SOVA is planning to refer the family to ART center at Vishakhapatnam for
antiretroviral therapy.
Laxman is presently a member of network of Indore
people living with HIV (NKP +).
37
Chapter - Five
Chapter - Five
HIV/AIDS HAS NO CURE
Some intellectual persons have opined that HIV may be the third Phobia
for the globe after terrorism and nuclear war.
In a country if 15% people will be
infected with HIV the GDP will be slashed down to 1% (WHO Report). Prevention
is critical as there is no cure for AIDS. However prevention should go hand in
hand with high quality health care.
Government agencies, Non-Governmental
organizations, Leaders, Religious authorities, Community Care Centers will have

a substantial contribution to make people living with AIDS. The basic objectives
of the agencies should be to provide care and treatment interventions in the
workplace, to provide counseling to the persons infected by HIV/AIDS, to provide
nutrition support to bring awareness about HIV/AIDS opportunistic infections to
motivate people to attend voluntary counseling and testing centre (VCCTC) and
get tested and to facilitate formations of solidarity groups off people infected and
affected by HIV/AIDS.
GOVERVMENTS' RESPONSIBILITY
National Council on AIDS
Soon after reporting of the first few HIV/AIDS cases in the country in 1986,
governments recognized the seriousness of the problem and took a series of
important measures to tackle the epidemic, by this time AIDS had already
attained epidemic proportion in the African region and was spreading rapidly in
many countries of the world, government of India without wasting time initiated
steps and started pilot screening of high risk population. A high powered national
AIDS committee was constituted in 1986 and a national aids control programme
was launched in the year 1987.
State Level Strengthening
In order to strengthen the programme at the state level, the State
Government has established their own managerial organizations which include
State AIDS Control Societies, Technical Advisory Committees and Empowered
Committees as per the guidelines of the strategic plan.
The structure of the
State Aids Societies shown below indicate the progress in the development of
State Management Teams.
Sate Aids Control Societies
State aids cells were created in all the 32 states and UTs of the country for
the
effective
implementation
and
management of
national
aids control
programme. However over a period of time it was realized that due to many
cumbersome administrative and financial procedures there was delay in release
of financial outlay.
But Government of India has taken steps to remove the
bottlenecks faced by the programme implementation at state level. Ministry of

Health and Family Welfare advised the State Governments and Union Territories
to constitute a registered society under the chairmanship of the secretary of
health. The society should be broad based with it members representing from
various ministries like social welfare, education, industry, transport finance etc.
and non government organizations. On an experimental basis Tamilnadu AIDS
control society was created which was followed by Pondicherry.
Successful
functioning of these societies led the government of India to advise other states
to follow this pattern for implementation of the national AIDS control programme.
NETWORK OF PEOPLE LIVING WITH HIV/AIDS

INP+ is a national, community based non-profit organization representing
the needs of people living with HIV/AIDS ( PLHA ) formed in 1997 by twelve
people living with HIV in India INP+ aims to improve the quality of life for people
living with HIV?AIDS in India the fundamental principle guiding the work of INP+
is the centrality of PLHA in decision making processes that affect their lives
consequently INP+ is the centrally of PLHA in decision making processes that
affect their lives , consequently INP+ is the centrality of PLHA in decision by
people living with HIV.
SIX STRATEGIC OBJECTIVE OF INP+
1. to facilitate and improve access to treatment for people living with HIV
2. to provide access to correct information to people living with HIV
3. to promote and protect the human rights of people living with HIV
4. to promote involvement of people living with HIV at all levels of
decision making
5. to promote social acceptance of people living with HIV and to end
stigma and discrimination
39
6. to provide opportunities for networking for peoples living with HIV

INP IN MADHYA PRADESH
INP has been trying to develop a state and district level networks for the
last one year since January (year?).
INP+ has established its office in
Bhubaneswar to strength the network formation process among PLHIV in Madhya

Pradesh INP+ has developed 8 districts PLHA in Khurda, Cuttack, Indore, Ganjam,
Puri, Rayagada, Malkangiri, and Nabrangpur district of Madhya Pradesh. More
than 400 PLHIV and their families have been reached through peer counseling,
hospitals and family visits support group meetings and capacity building
trainings by INP+ in the last ten months, 300 PLHA have joined the networks in
the districts as members. INP+ has developed a group of 25 positive speakers
and have provided them necessary training.
ROLE OF NGO IN INDORE DISTRICT
SOVA (South Orissa Voluntary Action)
SOVA is a secular non political non-profit making voluntary organization. It
is a grass root level development organization working among displaced tribals
and dalits of Indore district in India since 1994. As this organization is working
for creating awareness among the people about HIV/AIDS, giving timely
counseling and taking up rehabilitations measures, the scholar took it a case for
a detailed study.
EXPERIENCE OF SOVA IN MANAGING THE HIV/AIDS PROGRAMME
SOVA is involved in various HIV/AIDS intervention programme since last
ten years. SOVA is working presently on truckers migrant workers, female sex
workers and youths in four blocks of Indore district. It has
wide experience in
developing BCC material and is one of the leading institutions in the state of
Madhya Pradesh, the organization has its own cultural group to perform street
play on HIV/AIDS.
The organization has a training team and has developed
training modules and manuals for various groups. SOVA has the experience in
implementing targeted intervention program for migrant workers of NALCO area
with the support of NACO/ OSAC the organization has the experience of running
STI/RTI clinic and conducting health camps for 5 years.
40
In concern to care and support SOVA has aim to bring all the affected and
infected people to part form called + people network in Indore district in order to
provide basic counseling referral and opportunistic treatment. This project will
support to provide better care to the people and reduce the vulnerability in
Indore district which is now treated as a priority in Indore region.
CONCLUSION
Community development is an integral part of SOVA's core objective of
peoples empowerment and emancipation and enhancement of the living
standard of the people specially children and women. SOVA locates people at the
centre of their development.
41
Chapter - Six
Chapter - Six
SUGGESTION & FINDINGS OF THE

STUDY
If we look at AIDS as a world wide pandemic, it appears as if it is

something new and rather sudden. But if we look at AIDS as a disease and at the
virus that causes it we get a different picture, we find that both the disease and
the virus are not new they were there well before the epidemic occurred, we
know that virus sometimes change, a virus that was once harmless to humans
can change and become harmful, this is probably what happened with HIV long
before the AIDS epidemic
What is new rapid spread of the virus? The spread of HIV is somewhat
similar.
Researchers believe that the virus was present in isolated population
groups years before the epidemic began, then the situation changed, people
moved more often and traveled more they settled in big cities and life styles
changed including patterns of sexual behavior, it became easier for HIV to
spread through sexual intercourse and contaminated blood. As the virus spread,
the disease which was already in existence became a new epidemic.
Highlights on HIV/AIDS
There is a lack of data and information in relation to HIV and the links with
migration and sexual practice in Madhya Pradesh. Surveillance data is also not
very representative; under this strategy research will be an important approach
involving the community. The study conducted indicate the target group, the rate
of spread of HIV is increasing at an alarming rate.
HIV/AIDS is not merely a health issue and its impact goes beyond its
sufferers, their families and communities.
economic
social
and
human
It also has the potential to erode
development
across
the
full
spectrum
of
development gains. HIV/AIDS disproportionately affects the poor and the

disadvantaged, while it is not in itself a disease of poverty significantly increases
a persons susceptibility to the disease there fore the impact of HIV /AIDS is most
severely felt by the poorest and in particular by the vulnerable groups such as
women and children
Despite the magnitude of the problem and challenges faced by the poor
and vulnerable in Madhya Pradesh the NGOS have an important and very special
role to play, the close interpersonal interaction that NGOS have with people in
the communities they work is extremely useful for implementing the behavioral
interventions necessary for HIV/AIDS prevention and care, NGOs are also not
under
the
same
political
and
administrative
constrains
as
government
programmes are. They therefore have greater flexibility and the capacity to
accommodate changing programmes and public needs and can innovate and
implement new initiatives more easily, they can ensure that those people living
with HIV/AIDS, who are affected by it, have and improved quality of life. SOVA a
Indore based NGOs may be taken as an example in this area of operation.
Most workers face no risk of getting the virus whole doing their work, if
they have the virus themselves, they are not a risk to others during the course of
their work, as explained already, in adults, the virus is mainly transmitted
through the transfer of blind or sexual fluids, since contact with blood or sexual
fluid is not part of most peoples work most workers are safe, those who are likely
to come into contact with blind that contains the virus are at risk these include
health care workers doctors dentists nurses laboratory technicians and a few
others such workers mist take special care against possible contact with infected
blood as for example by using gloves there are no risks involved.
One may share the same telephone with other people in their office or
work in a crowded factory with other HIV infected persons even share the same
cup of tea but this will not expose them to the risk of contracting the infection,
being in contact with dirt and sweat will also not give any infection, for example,
it is not spread by sitting next to someone who is infected, shaking hand,
coughing, or sneezing, HIV is not spread by public transportation, public
telephones, restaurants, food, cups, glasses, plates, drinking water, air, toilets
swimming pools or insects. The virus spreads most frequently through sexual
activity, from an infected person to his or her sexual partner, it also spreads
through contaminated blood in transfusions on needles or any other skin piercing
instruments.
A positive HIV test result does not mean that a person has AIDS. A
diagnosis of AIDS is made by a physician using certain clinical criteria that aids
indicator illnesses an HIV infected AIDS indicator illness. An HIV infected person
43
receives
diagnosis of AIDS after developing one of the CDC defined aids
indicator illnesses, and HIV positive person who has not had any serious illnesses
also can receive and aids diagnosis on the basis of certain blood tests ( CD4
COUNTS ).
Infection with HIV can weaken the immune system to the point that it has
difficulty to fight off certain infections these types of infections are known as
opportunistic infections because they take the opportunity of a weakened
immune system to cause illness, many of the infections that cause problems or
may be life threatening for people with AIDS are usually controlled by a healthy
immune system the immune system of a person with AIDS is weakened to the
point that medical intervention may be necessary to prevent or treat serious
illness.
Today there are medical treatments that can slow down the rate at which
HIV weakens the immune system, there are other treatments that can prevent or
cure some of the illnesses associated with AIDS as with other diseases, and early
detection offers more options for treatment and preventative care.
HIV is seen as the result of personal irresponsibility, and as such
individuals are labeled and targeted, by blaming certain individuals or groups,
society can excuse itself from the responsibility of caring for and looking after
these people.
Stigma is a powerful tool of social control which is usually used to
marginalized and exercise power over individuals who do not conform to the
norm discrimination related to HIV has spread rapidly fuelling anxiety and
prejudice while the societal rejection of certain social groups that is MSM
injecting drug users, sex workers may predate HIV and aids , the disease has in
many cases reinforced this stigma MSM and sex workers are not coming forward
for fear of rejection and people are not coming forward for testing for fear of
rejection stigma and discrimination at various levels in society.
Findings about the PLHIVs
44
In the block wise distribution of PLHIV in district Indore a maximum number

of cases are found in Jeypore followed by Indore , Semiliguda and Pottangi,
this shows that the urban areas or the block adjacent to Andhra Pradesh and
Chhattisgarh are more vulnerable to HIV infection, so more intense AIDS
awareness programs should be started in these areas.
The incidence of HIV is found mostly in the age group of (25 - 49), (77%)
followed by 15 - 24 years (13%) age group. This shows that the adolescent
and young adults are the most vulnerable to HIV. Hence more preventive
measures need to be taken for the age group 15 to 49 years age group in
particular.
More than 40% for the PLHIV are now below poverty line. The APL categories
majority of the affected persons are assumed to be above poverty. The
sample indicates there are 64% of the sample is below poverty line (BPL).
Hence more care should be taken as regards the livelihoods of these PLHIV.
poverty leads to lack of proper nutrition and medicines and quick
progression of disease and death.
The number of illiterate PLHIVs is very high ( 50% ) and illiterate will result in
quicker spread of HIV in the area.
HIV is seen in all caste categories, general class has the maximum numbers
of HIV cases and the HIV virus is also seen among the tribals. Out of the
sample 52% belong to ST followed by SC (28%) and 10% belong to the
general category in the setting of high illiteracy, poverty and sexual
promiscuity at early age amongst tribals will lead to a faster spread of HIV
amongst tribals.
Hence more interventions are necessary for tribals
especially those who are migrating for jobs a long with other persons.
6
Most of the affected PLHIV are daily labors self employed and 20% are
dependants that women and children out of them 18% are drivers who
unknowingly indulge in sexual activity during their leisure time.
The sample clearly reveals that 80% for the affected cases got infected
either due to pre marital or extra marital affairs, it also show s that 18% of
the cases fare parent to child transmission.
Out of the sample taken it was reported that 90% had visited VCCTC for their
testing and the rest were tested in private clinics.
Among 60% in the
sample, the pre and post test counseling was very poor.
45
Out of the sample not a single affected person got free treatment, free X
RAY and investigation, the only medicines given to them free of cost were for
the opportunistic infections (OI) when ever available.
Only 70% of the
sample got these medicines the medicines purchased for OI from outside
were not reimbursed till date.
10 The PLHIV are subjected to various psychological and economic problems.
There is a lot of stigma involved in waiting outside a testing center which sis
testing only HIV.
Suggestions
The problem arising out of PLHIV s mainly relate to stigma and
discrimination, ill health malnutrition, poverty lack of education lack of proper
information on HIV and aids these problems can be solved t a greater extent by
the following ways.
Capacity Building of PLHIV
The concept of positive speaker is that a person living with HIV will take
the initiative to speak positive words and the true information and disseminate
the information to the people living with HIV where there will be creation of
enabling environment for positive people for positive life.
Development of communication skills of the people living with HIV is
important, practical sessions on public speaking, communication and positive
living information and knowledge should be provided; the training should include
positive life style that is stress management, management of food and nutrition,
management of ART and OI enhancing knowledge in the health care services
available for PLHIV etc.
Capacity building and positive speaker training is a unique concept.
Through these positive speakers the myths about HIV/AIDS can be dispelled, this
will also help in improving the quality of the life of peoples living with HIV/AIDS.
1. Formation of district levels network this net work will be as pressure
group to implement the all schemes of government.
2. Sensitize to government to for proper access to health services for
PLHIV.
46
3. Access to proper health information especially HIV/AID.

4. Capacity building of the community for better care and treatment of
the positive people and reducing the stigma and discrimination.
5. Confidentiality must be maintained in the hospital.
6. Proper counseling that is pre and post counseling must be ensured.
7. Mobile VCCTC should be introduced to ensure that more people who
want to get tested can be reached.
8. Providing livelihood to PLHIV with help of government NGOs and
positive peoples networks so that they can earn and live a life of
dignity.
Self Care Training of PLHIV and Care Givers Training for the Relatives
1. One should see a health care professional for a complete medical work up for
HIV infection and advice on treatment and health maintenance, one should
make sure that PLHIV are tested for TB and other STIs for women, this
includes a regular gynecological examination.
2. It is very important for a PLHIV to inform their sexual partner about their
possible risk of HIV the health department has a partner notification programs
that can assist PLHIV.
3. The PLHIV should protect yourself from the virus by following the precautions
for example always using condoms and not sharing needles with others.
4. They should avoid drugs and alcohol use practice good nutrition, and avoid
fatigue and stress.
5. They should not donate Blood, Plasma, Semen, Body organs or any other
tissue.
6. They should seek support from trustworthy friends and family when possible,
and consider getting professional counseling or find a support group of people
who are going through similar experiences.
7. Those with AIDS or AIDS related illness should be treated in the same way as
any other worker who is ill. Infection with HIV is not a reason in it self or
termination of employment. Anyone infected or thought to be infected must
be protected from discrimination by employers, co workers unions or clients.
8. Employees should not be required to inform their employer about their
infection. If good information and education about AIDS are available to
47
employees a climate of understanding may develop in the work place

protecting the rights of the HIV infected person.
9. Any one infected, or thought to be infected, must be protected from
discrimination by employers, co worker unions, unions or clients.
10.Testing for HIV should not be required for workers; as far as work is concerned
the information about the infection is private. If it is made public, one could
be a target for discrimination.
11.The employers in different parts of the world are beginning to deal with these
problems more humanely. Their associations and workers unions can be
consulted for advice
12.Every one contact with an HIV/AIDS person is a potential care provider. In
particular, this includes health care workers at various levels of the health
care delivery system social workers and counselors and close family members
who are important care providers at home, car basically involves clinical
management nursing care, counseling and social support.
Some Ways to Reduce Risk and Vulnerable to HIV Infection
For safety and to avoid the risk of being infected by HIV these are mainly
the following ways have been advised by experts in this field.
1. Abstain from vaginal anal and oral sex, safe activities include hugging,
cuddling, masturbating, kissing and touching.
2. Use condoms, unless you are 100% sure your sexual partner is not
infected with HIV or other STDs reduce your risk by using a latex
condom (rubber) on the penis from start to finish every time you have
anal, vaginal or oral sex, learn to talk with your partner about condoms
and safer sex, condoms can protect both of you from many STIs.
3. Avoiding mixing alcohol or other drugs with sexual activities, they
might change your judgment and lead you to engage in unsafe sexual
practices
4. If you test positive for HIV the sooner you take steps to protect your
health , the better , early medical treatment and a healthy lifestyle can
help you stay well , prompt medical care may delay the onset of AIDS
and prevent some life threatening conditions , there are a number of
important steps you can take immediately to protect your health. See
48
a doctor, even if you do not feel sick. Try to find a doctor who has
experience treating HIV. There are now many drugs to treat HIV
infection and help you maintain your health. It is never too early to
start thinking about treatment possibilities
5. Have a TB (tuberculosis) test done. You may be infected with TB and
not know it , undetected TB can cause serious illness , but it can be
successfully treated if caught
6. Smoking cigarettes, drinking too much alcohol, or using illegal drugs
(such as cocaine) can weaken your immune system. There are
programs available that can help you reduce or stop using this
substance.
There is much you can do to stay healthy. One learn all
about maintaining good health.

Source www.naco.online.org
SUMMARY OF THE STUDY

The data was collected through qualitative techniques.
Observations,
informal interview and discussions, after collections the interview schedule was
scrutinized, it is really pathetic to observe the poor conditions of the affected
people mostly belonging to the tribal folk
community.
Similar the economic
conditions of the SC and other backward community is miserable, the various

problems are included in the study.
The present scenario is that most of the problems emanate from the poor
economic conditions of the affected people which compel them to live a life of
hardship. Their agricultural practices are too traditional and absences of
irrigation facilities, dependence of rainfall are some of the major factors for low
agriculture produce from the land. The fertility of high and hilly land used for
agriculture in Indore district is very low.
The affected people suffer from social prejudices, suffer from lack of
education, health services and independent economic activities hence poverty
and ignorance are the two major factors for their sufferings.
People are unaware of HIV/AIDS. They only come to know about it after
being tested or frequent weight loss, the fear of early death, discrimination in the
49
society, stigma comes after they are tested positive, and they feel that their
future is vague and uncertain. They believe it as fruits of their bad karmas. They
feel themselves as untouchable as treated by their family and friends and also
discriminated by the hospitals, doctors and staff. The hospitals do not keep any
confidentiality and abuse them too as a curse for society. It is alleged by the
affected people in large number.
The affected families are too poor to buy medicines and no proper
nutritional diet is really available some have no source of livelihood as they are
now dependants mostly (widows and children). Some have lost their jobs too, in
some families both parents are dead and their children are loaded after their
grand parents.
No proper guidance neither proper counseling is there for the target
groups. They fear about maintaining their status in the society and they fear to
form a network too, some are very helpless and rely on NGOs for their help and
support.
The NGOs are a very few in number who look after AIDS related projects as
mentioned earlier SOVA is one such NGO working for these people. They too are
bound by their financial constraints. They cannot afford to provide nutritional
facilities and required medicines to all the affected families, even getting a
widow pension card for a widow is very difficult as she has to undergo a series of
questions which makes life more miserable for them. There are various govt.
schemes like Antodaya Anna Yojana but only a very few are able to avail it.
Among the tribals their Parabas, their traditions entertainment, lack of
awareness about HIV and migration are some of the causes which are directly of
indirectly responsible for the spread of HIV/AIDS. Moreover people are illiterate.
They cannot read and write and understand about the prevalence causes and
effects of HIV/AIDS. They keep on passing the virus unknowingly as they do not
know what safe sex is.
CONCLUSION ONLY KNOWLEDGE IS THE POWER OVER HIV/AIDS
Concluding Remark
50
India is home to one in seven HIV/AIDS cases. The 2006 UNAIDS report on
the global AIDS epidemic estimated that 5.7 million Indians are living with
HIV/AIDS out of which 35% are young people aged between 15 to 29 years.
In Madhya Pradesh HIV/AIDS epidemic is spreading through poor public
awareness about the modes of transmission and result in high levels of stigma
and
discrimination.
Poverty
migration
and
displacement are
also major
contributing factors for the spread of virus together with poor access to health
service high levels of illiteracy, striking gender imbalance and weak governance.
Many of HIV cases already exist in Madhya Pradesh and likely to increase
in the near future, it is therefore of prime importance that action are taken at this
early stage to try and halt the spread of the virus.
HIV and AIDS are equally so closely linked with the fact that the partners
cannot address issues of HIV and AIDS has attracted much attention of the
people both within and out side the medical and civilized communities. HIV is
attributed to some of the socio economic issues like homosexuality, drug use
poverty etc. although the scientific evidence is overwhelming and compelling
that HIV is the cause of AIDS, the process of transmission and the spread of the
disease is not yet completely understood.
This incomplete understanding has
led some persons to make statements that AIDS is not caused by and infectious
agent or is caused by virus that is not HIV this is not only misleading, but may
have dangerous consequences.
Infection with HIV has been the sole common factor shared by AIDS cases
throughout the world among homosexual men transfusion recipients, persons
with hemophilia sex partners of infected persons children born to infected
persons, children born to infected women and
occupationally exposed health
care workers, recommendations to prevent HIV involve guidance to avoid or

modify behaviors that pose a risk of transmitting the virus as well as the use of
tests to screen donors of blood and organs.
NGO work should be focused where vulnerability and risk are high and
engagement of civil society and government is perceived to be low.
Projects
should cover both rural and urban areas as appropriate.
51
The inescapable conclusion of more than 15 years of scientific research is

that people if exposed to HIV through sexual contact of injecting drug use may
become infected with HIV if they become infected, most of them will eventually
develop AIDS which can eventually kill them.
52
Questionnaire
QUESTIONNAIRE FOR S.O.V.A.

01
How many positive people you are dealing in your organization?
02
What assistance you are supporting to people living with HIV?
03
What are the activities of your organization implemented for prevention of

HIV?
04
Who is your primary stakeholder?
05
How many staff engaged to prevent HIV in your locality?
06
Does your organization have work place policy for HIV positive people?
07
What are the specific facilities available for HIV positive people?
08
Is your organization promoting condom for HIV prevention?
09
Do you provide any facilities for the affected families?
10
Do you have any specific facilities for the HIV positive children?
11
Do you have any future plan for integration of HIV with different sector?
12
Do you have any further action agenda for HIV in the district?
-A-
INTERVIEW SCHEDULE FOR A PLHIV

01
Name of the Person Interviewed (optional)
02
Address -
03
Marital Status
04
No. of Children
05
What is your Occupation?
06
Where you have tested HIV and when?
07
Is any other person infected is in your family?
08
Risk Assessment (how he has infected with HIV)
09
Any assistance you are getting from govt or any organization
Male
Female
a) OI Treatment
b) Nutrition Support
c) Counseling Support
-B-
INCOME GENERATION SUPPORT

1. What are the main concern areas for you?
2. Do you like stay with your family?
3. Do you know the facilities are available for you which are being provided by
the government?
4. Are you a member of any association?
5. Are you aware of district AIDS prevention initiatives implemented by
government and non government agencies?
6. How HIV/AIDS prevented from your district?
7. How many times you visited the hospitals?
8. What is the response and behaviour of the doctor?
9. How many times you met the counselor of ICTC?
-C-
INTERVIEW WITH STAFF IN I.C.T.C.

1. Name of the ICTC Center
2. Designation
3. Since how long you have been associated with this responsible
4. Since joining how many cases you are dealing
5. In your feeling what are the main areas of concern of PLHIV in the district
6. What is the average testing rate per month in this hospital?
7. Do people get access STI and OI medicine in your center?
8. Is ARV available in the center?
9. How frequently patients are visited to your center?
10.Do you counseling to the positive people at their house?
11.What are specific facilities available for the positive people?
12.What is the figure of children infected with HIV?
Below the age of 5years
Between the age of 5 to 18
13.Total number of tribal infection rate
Male
Female
Children
14.Where you are getting condom for safe sex?
15.Do you know the detail knowledge about HIV? (modes of transmission, modes
of prevention, misconception relating to HIV)
-D-
Bibliography
BIBLIOGRAPHY
01. AIDS and LAW
63/96
02. Understanding and living with

AIDS
03. Carrying
out
surveillance
HIV
sentinel
04. National work shop on HIV and

AIDS counselling
05. Hand book on AIDs home care

06. Guidelines
for
preventing
HIV,HBV and other infections in
the health care setting
07. Hand book on AIDS home care
08. Condom AIDS and Sexuality
09. Strategic
for
transfusion
safe
Indian Social Institute, 10

Institutional Area, Lodi
Road, New Delhi - 110003
1992
World Health Organization,
Regional Office for South
East Asia, New Delhi, India
1992
World health organization
regional office for soth
east asia new delhi India
1993
International Society for
Research on Civilization
Disease on Environment ,
India B/02 Sidhachakra
Apartment, Ellis Bridge
Ahmadabad - 380 006
1996
1996
1996
1998
D.K. Publishers &
Suchitra Chopra Distributors (P) Ltd
(b. 1959)
1 Ansari Road, Daryaganj,
New Delhi-110002
blood
1998
10. NGOS and AIDS responding to

the expanding epidemic
2000
11. HIV/AIDS counsellindg manual
2000
12. AIDS the challenges
2001
13. Condom , aids and sexuality

(Suchita Chopra )
2003
14. Social concern and strategies
January 2002

AIDS Forum, Karnakata,
No. 268, 1st Main Defense
Colony, HAL 2nd Stage,
Bangalore - 5282314
B R publishing corporation
A-6 nimari commercial
center near bharat nagar ,
ashok vihar delhi 110052
Center for social medicine
-E-
for AIDS control in India

15. Guidelines for preventing HIV,
HBV and other infections in the
health care settings
Year 1996
and community health ,

jahaharlal Nehru university
new delhi 110067
Regional office for South
-F-
Reference
REFERENCE
REFERENCE
REFERENCE
1. National Aids Control Organization
2. Madhya Pradesh State Aids Control Society
3. South Madhya Pradesh Voluntary Actions
4. ART Center (Vishakhapatnam, Vizianagaram)
5. ART Center Indore, Madhya Pradesh
SOME IMPORTANT WEB SITE

1. www.nacoonline.org
2. www.unaids.org
3. www.youandaids.org
4. www.indiaaids.org
5. www.hivsite.org
6. www.aegis.com
7. www.thebody.com
8. www.globalhealth.org
-G-
Project Proposal
PROJECT PROPOSAL
PROJECT PROPOSAL
PROGRAMME TITLE
Programme Code
Master Degree in Rural Development

-
M.A (R.D)
Enrolment No.
062978462
Name
Miss Sakuntala Ray
Address
Study Center
Sakuntala Ray
D/o - Ghanashyam Ray
At - Housing Board, Gandhi Nagar
Po/Dist - Indore
MADHYA PRADESH
PIN - 764 020
Mobile No. - 9437272485
E-mail - sray.montu@gmail.com
sray.montu@rediffmail.com
- 2123D
Regional Center
Name of the Project
- A study on the problem of service

delivery of the people living with
HIV/AIDS of four blocks of Indore
district.
Name of the Supervisor
(44) Indore, Madhya Pradesh
Dr. P . C Mohapatra
PROJECT TITLE
A study on the problem of service delivery of the people living with
HIV/AIDS of four blocks of Indore district.
INTRODUCTION
The study introduces to social determinates of behavior patterns and
practices that facilitate HIV transmission and social dimensions of HIV/AIDS
prevention, some social factors and customs among tribals leading to the
increase in HIV/AIDS transmitting behavior.
STATEMENT OF THE PROBLEM
HIV/AIDS is now becoming a killer disease and spreading very rapidly in
Indore district.
While offering curative care to AIDS patients seems to be a
distant reality in the absence of vaccine evolving strategies immediate and

effective response is required from every educated individual of this country.
This dissertation tries to understand the various problems of HIV/AIDS patients of
a backward tribal dominated area like Indore district.
OBJECTIVE
The study is undertaken with the following objectives.
1. To know the socio economic back ground of the people infected with
HIV/AIDS.
2. To know the incidence of aids related complicated among the PLHIV.
3. To access the knowledge and awareness level about HIV/AIDS of PLHIV
and their family member.
4. To study the discrimination back ground towards PLHIV.
5. To study the socio psychological and counseling problems of HIV
infected person.
6. To evaluate the initiative implemented by Govt. and NGO for creating
awareness and controlling further spread of the pandemic.
HYPOTHESIS
The following hypotheses are proposed to be tested in course of the study.
-I-
1. The sexually active and economically productive age group (1445)

age group account for the major HIV/AIDS cases in Indore district
2. The high risk group also belongs to SC and ST or socio economically
back ground population
3. Though government and non government organizations seem to be
working sincerely but the measures taken are not adequate to solve
the problem
UNIVERSE
The universe of the present study includes four blocks of Indore district i.e.
Indore, Jeypore, Borigumma and Semiliguda. It is a back word district with heavy
concentration of SC and Stand other weaker sections of the society.
Nearly 50% of the people of the district belong to ST and 14% SC (2001
census) in addition to ST and SC there are also other backward people living in
the district who are economically poor and socially backward 78.65% of the
people in the undivided district live below poverty line (as per Human
Development Report).
Due to poverty and unemployment people generally migrate outside the
districts on state in search of employment. Migration of people in and out of
Indore is one of the causes of spread of HIV/AIDS in Indore. The main cause of
spread of HIV is sexual contact transmission from mother to child. There are
some causes due to use of unsterile syringes also.
Transmission of blood
transfusion is also one of the causes but it very rare.

Patients registered in the district headquarters hospital will be the main
focus of the study. The scholar intends to study of the cases of Indore 17% to
20% of the PLHIV on the basis of a random sample.
METHODOLOGY OF THE STUDY
Both primary and secondary sources of information will be taken into
account secondary sources include information from various books journals news
papers and the internet. Data from NACO, Madhya Pradesh state aids control
society and district head quarter hospital and ICTC of Indore will also be collected
-J-
for this purpose. Primary sources include data collected through personal survey
interviews and case studies.
TOOLS OF DATA COLLETION
The main tool of data collection will be interview schedule administered on
the affected patients of area.
The interview schedule consists of simple
questionnaire relating. In addition to this case studies shall also be used as a tool
for data collection. Direct observation method shall also be used for getting
required information
DATA ANALYSIS
Data shall be coded verified analyzed using statistical methods and
processed on computer. Simple average will taken while analyzing the data Bar
and pie graphics are drawn to highlight each coded data
LIMITATIONS
As an individual scholar with limited time and resources at my disposal it
is difficult to cover the whole area on a census method. The scholar has taken
adequate measures to choose the sample which will represent the entire
universe.
-K-
Chapterisation
CHAPTERISATION
First INTRODUCTION
Gives general introduction about HIV/AIDS its dimension and extent tests
for HIV medicines the modes of transmission, prevention, symptoms and
misconception about of HIV/ AIDS.
Second RESEARCH DESIGN
The second part deals with the conceptual framework and research design
of the present study that is objective hypothesis universe, sample size and tools
of data collection
Indore District Profile
This chapter gives the detail about the district its location number of
population of the district and background of the people. Their living conditions,
poverty, literacy rate, unemployment, customs and traditions are briefly
discussed. This chapter also highlights the scenic beauty of the places, the hills
and the tribals residing there.
Third HIV/AIDS A SITUATIONAL ANALYSIS
The chapter gives the magnitude and incidence of HIV infection in the
district the areas of vulnerability. The analysis is based on the secondary data
collected from the testing centers (ICTC, PPTCT of Indore and Jeypore)
Fourth PROBLEMS OF THE PEOPLE AFFECTED BY HIV/AIDS
The chapter deals with the major and minor problems of the people and
the influence on the society of them. Some of the case studies are also included
in this regard.
Fifth MEASURES TO CONTROL HIV/AIDS
Role of government and non government agencies and networks of positive
people initiative taken by them in handling the situation in Indore district
Sixth SUGGESTIONS AND FINDINGS OF THE STUDY
This chapter deals with major findings of the study area. Some of
the important suggestions are also included.
Signature of Supervisor
Signature of Scholar
Date
[Type text]
Date

DMSW Project

Transféré par

Informations du document

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

DMSW Project

Transféré par

Droits d'auteur :

Formats disponibles

A

This Dissertations is submitted for the partial

Mahatma Gandhi Chitrakoot Gramoday

By:Dr. P.C. Mohapatra

Director, COATS, Indore

Distance Education Center

DEVI RUDRAPRIYA SHIKSHA PRASAR

Satna (M.P.) was working under my

supervision and guidance for herDissertationst work for the course

Dr. P.C. Mohapatra

own original work has not been submitted earlier either to

preparation of the manuscript.

Date : 5th July 2015

Sexually Transmitted Infection

Human Immune deficiency Virus

Acquired Immune Deficiency Syndrome

Below Poverty Line

Above Poverty Line

National Rural Employment Guarantee Act

South Orissa Voluntary Action

Non Government Organization

Madhya Pradesh State Aids Control Society

National Aids Control Society

Voluntary Counseling and Confidential Testing Center

Integrated Counseling and Testing Centre

Indian Network for Positive People

People Living with HIV AIDS

Chapter - One INTRODUCTION

Chapter - Two RESEARCH DESIGN

- SITUATIONAL ANALYSIS REGARDING HIV/AIDS

- PROBLEMS OF THE PEOPLE LIVING WITH

Other Problem of PLHIV

Chapter - Five HIV/AIDS HAS NO CURE

SUGGESTIONS AND FINDINGS OF THE

State wise Cases of AIDS Case

Map of Madhya Pradesh

Map of Indore District

Map of Study Area

HIV/AIDS The Problem and Analysis

State or Union Territory

State or Union Territory

Table 1.2 : Risk/Transmission Categories

It is therefore most important to note that every woman has

access to information about HIV/AIDS to protect herself.

HIV is a virus that causes AIDS.

This virus passes from one person to

another through blood to blood and sexual contact.

In addition, can infected

OTHER BODY FLUID CONTAINING BLOOD

immunodeficiency syndrome or AIDS to describe the occurrences of opportunistic

Committee. This name was later changed to HIV.

However, recently developed

In this stage, the body immune system has been incapacitated, a

AS WITH OTHER DISEASES EARLY DETECTION OFFERS MORE

OPTIONS FOR TREATMENT AND PREVENTIVE HEALTH CARE.

Rapid weight loss

Recurring fever or profuse night sweats

Profound and unexplained fatigue

Swollen lymph glands in the armpits. Groin. Or neck

Diarrhea that lasts more than a week

White sports or unusual blemishes on the tongue, in the

Red, brown, pink or purplish blotches on or under the skin or

inside the mouth nose or eyelids