AIDS(Acquired Immune Deficiency Syndrome or Acquired Immunodeficiency Syndrome ) Is a set of symptoms and infections (or: syndrome) arising out of damage to the human immune system caused by HIV infection.
HIV(Human Immunodeficiency Virus) Virus that weakens the immunity in the human body. People affected by this virus will become vulnerable to opportunistic infections or tumors susceptible.
HIV and similar viruses are generally transmitted through direct contact between the skin layers(mucous membrane) or the bloodstream with a bodilyfluid containing HIV, such as blood, semen, vaginal fluid, preseminal fluid, and breast milk. Transmission can occur through sexual intercourse (vaginal, anal, or oral), blood transfusion, contaminated hypodermic needles, between mother and baby during pregnancy, childbirth, or breastfeeding, as well as other forms of contact with body fluids.
Scientistsgenerally believethat AIDSoriginated fromSub-SaharanAfrica.Now that AIDShas become aplague. AIDS hasinfected anestimated 38.6million peoplearound the world.
Estimated number of people living with HIV/AIDS by country
Estimated Worldwide HIV Prevalence, 1980-2000 30HIV Frequency (in millions) 25 20 Sub-Saharan Africa 15 Asia/Pacific Western Hemisphere 10 5 0 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000
PSI ProfileA leading global health organization with programstargeting malaria, child survival, HIV, and reproductivehealthWorking in partnership within the publicand private sectorsProvides life-saving products, clinical servicesand behavior change communications
PSI Story1970 1972 1973 1987 2002 Nonprofit NGO Launched First Family The name Launching Lauch mass- Program to became Prudence media in Promote Population brand of male Zimbabwe Condom Use Services condoms in called “Studio as a Form of International Congo 263”First named as Contraception Population Services Inc
PSI Programs in Africa • Delay of Sexual Relations promoted to young Abstinence people • Promoted to Stable Couples as their first line Mutual Fidelity of defense against HIV • Targeted at High Risk groups such as Condom Use commercial sex workers and othersVoluntary Counseling • An intervention that historically resulted in and Testing increased condom use and partner reduction
In 1986, the 1st case HIV/AIDSin sex worker from the port of Chennai In 2002, about 1% of 1 billion India’s population observed potential disaster In 2002, India was 2nd in the world after South Africa with number of people living with HIV/AIDS HIV-positive Indians had now reached almost 5 million
The driver of heterosexual transmission of HIV/AIDSwas increasingly younger and more sexually activeIndians The majority of HIV infections 87.7% were in the age group of 15 to 44 yearsThe ratio of male to female cases was 3:1 The ratio urban to rural cases was 8:1Trends in transmission were toward greater femaleand rural exposure to HIV
Indian states categorized by prevalence based1 High prevalence states HIV prevalence rates exceeding 5% among high- risk groups and exceeding 1% among antenatal women.2 Moderate-prevalence states HIV prevalence rates exceeding 5% among high- risk groups but less than 1% among antenatal women.3 Low-prevalence states HIV prevalence rates less than 5% among high-risk groups and less than 1% among antenatal women.
• Maharastra and Tamil Nadu accounted for no less than 2/3 of India HIV/AIDS cases (High prevalence states categories) • Mumbai contained the largest concentration of HIV infections. • The total number of people in India could skyrocket to 35 million over the next five years.Map of HIV Risk Group Severity byIndian State
Affect to Rural PopulationHIV also spreading to the rural population through migrant workers and commercial truckerCause : Less family interactionTend to visit prostitutes places while work and finally bring it to their home
Sex workers said:“You don’t need to tell meabout safe sex. I know allabout it. You need to go tellthe thousand of men outthere that come to womenlike me. They hold up thepower. Go and talk to themen about safe sex.”
HIV/AIDS TREATMENT AND PREVENTION IN INDIA 1986-2002
•Founded in 1992 by the governmentof India’s Ministry of Health•Function : Coordinate treatment andprevention activities at a nationallevel•HIV Sentinel Surveillance program : – Monitor disease prevalence – Establishing the first voluntary testing and counseling centers in key areas around the country – Modernizing blood Bank to prevent HIV transmission via blood transfusion – Raising general awareness of the disease – Its prevention through the use of condoms
Challenges to Raising Awareness of HIV• HIV thought to be a disease only of those on the fringe of society (sex workers, etc)• Fearful public responses• Public discussion about sex was not acceptable because culture in India• Variety language, social customs, cultural norm
Program 1 AIDS Prevention and Control Project (APAC) in Tamil Nadu One of the first large-scale HIV prevention projects in INDIA to :• Focus on high-risk transmitters of HIV• Specifically by introducing and reinforcing preventive behavior• Promoting the sale and use of condoms• Promoting other safe-sex practices• Enhancing services and counseling
Price Comparison of Condoms : Social Marketingversus Commercial Brand Type of Distribution Approximate Unit Price (in Indian rupees) Deluxe Nirodh Social Marketing 0,4 Super Deluxe Nirodh Social Marketing 0,75 Masti Social Marketing 1,0 Thril Social Marketing 1,25 Kohinoor Commercial 3,33 Kama Sutra Commercial 4,50 Durex Commercial 7,0
National Statistic for Free Distribution and Sales ofCondoms in India via Social Marketing as well as Salesof Masti and Nirodh Brand Condoms Year Free Social PSI Masti PSI Nirodh Distribution Marketing Brand Brand 1995-1996 891,22 162,92 13,97 27,41 1996-1997 685,85 263,25 25,91 29,96 1997-1998 741,70 324,42 40,52 17,27 1998-1999 660,76 348,74 48,93 38,23 1999-2000 674,36 477,74 60,49 24,10 2000-2001 627,42 465,43 74,23 16,38
Program 2 Prevention programs on the growing HIV/AIDS threat in Mumbai, the capital Maharasta Project Goals :• Establish relationship with the sex worker• Build awareness of HIV/AIDS and the health risks associated with the disease• Encourage preventive behavior• Demonstrate correct condom usage when possible
That “day” came in 2000 when NACO launched theSecond National AIDS Control Program (NACP-II) withfunding from the World Bank, USAID, and the BritishDepartment for International Development, amongothers.
Operation Lighthouse• Project to reduce HIV prevalence in India’s 12 Major port Communities• Port communities as a convergence point for many Indians at the highest risk for contracting the disease and transmitting it to others
Major Port Cities of IndiaKandla Calcutta Haldia Mumbai Paradeep Vashi Vizag Goa Chennai Manglore Cochin Tuticorin
Objective Goal • Increased reported condom use among target populations1 • Decrease number of sex acts with nonregular partner2 • Incrase correct STI diagnosis and treatment among target populations3 • Increased number of outlet providing condom4 • Shift in the public environment so they able to talk frankly and intelligently about5 HIV/AIDS) • Significant policy about prevention, care, and support from port management6
Research Studies in Operation LighthouseGeneral attitude Current consumer Triggers and and risk attitudes toward barriers to use perceptions of sexual activity and condom AIDS sexual partner
HIV/AIDS Risk Perception (Survey) Description Value High personal risk perception with a sex worker. 74% High personal risk perception with an unpaid (noncommercial) partner. 18% HIV risk will not decrease with expensive sex worker 52% HIV risk will not decrease with healthy sex worker 34% HIV risk will not decrease with inconsistent condom use 43% Belief that HIV was viewed as a disease affecting only certain groups at the fringe of Indian Society like sex worker. Perception that prostitute were associated wit a high risk of HIV 88% of men visiting sex workers claimed to have used of condoms
Barriers to the use of CondomsTrusting/knowing a girl• “She will sleep with me only and no one else”• “If you know she doesn’t go to anyone else, don’t use condom”Lack of pleasure• “Regardless of what you say, it reduces sexual pleasure”• “Even we want to, we can’t use condom now”She looks healthy• “Look how good she looks. She’s not sick!”Loyalty to one or two partners• “I will only get AIDS when I change my partners fast and have many partners”Lack of preplanning• “If you want it now, you just want it…you won’t think of condom”• Drinking Alcohol on a date and inconvenience of storing condom at home led poor planning
Campaign Objectives To increase the perception of HIV / AIDS risk from unprotected sex with nonregular partners by personalizing the message and creating emphaty through identifiable real-life situations To generate discussion about HIV / AIDS among the target populations andopinion leaders in order to facilitate understanding and knowledge acquisition To motivate people to access PSI’s HIV / AIDS Help Line and VCT services
A fictional character. Started with teasers asking, “Will Balbir PashaBalbir Pasha get AIDS?” The next phase conveyed key messages on HIV that would cause the target audience to question their own behavior. Encouraged people to call the HIV helpline for information.
General AIDS awareness and diseases risk perception/target particularFocus Issue barriers to use of Condom/some combination of both? How customized the first phase shouldScalability be to Mumbai’s language and culture? Mass media was a risky investment Risky required high cost and no guarantee of success.
Mass Media vs IPC Operations MASS MEDIA IPC OPERATIONSPROS Large coverage Cheap Attractive Direct to the targetCONS Reach non target Take time longer Expensive Required many new persons Meet local cultureAlthough IPC Operations is cheaper and could be more efficient,but PSI need instant action to stp the HIV / AIDS before it’s gettingworse, so mass media could be more effective to reduce HIV /AIDS in India at this time
High STI / HIV Risk Status in PortsGroup SizeInformally Employed Port Workers 100.000 – 200.000Sailors 20.000Port Securitiy 4.000 – 5.000Truckers and Helpers 200.000Sex workers 70.000
Campaign • Print mediaUse Mass Media and • TV, Radioa little ICP Operations • On the spot activities Use both AIDS • AIDS awareness to make people awareness and educated about AIDS barriers to use • Condom use to mitigate the AIDS on people condoms • Many type of Balbir Pasha’s advertisement with many situation The advertisement • Played at night to decrease probability that the advertisement watched by kids
MASS MEDIA Communication Mix Print media TV and RadioPosters in Red Light Districs Advetisement about Balbir PashaBillboard near the Port Soap Opera in TelevisionPrint on the truck shelter Short stories on RadioOn the gas station Movies about HIV / AIDSAttitudinal Change • Use simple words and real life situationsChange Social Norms • Use Balbir pasha as the Icon of AIDSBehavioral Change • Always put the further contact of PSI’s HIV / AIDS Help Line and VCT services
Steps :1. Introduce Balbir Pasha as an icon of AIDS.2. Attack the attention of community - Build print media of Balbir Pasha especially around ports - Advertisement of Balbir pasha on TV and radio
3. Campaign activity : Hire college students and high school students to make the activities of HIV/AIDS Campaign: - Free condoms around Red Light District - Free shirts written “Will Balbir Pasha Get AIDS?” - Condoms for women Balbir Pasha advertisement must available in indoor and outdoor places Increase entertainments in Truck shelter and Ports (ex:adding Television) Create Balbir Pasha advertisement on TV that change HIV / AIDS Risk Perception Always gives PSI’s HIV / AIDS Help Line and VCT services on every advertisement
Balbir Pasha AdvertisementBalbir Pasha love Shireen so much and used to have sex onlywith her, but Balbir Pasha doesn’t know that Shireen is also have sex with another guy. Will Balbir Pasha get AIDS? Balbir Pasha usually have sex with condoms, but one day he got drunk and have sex with someone he didn’t know without using a condom. Will Balbir Pasha Get AIDS? Balbir Pasha have sex with his new working partner. His partner looks so healthy and shiny. Suddenly his new partner’s boyfriend died because of AIDS. Will Balbir Pasha Get AIDS?
Balbir Pasha Post-Advertisement Flashback of what Balbir Pasha did and then Balbir Pasha suffer AIDS and get his life so bad withunstoppable sickness. But suddenly he woke up and he recognize that it was only a dream and he feel safe because he always bring and use condoms