The core of Operation Lighthouse was to be the creation of targeted behavior-change communication focused on high – risk male workers associated with the ports and related industries supported by condom social marketing in each port.Mumbai is the first port to implemented the program strategies and then replicate to other ports
What?Disease of the human immune system caused by the human immunodeficiency virus (HIV). Why? Virus that weakens the immunity in the human body. People affected by this virus will become vulnerable to opportunistic infections or tumors susceptible. How ? a. Unprotected sexual intercourse with an infected patner b. Vertical transmision c. Injection drugs use
Estimated Worldwide HIV Prevalence, 1980-20004035302520151050 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Sub-Saharan Africa Asia/Pacific Western Hemisphere
Profile Nonprofit NGO founded in 1970 based in Washington DC under the name Population Inc. In 1973 the name was officially change to Population ServicesInternational, and the new name was beffiting of the Organization The mission of PSI is to measurably improve the health of poor and vulnerable people in the developing world, principally through social marketing of family planning and health products and services, and health communications. * It had also concern of public health, included malaria, safe water, iodized salts, multivitamins, and HIV / AIDS * Source : http://www.psi.org/about-psi/mission
Programs •1972 - Promote condom use as a form of contraception (launch in Kenya) •1987 – Launch Prudence brand of male condom in Congo Republic •2002 – Launch “Studio 263”, a soap opera series in Zimbabwe Africa PSI Programs primarily focused on : •Absistency (Delay of Sexual Relations promoted to young people) •Mutual fidelity (Promoted to Stable Couples as their first line of defense against HIV) •Condom use (Targeted at High Risk groups such as commercial sex workers and others) •Voluntary counseling and testing (An intervention that historically resulted inincreased condom use and partner reduction)
Balbir Pasha Who is Balbir Pasha? Balbir Pasha is a fictional characther to educate India people about HIV / AIDS, and to practicing save sex. How Balbir Pasha working?Started with teasers asking, “Will Balbir Pasha get AIDS?” The nextphase convey key messages on HIV that would cause the targetaudience to question their own behavior.
Balbir Pasha Mass Media IPCPros •More wider (large scope) •Well trained army •Attractive •Direct to the target •Cheaper ($100/week per IPC`s)Cons •Risky investment •Hiring more IPC`s •Expensive (could reach •Increasing the training that $100.000) each IPC`S received •No guarantee of success •Take a long time •Statured market
PSI India Port AssessmentGroup Size Profile STI/HIV Risk StatusFormally 60.000-80.000 Living with his family, some LowEmployed port live in port-trust providedworkers housingInformally 100.000-200.000 Work in shift to Medium toEmployed Port unload/load trucks, HighWorkers containersSailors 20.000 Visit sex workers in up- Medium to market hotels and bars in High the area during free timesPort Security 4000-5000 Most live in barracks away Medium to from families HighTruckers and 200.000 Most spend significant HighHelpers amounts of time away from home (high rate of patner change)
PSI India Port AssessmentGroup Size Profile STI/HIV Risk StatusSex workers 70.000 Sex workers attached to High brothels/ hotels /lodges, street based, and family based.Migrant unknown Most live in urban slums MediumLaborers and work on construction projectsBlue-collared unknown Both married and Mediumindustry unmarriedworkersaround portsFamilies of unknown Wive and children living LowPort with men in portCommunity authority-supplied housingWorkers or in residential communities
PSI India Port Assessment Group STI/HIV Accesibility Risk StatusPrimary •Truckers and Helpers High •Petrofilling stations,concern •Sex Workers termini, rest stops, transport company offices •NGO`s working with CSWSecondary •Informally Employes Port Workers Medium or Medium •Reachable throughconcern •Sailors to High employer and unions •Port Security •Immigration office, up- •Migrant Labores market beer bars/hotels •Blue-collared industry workers •Several CISF around ports commandants indicated interest •Residential areasTertiary •Formally employed Port Workers Low •Reachable throughconcern •Families of Port Community Workers employer, residential colonies •Via port auhority welfare programs and community outreach
-National AIDS Control Organization (NACO) Annual Report, 2002-2004, Ministry of Health and Family Welfare, Government of India (GOI)-
Routes of Trasmission of HIV/AIDS in India 2,6% 2,7% 6,8%2,2% Sexual Unidentified Intravenous Drug Use 85,7% Blood Transfusion Perinatal• Predominantly by heterosexual contact (85,7%), and followed by perinatal transmission (2,7%), blood transfusion (2,6%), Intravenous drug use (2,2 %).• 87,7% of HIV infections were in the group of 15-44 years old.• The ratio of male HIV/AIDS cases to female was 3:1.• The urban-rural ratio 8:1. The trends transmission, greater female and rural.
Prevalence Category in India :• High prevalence states : Exceeding 5% high risk group and exceeding 1% among antenatal women.• Moderate prevalence states : Exceeding 5% high risk group but less than 1% among antenatal women.• Low prevalece states : Less than 5% high risk group but less than 1% among antenatal women.
Disease Prevalence • Two-thirds case of HIV/AIDS epidemic are from Maharastra and Tamil Nadu. • Mumbai, the capital of Maharastra, have the largetst concentration of HIV infection in India. • Some of truckers visited prostitutes in the red-light district, and brought the diseas to their home. • The total number of infected, 35 million in the next 5 years.
National AIDS Control Organization (NACO)• Created in 1992.• Focus : - Establishing the HIV Sentinel Surveillance, to monitor the disease. - Voluntary testing and counselling. - Modernizing blood banks. - Raising the awareness and the prevention with use of condoms.
Challenge• The most Indians, thought that HIV only of those on the fringe of society.• Similar to the fearful public response in the U.S and other countries in 1980.• The conservative culture in India, cause the public discussion about sex not acceptable.• Every state have its own languange, social customs and cultural norms.
• Established in the 1990s, in Tamil Nadu.• Implemented by Voluntary Health Service, an NGO based in Chennai.• Focus : - High-risk transmitters of HIV - Introducing & reinforcing preventive behavior - Promote condoms and safe sex practices - Enhancing STD service and counseling.
Exhibit 6 : Price Comparison of Condoms Brand Type of Distribution Approximate Unit Price (in Indian rupees) Deluxe Nirodh Social Marketing 0,4Super 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
Exhibit 7 : Free Distribution and Sales of Condoms in IndiaYear Free Social PSI Masti PSI Nirodh Distribution Marketing Brand Brand1995-1996 891,22 162,92 13,97 27,411996-1997 685,85 263,25 25,91 29,961997-1998 741,70 324,42 40,52 17,271998-1999 660,76 348,74 48,93 38,231999-2000 674,36 477,74 60,49 24,102000-2001 627,42 465,43 74,23 16,38
Project in Mumbai• Concentrate its efforts on the growing HIV/AIDS threat in Mumbai.• Budget $30.000 to $50.000 per year.• The goals : - Establish relationship with sex workers - Build awareness of HIV/AIDS - Encourage preventive behavior - If possible, demonstrate correct condom usage.
Second National AIDS Control Program (NACP-II)• Launched by NACO in 2000.• Funded by World Bank, USAID & the British Department for International Development.• Recognize the need to prevent HIV from high risk group.• 1/3 of $300 million, targeting sex workers, migrant workers, truckers and other high risk group.• Develop new programs, with openness to several NGOs, including PSI.
Operation Lighthouse Development of communication programs aimed at motivating high – risk individuals such as sex workers in Mumbai and other Indian port cities to practicing safe sex. Project to reduce HIV prevalence in India’s 12 Major port Communities Port communities served as a convergence points for many Indians at the highest risk for contracting the disease and transmitting it to others.
Operation Lighthouse The core of Operation Lighthouse was to be the creation of targeted behavior-change communication focused on high – risk male workers associated with the ports and related industries supported by condom social marketing in each port. Mumbai is the first port to implemented the program strategies and then replicate to other ports
Objective of Operation Lighthouse 1. Increased reported 2. Decrease number of sex condom use among target acts with nonregular populations partner 3. Incrase correct STI 4. Increased number of diagnosis and treatment outlet providing condom among target populations 5. Shift in the public 6. Significant policy about environment so they able prevention, care, and to talk frankly and support from port intelligently about management HIV/AIDS)
Obstacle to Safe – Sex PracticesResearch studies were conducted by PSI inorder to assess: General attitudes and risk perception of AIDS Current consumer attitudes toward sexual activity and sexual partners Triggers and barriers to the regular use of condoms
HIV/AIDS Risk Perception Survey of HIV / AIDS Risk PerceptionHigh personal risk perception with a sex worker 74%High personal risk perception with an unpaid (noncommercial) 18%partnerHIV 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%o A perception that prostitutes were associated with a high risk oh HIVo Perception that girlfriend / mistress were not perceived as a high risk for HIV (18%)o 88% of men visiting sex workers claimed to have used of condoms
HIV/AIDS Risk PerceptionAs a part of its assessment of Barriers to the use ofcurrent consumer attitudes condom:toward a barriers to regularcondom usage, PSI conducted 1. Trusting / knowing a2 focus group of Mumbai girlMen: 2. Lack of pleasure• 18 – 24 years old males 3. She looks healthy who sexually active with at least 2 – 3 partners 4. Loyalty to one or two• 25 – 35 years old married partners man who had extramarital 5. Lack of preplanning affairs
The Decision to Use Mass Media Primary target of Operation Lighthouse: male migrant workers between 18 – 34 yrs old who were associated with port. Men who were visiting brothels in Mumbai’s red light district were increase from across city, creating challenge for IPC’s to contact them. PSI felt they previous HIV’AIDS treatment & prevention in India didn’t sufficiently enough to educate public. That’s why PSI decided to use a mass – media campaign.
Campaign ObjectivesTo increase the perception of HIV / AIDS risk from To generate discussion about unprotected sex with HIV / AIDS among the target To motivate people to access nonregular partners by populations and opinion PSI’s HIV / AIDS Help Line and personalizing the message leaders in order to facilitate VCT services (Goal : and creating emphaty understanding and Behavioral Change) through identifiable real-life knowledge acquisition (Goal :situations (Goal: Attitudinal Change Social Norms) Change)
Balbir Pasha Who is Balbir Pasha?Balbir Pasha is a fictional characther to educate Indiapeople about HIV / AIDS, and to practicing save sex. How Balbir Pasha working?It used a storyboard to place him in various high-risk sexual situations with unknown outcomes and then to ask, “Will Balbir Pasha Get AIDS” as a tagline.
Issues• Should PSI’s communications be focused on general AIDS awareness and disease risk perceptions or should it target particular barriers to condom use or combination of both?• How customized the first phase should be to Mumbai’s language and culture?• Sanjay wondered whether or not a mass-media campaign was the best way or PSI could expand on- the-ground IPC operations?
The Balbir Pasha Campaign Using Mass – Media CampaignCampaign Campaign PSI should combine campaign and value The character Balbir the AIDS awareness remains in deploying Pasha was portrayed and barriers to use IPCs, they are able across various condom. to engage the target communications • To increase channels in fascinating audience personally. scenarios, serving as perception Outdoor a behavioral model for of HIV/AIDS risk communication in people to relate to and from unprotected the red light area empathize with. sex with non- Outdoor 5 stage mass media regular partners. communication & campaign, centered • Reducing the public transport around Balbir Pasha number of AIDS Outdoor in high risk sex people by using communication at situation. condom. cinema halls Each stage builds TV and radio intrigue and gossip channels value. Print Media
Marketing CommunicationOutdoor communication in the red light area• Billboard and poster around the port and other place that target audience frequently see , so the campaign high reach and visibility.Outdoor communication & public transport• Placing poster in bus/train station to reach more geographical target.• Use rear side of truck as media to campaign Balbir Pasha, such as draw pictures to illustrate the balbir pasha campaign.Outdoor communication at cinema halls• The high popularity of Bollywood films provides an opportunity to communicate Balbir Pasha via short ad before the movies showed.TV and radio channels• Make a short story to be advertised on TV, centered around Balbir Pasha in high risk sex situation. In order to overcome language barriers, it has to be executed across a range of channels, dubbed in local dialects and subtitled in Hindi, the main language in India• Make a short conversation / song to communicate about unprotect sex that happened to Balbir Pasha allows to higher frequency messaging and helps to provide additional exposure.Print Media• Placing daily advertisement to local daily newspaper or magazine to increase visibility of the campaign.
“Will Balbir Pasha get AIDS ?” • “Balbir Pasha always use condom, but when Alcohol drunk, he forget to wear it.”Non-Reguler • “Balbir Pasha only has one sex partner, but he doesn’t know that she have sex with another Partner guy.” Healthy • “Balbir Pasha has new sex partner, health & beautifull, but he didn’t know that she infected.” Partner • “I don’t want to get HIV/AIDS and be the nextFinal Stage Balbir Pasha. So, what should I do ?”
ConclusionIf Balbir Pasha message sentclearly and correctly, it canincrease the awareness aboutHIV/AIDS & its prevention.Balbir Pasha shouldcommunicate in all mass mediaand IPC program to strenghtenthe efforts against HIV/AIDS.Give awareness to always usecondom to prevent the HIVinfection.