Evaluation of AVAHAN, HIV prevention in India

22/04/2010 at 09:25 1 comment

Text taken directly from Avahan…

Avahan, the India AIDS Initiative of the Bill & Melinda Gates Foundation was begun in 2003 with the National AIDS Control Program and other donors to curtail the spread of HIV in India. In the first five years, Avahan designed and operated its programs in six states in India (Tamil Nadu, Andhra Pradesh, Maharashtra, Karnataka, Nagaland and Manipur), which have a combined population of 300 million people. At the end of the first five years  Avahan  provided prevention services to nearly 220,000 female sex workers, 80,000 high-risk men who have sex with men and transgenders, and 18,000 injecting drug users, together with 5 million men at risk. 

Emerging evaluation results from this large scale HIV prevention program have just been published in a special peer-reviewed supplement of Sexually Transmitted Infections that can be accessed at http://sti.bmj.com/content/86/Suppl_1.  In the papers you will find  details and measurement issues related to  rate of scale up, costs, quality measures, multiple approaches to condom use, and modeled estimates of infections averted.  All twelve papers and the six accompanying editorials are open access. 

The papers are:

  • Alary M, et al. Ecological analysis of the association between high-risk population parameters and HIV prevalence among pregnant women enrolled in sentinel surveillance in four southern Indian states. 
  • Ramesh BM, et al. Changes in risk behaviours and prevalence of sexually transmitted infestions following HIV preventive interventions among female sex workers in five districts  in Karnataka state, south India.
  • Lipovsek V, et al. Increases in self-reported consistent condom use among male clients of female sex workers following exposure to an integrated behavior change program in four states in southern India.
  • Pickles M, et al. . Interim modeling analysis to validate reported increases in condom use and assess HIV infections averted among female sex workers and clients in southern India following a targeted HIV prevention program.
  • Bradley J, et al.  Assessing reported condom use among female sex workers in southern India through examination of condom availability. 
  • Lowndes C, et al. Assessment of intervention outcome in the absence of baseline data: ‘reconstruction’ of condom use time trends using retrospective analysis of survey data.
  • Piot B, et al.  Lot quality assurance sampling for monitoring coverage and quality of a targeted condom social marketing program in traditional and non-traditional outlets in India.
  • Ramakirshnan L, et al. Program coverage, condom use and STI treatment among FSWs in a large-scale HIV prevention program: results  from cross-sectional surveys in 22 districts in southern India.
  • Blakenship K, et al.  Factors associated with awareness and utilization of a community mobilization intervention for female sex workers in Andhra Pradesh, India.
  • Verma R, et al. Scale-up and coverage of Avahan: a large scale HIV-prevention program among female sex workers and men who have sex with men in four Indian states.
  • Mogasle V, et al. Quality assurance and quality improvement using supportive supervision in a large-scale  STI Intervention with sex worker, men who have sex with men and injecting drug users in India.
  • Chandrashekar S, et al. The effects of scale on the costs of targeted HIV prevention interventions among female and male sex workers, men who have sex with men, and transgenders in India.

The editorials are :

  • Piot P.  Setting New Standards for Targetted HIV Prevention :  the Avahan Initiative in India.
  • Sarkar S.  Community Engagement in HIV Prevention in Asia :  Going from « for the Community » to « by the Community » – must we wait for more evidence ?
  • Bertozzi SM, et al.  Evaluation of HIV Prevention Programs : the Case of Avahan.
  • Laga M, et al.  The importance of sex-worker interventions :  the case of Avahan in India.
  • Rao PVJR.  Avahan: the transition to a publicly funded programme as the next stage.
  • Zenilman JM.  Recreating the impact of interventions in the absence of baseline data :  challenges for intervention programs.

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Now that sounds familiar…40,000 sex workers on the move…again Botswana makes positive moves towards LGBTI and Sexworkers

1 Comment Add your own

  • 1. kohinoor devroy  |  20/05/2010 at 13:06

    Avahan sounds good.
    Health care remains another huge concern. According to a recent Planning Commission assessment, the shortfall of primary health centres and sub-centres in 2008 has remained almost the same as in 2005, and the number of auxiliary nurse midwives has, in fact, decreased over the same period. Today, there is a 50 per cent shortfall in trained health workers, radiographers, lab technicians and doctors. At the existing rate, only 62 per cent deliveries will be attended by skilled personnel by 2015 – with rural areas being particularly under-serviced.

    Sanitation, unfortunately, has never been a policy priority for India despite that fact that drinking water contaminated by faecal matter is a major cause of child deaths. The Report admits that India has the lowest sanitation coverage in the world – in 2007-08, an estimated 66 per cent of rural households did not have toilet facilities.

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