World Hepatitis Day 2013: Making Hepatitis C a Priority

Sixteen million people inject drugs worldwide. Three million live with HIV, and two-thirds of them live with Hepatitis C. (Photo by Francis Joseph for India HIV/AIDS Alliance)

Sixteen million people inject drugs worldwide. Three million live with HIV, and two-thirds of them live with Hepatitis C. (Photo by Francis Joseph for India HIV/AIDS Alliance)

A dear friend of mine was struggling as a single mother, working two jobs and balancing drug use. To make things simpler, she quit the jobs and started working from home. Unfortunately, her drug use turned out to be more problematic than anticipated. Her situation was further complicated when she was diagnosed as positive for Hepatitis C, a viral disease that leads to the inflammation of the liver and related complications.

With no medical insurance, she faced a financial challenge to cover the six-month long treatment. At first, she got contributions from family and friends and then a loan, and lastly she sold her jewellery. She recovered only to be hit with the virus again. This time her condition deteriorated so quickly that she was not able to make it through a second round of treatment. Only half of those who are treated actually recover. My friend’s is just one of the many stories of people struggling with Hepatitis C.

Hepatitis C represents a huge public health problem in India and globally. According to the World Health Organization about 150 million people are chronically infected with the Hepatitis C virus, and more than 350,000 people die every year from Hepatitis C-related liver diseases. The Hepatitis C virus is more infectious than HIV. An estimated 10–12 million people in India are infected with Hepatitis C, including 50 percent of people who inject drugs (PWID) nationally and 90 percent of PWID in the northeast. Left untreated, Hepatitis C can lead to liver cirrhosis, liver cancer or liver failure.

Hepatitis C is especially of concern for those co-infected with HIV, as several studies have shown that HIV-Hepatitis C co-infection leads to increased rates of disease progression. PWID are especially vulnerable to infection by both HIV and Hepatitis C; co-infection rates are as high as 93% among PWID in Manipur. However, unlike first- and now second-line HIV treatment, which is available to people living with HIV who need it in India, Hepatitis C treatment is not available in government hospitals largely due to its high cost, and health programmes for PWID typically do not screen patients for Hepatitis C due to the unavailability of treatment. Consequently, this results in high morbidity and mortality among PWID.

To address this concern, our Government of the Netherlands-supported Hridaya programme disseminates information on Hepatitis C prevention through outreach and counselling sessions at drop-in centers (DICs) in 36 sites in four states: Bihar, Jammu, Haryana and Uttarakhand. The programme also identifies clients and refers them for testing. Those found to be Hepatitis C-positive are further educated on self-care and positive prevention. The programme’s outreach team works with spouses and families of PWID, explaining Hepatitis C risk and prevention in the context of injecting drug use.

To address the growing problem of HIV-Hepatitis C co-infection among women who inject drugs, our Elton John AIDS Foundation-funded Chanura Kol project has initiated Hepatitis C interventions. Women enrolled in the project are educated about transmission risks, prevention strategies, and the importance of testing.

With both programmes, Alliance India is working to ensure that Hepatitis C prevention education and treatment literacy become a priority for PWID and a core part of this country’s efforts to improve the lives and health of PWID.

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The author of this post, Simon W. Beddoe, is Advocacy Officer: Drug Use & Harm Reduction.

With funding from European Commission, the Asia Action on Harm Reduction programme supports advocacy to increase access by people who inject drugs (PWID) in India to comprehensive harm reduction services and reduce stigma, discrimination and abuse towards this vulnerable population. The three-year programme in the beginning will primarily engage with PWID and local partners in Bihar, Haryana, Uttarakhand, Delhi and Manipur and  gradually extend its reach across India.

Registering for a Healthy Life: Chanura Kol Helps Women Who Inject Drugs

A registration book lies open in front of a woman who has just used a clean syringe provided by a Drop In Centre in Manipur. The needle is being washed and will be discarded in one of the trash cans that can be seen in the background. Photo by Prashant Panjiar for India HIV/AIDS Alliance

A registration book lies open in front of a woman who has just used a clean syringe provided by a Drop In Centre in Manipur. The needle is being washed and will be discarded in one of the trash cans that can be seen in the background. Photo by Prashant Panjiar for India HIV/AIDS Alliance

Chochong was married at the young age of 15. Unable to cope with her husband’s abuse, she was tempted to try drugs. It was an easy way for her to overcome the suffering she endured every day. In 2010, Chochong met a field worker at a hotspot in Imphal who motivated her to register with Alliance India’s Chanura Kol project. “I was hesitant at first and scared thinking, ‘What will they do?’ Their guidance has helped me lead a healthier life.”

Chochong is not alone. Since 2010, 720 women who inject drugs (WWID) have registered with Chanura Kol to avail a range of services provided by the project. Registered WWID have received psychological and social support through counseling services from Chanura Kol. They have also received information about HIV-related services, as their risk of infection is high, because of injecting drug use and sex work, which many depend on as their primary source of income. Services also include free health checkups with the provision of basic healthcare and treatment support for those living with HIV.

In addition, WWID registered with the project receive income generation support from activities like making pickles, selling dry fish, catering and supplying clothes. This new income can play an essential role in preventing relapse into drug use. Chanura Kol aims to ensure that WWID receive essential support and care services which can prevent them from relapsing and protect them from HIV and other blood-borne viruses like Hepatitis C.

“I have a hope that if I continue to avail services of Chanura Kol, I will soon be able to meet my son whom I left back because of this habit,” Chochong says.

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The author this post, Ankita Bhalla, is Communications Associate, India HIV/AIDS Alliance.

India HIV/AIDS Alliance in partnership with SASO, implements the Chanura Kol project in Manipur. Funded by the Elton John AIDS Foundation, Chanura Kol was initiated in 2010 and serves to expand interventions to reduce drug relapse among female injecting drug users. Based on a holistic and sustainable approach, Chanura Kol aims to address the root causes of vulnerability and the primary causes of relapse post-detoxification for women who inject drugs in India’s north-eastern state of Manipur, many of whom are also sex workers. Chanura Kol provides these women with long-term shelter, creates opportunities for income generation outside of sex work, and encourages the rebuilding of family relationships.

Detox and a New Life: Supporting Options for Women Who Inject Drugs in Manipur

Post detoxification, women are encouraged to learn new vocations. In this photograph, a woman at the Chanura Kol short stay home learns to make frankincense sticks. (Photo by Prashant Panjiar for India HIV/AIDS Alliance)

Post detoxification, women are encouraged to learn new vocations. In this photograph, a woman at the Chanura Kol short stay home learns to make frankincense sticks. (Photo by Prashant Panjiar for India HIV/AIDS Alliance)

Alliance India’s Chanura Kol project offers a range of harm reduction services for women who inject drugs to help them lead a better life. Detoxification is the most important option in this strategy.Since the inception of the project in 2010, 113 women have completed detoxification to wean themselves off drugs.

Detoxification reduces withdrawal symptoms and helps an addicted person adjust to living without the effects of opiates or other drugs. Alliance India’s partner in the project, Social Awareness Service Organisation (SASO), provides this option either at the homes of female injecting drug users in situations where they have supportive family members or in a clinical setting when drug users lack family support.

Once detox is completed, the process of rehabilitation begins. Chanura Kol encourages the rebuilding of strained family relationships during the reintegration period. As a key part of rehabilitation, these women are helped to learn new vocations to earn a living. They often receive loans from self-help groups established by their peers to support these efforts to start small businesses.

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India HIV/AIDS Alliance in partnership with SASO, implements the Chanura Kol project in Manipur. Funded by the Elton John AIDS Foundation, Chanura Kol was initiated in 2010 and serves to expand interventions to reduce drug relapse among female injecting drug users. Based on a holistic and sustainable approach, Chanura Kol aims to address the root causes of vulnerability and the primary causes of relapse post-detoxification for women who inject drugs in India’s north-eastern state of Manipur, many of whom are also sex workers. Chanura Kol provides these women with long-term shelter, creates opportunities for income generation outside of sex work, and encourages the rebuilding of family relationships.

Coffee, Noodles and Harm Reduction: A Menu to Reach Women Who Use Drugs in Manipur

A counsellor advises a client at the Chanura Kol drop-in centre in Imphal. (Photo © Prashant Panjiar for India HIV/AIDS Alliance)

A counsellor advises a client at the Chanura Kol drop-in centre in Imphal. (Photo © Prashant Panjiar for India HIV/AIDS Alliance)

In an effort to increase uptake of essential harm reduction services in Manipur, India, the Chanura Kol project did more than expand its service menu to reach women who inject drugs.

Early on, the Chanura Kol team realised that many women who inject drugs neither have the time nor inclination to stop by the project’s drop-in centre (DIC) in Imphal for counselling services or to meet a doctor. To encourage these women to avail these services, team members initiated special days when free coffee and the popular dish of chow mein noodles were served to visitors.

Soon, Chanura Kol’s ‘Chow Mein & Coffee Days’ gained popularity among community members, and the DIC saw more and more women stopping by and speaking with the doctor and counsellor on duty.

The women who visit are offered a range of services in addition to counselling: needle or syringe exchanges, free condoms, and health checks-up, including medicine for basic health conditions. Additionally, linkages to reproductive health and HIV-related care and clinic-based detoxification therapy are available along with overdose prevention education and Naloxone for overdose-related emergencies.

By offering the hospitality of a simple meal, the DIC has become a more welcoming and comfortable place for the women who use drugs that Chanura Kol is trying to reach. Many of them now refer to the DIC as a second home where they cannot only access health and harm reduction services but also build supportive connections with their peers.

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India HIV/AIDS Alliance in partnership with SASO, implements the Chanura Kol project in Manipur. Funded by the Elton John AIDS Foundation, Chanura Kol was initiated in 2010 and serves to expand interventions to reduce drug relapse among female injecting drug users. Based on a holistic and sustainable approach, Chanura Kol aims to address the root causes of vulnerability and the primary causes of relapse post-detoxification for women who inject drugs in India’s north-eastern state of Manipur, many of whom are also sex workers. Chanura Kol provides these women with long-term shelter, creates opportunities for income generation outside of sex work, and encourages the rebuilding of family relationships.

Changing a Habit of Addiction in the Land of the Gods

Severe punishments doled out to drug offenders in Uttarakhand have motivated users to shift from heroin and brown sugar to injecting pharmaceutical cocktails. (Photo by G. Charanjit Sharma for India HIV/AIDS Alliance)

Severe punishments doled out to drug offenders in Uttarakhand have motivated users to shift from heroin and brown sugar to injecting pharmaceutical cocktails. (Photo by G. Charanjit Sharma for India HIV/AIDS Alliance)

Uttarakhand’s natural beauty has captivated tourists and residents alike for centuries. Wildlife and nature enthusiasts, pilgrims, and even those wanting an escape from city life have turned to the serenity of Uttarakhand’s lush green mountains, fresh air, and the sacred Ganges river that runs through this North Indian state, often called ‘the Land of the Gods.’

Beyond its scenic beauty, Uttarakhand is also well-known for the cannabis that naturally grows all over the state. Cannabis has traditionally been associated with the holy men of this region but recently has seen an increase in consumption by the local population and tourists. Over the years, however, drug consumption has shifted towards heroin and brown sugar. Severe punishments given to drug offenders by the government for using these substance have motivated users to shift to injecting pharmaceutical cocktails, sold not by pharmacies but by local residents who bring them from outside the state.

New options for drug use have also led to an increase in number of people who inject drugs (PWID) and growing numbers who are infected with HIV, Hepatitis C and TB from sharing of syringes. Prolonged drug use impacts individual productivity. Most PWID are unable to keep steady jobs; they have limited financial resources, little family support or no meaningful access to drug treatment facilities. Social stigma and exclusion are constant features of daily life for PWID in Uttarakhand. Marginalized, they are routinely treated with disrespect and denied access to services they need, including healthcare.

Mindful of the current state of drug use in Uttarakhand, Alliance India’s Hridaya programme is working with seven organisations to offer harm reduction services in four districts, including the holy town of Haridwar and the state capital of Dehradun. Aiming to cover all PWID in these areas over the next two years, the programme will focus on the unmet needs of this vulnerable populations and complement activities in the state under India’s National AIDS Control Programme.

In addition to providing PWID with Hepatitis C education and overdose management, Hridaya will also encourage Hepatitis C testing, work with families of PWID to strengthen community mobilization, establish legal support and crisis response teams, and offer counselling on sexual and reproductive health, along with service referrals. To improve implementation and impact, the programme will also conduct drug pattern assessments to understand the dynamics of drug use in the state to respond more effectively to the needs of PWID.

In January 2013, the Hridaya team trained 30 newly recruited staff in Uttarakhand, including project officers, outreach workers, peer educators and peer counsellors from six CBOs. In these sessions, special effort has also been made to increase capacity overall and specifically train women in these roles to respond more effectively to the needs of female PWID. Similar staff trainings were held in Hridaya’s two other focus states, Haryana and Bihar.

Hridaya’s three-day training on harm reduction uses an intensive participatory workshop model featuring various techniques such as interactive presentations, group discussions, demonstrations, and feedback. Topics covered include: an overview of Hridaya; drug basics; drug-related harms; principles of harm reduction; outreach and peer education; Targeted Intervention (TI) prevention interventions under the national programme; needle and syringe exchange; operational aspects of interventions such as demand calculation, waste management and disposal; post-exposure prophylaxis for needle stick injury; sexually-transmitted infections; safer sex; drop-in-centres; service referrals; and networking.

As a guiding principle, Hridaya affirms the essential humanity and worth of PWID. This core value informs both the programme’s goals and its implementation. Building rapport with PWID and gaining their trust are essential steps in harm reduction programming, and Hridaya’s approach is designed to support the expansion of service offerings and demonstrate the importance of harm reduction as a key strategy to address HIV in PWID communities in India.

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The author of this blog, Francis Joseph, is Programme Officer for Alliance India’s Drug Use & Harm Reduction programmes and is based in New Delhi. 

Spanning five countries (India, China, Indonesia, Kenya, and Malaysia), Community Action on Harm Reduction (CAHR) expands harm reduction services to more than 180,000 injecting drug users (IDUs), their partners and children. The programme protects and promotes the rights of these groups by fostering an enabling environment for HIV and harm reduction programming in these five countries. CAHR is supported by the Ministry of Foreign Affairs, Government of Netherlands. 

CAHR in India is called ‘Hridaya’ and is implemented by India HIV/AIDS Alliance in partnership with SASO, Sharan, and a number of community-based harm reduction organisations and networks. This programme helps build the capacity of service providers, makes harm reduction programmes more gender-responsive, improves access to services and advocates for the rights of PWIDs. In addition to providing services, Hridaya has a strong capacity building component to support advocacy, knowledge management and improved services for PWIDs.

From Addiction to Action

Photo: Francis Joseph ( in middle) during a meeting of Alliance India members. Francis is the Programme Officer for Hridaya, an HIV and harm reduction programme supported by the Community Action on Harm Reduction (CAHR), Netherlands and implemented by Alliance India. Photographer: G Charanjit Sharma

Francis Joseph (center) with Alliance India colleagues. [Photo by G. Charanjit Sharma]

Francis Joseph is Programme Officer for Hridaya, our HIV and harm reduction programme in India supported through the five-country Community Action on Harm Reduction (CAHR) programme with funding from the Government of the Netherlands. Hridaya works in partnership with SASO, Sharan, a number of community-based harm reduction organisations, and the Indian Drug User Forum (IDUF), a national network of people who use drugs.‎

In this interview, Francis discusses the National AIDS Control Organisation’s approach to prevent HIV among people who inject drugs (PWID) and the work that Hridaya does to provide an additional package of services to this community, their spouses, children and families. Francis offers us a glimpse into the personal and programmatic consequences of social and self-stigma against people who inject drugs, and opens up about his personal connection to the PWID community which inspires his work every day.

Q: Why is a programme like Hridaya important especially in a country like India?

Francis Joseph (FJ): The National AIDS Control Organisation has adopted harm reduction strategy under the National AIDS Control Programme Phase three (NACP III) to prevent HIV amongst people who inject drugs (PWID), and has scaled up services through targeted interventions implemented by NGOs. The primary objective under the NACP III was to halt and reverse the spread of the HIV epidemic by 2012 and to cover 80% of the overall population of PWIDs through targeted interventions. By reaching out to a significant proportion of the estimated injecting drug users (IDU) population, the NACP III laid the foundation for an effective and evidence-based comprehensive response to halt and reverse the HIV epidemic among IDUs.

While considerable progress was made under NACP III with respect to the scale-up of interventions for IDUs as well as quality assurance in the country there were areas that were identified as emerging areas of concern. Some of these services include sexual and reproductive health services for spouses/sexual partners of male PWID, inadequate regulated drug treatment services and active engagement of PWID within the programme. The country lacks leaders from this community and especially lacks networks of drug users.

Any successful harm reduction approach requires greater involvement of PWID. Hridaya aims to empower drug users, identify individuals and build them as leaders from this community so that they are informed, educated and can voice for their basic human rights. Hridaya’s overall aim is to empower the drug using community in each of its focus states so that they can strengthen the harm reduction approach at the state and district level, and develop a local resource pool for capacity building initiatives.

Q: There are so many preconceived notions about IDUs. How does this affect their ability to seek treatment? Can you talk a bit about stigma?

FJ: Generally, people perceive drug users as criminals, social outcasts, and a threat to society. This makes it difficult for people who want to reach out to them to even contact them, or to build rapport and trust with them, and this is incredibly important since these factors further fuel the HIV epidemic in the country.

PWIDs are generally assumed to be HIV positive and are, hence, refused treatment when care and treatment is required. There have been many instances of PWID being denied treatment at public health care facilities, getting arrested and being treated with police brutality, and experiencing community hostility.

All of this leads to a complete lack of access to treatment and other essential services. The shabbily dressed appearance and unhygienic conditions of a number of PWIDs leads to them being denied access to any service. This has led to a sense of mistrust and has fuelled stigma and discrimination.

There was an incident in Delhi where a PWID burst his femoral vein due to injecting and was rushed to a nearby hospital. He was bleeding profusely and needed immediate critical care. The doctor on duty refused to help this man before an HIV test had been done on him. All through this, the man continued to be in incredible pain and was near death, but no one would help him.

Q: What motivates you about your job? Are there people you’ve met who inspire you to continue working in this area?

FJ: I come from the same community of PWID and have also experienced the pain of rejection, isolation, denial from family, friends, relatives and society at large. I know exactly what it feels like being socially rejected and ostracized, denied for many social entitlements and disowned by my family. I have lived a life full of negativity and have seen the inside of treatment centres and incarceration.

There are millions of people like me and very few have been fortunate enough to have come out of their dependence. I feel that I have a special calling that has motivated me to do something for my community. I began my new life of sobriety from the very basics, taking one day at a time, and I painstakingly built it up to where I am now. Today, I’m at a level where my voice is heard and I can speak up for the needs of the people who share a common background with me.

Q: What do you wish more people in general society understood about harm reduction and IDUs?

FJ: There are three approaches to any drug treatment programme: Drug demand reduction, drug supply reduction and harm reduction. The first two approaches see the solutions to this problem as generating awareness in reducing the desire to use drugs and prevent and delay the onset of drugs use to disrupt the supply of drugs through the implementation of draconian laws. Both these approaches focus on abstinence, which has constantly proven to result in a very poor outcome.

We at Hridaya follow the harm reduction approach, which-as the name suggests–aims to reduce the harm associated with injecting drugs use, such as HIV and Hepatitis C, and not eliminate the drug use per se. General society perceives that the only option to treat drug users is for them to follow the route of abstinence, which is practically impossible since there may be a certain segment of people who would never be able to give up drugs completely. Hence, the harm reduction approach advocates for drug users to stay safe and healthy regardless of whether they are still doing drugs or of the conditions that they live in.

Q: Are there any resources that you would recommend for people who want to learn more about harm reduction in relation to injection drug use?

FJ: I urge people to read more about this topic. To break the stigma against IDUs, we need more informed people. For those who are interested in learning more, there are some very good resources available on www.unodc.org/India/harmreduction,   www.nacoonline.org/publications/harmreduction and www.aivl.org

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The subject of this post, Francis Joseph, is Programme Officer for Alliance India’s Drug Use & Harm Reduction programmes and is based in New Delhi.

Spanning five countries (India, China, Indonesia, Kenya, and Malaysia), Community Action on Harm Reduction (CAHR) expands harm reduction services to more than 180,000 injecting drug users (IDUs), their partners and children. The programme protects and promotes the rights of these groups by fostering an enabling environment for HIV and harm reduction programming in these five countries. CAHR is supported by the Ministry of Foreign Affairs, Government of Netherlands.

CAHR in India is called ‘Hridaya’ and is implemented by India HIV/AIDS Alliance in partnership with SASO, Sharan, and a number of community-based harm reduction organisations and networks. This project helps build the capacity of service providers, makes harm reduction programmes more gender-responsive, improves access to services and advocates for the rights of PWIDs. In addition to providing services, Hridaya has a strong capacity building component to support advocacy, knowledge management and improved services for PWIDs.

Uniting Against Discrimination: Women form advocacy groups to respond to cases of violence

Building on the sense of community that exists within this peer group, the Chanura Kol has created Advocacy Groups to deal with challenges faced by female injecting drug users. Photographer: Prashant Panjiar

Building on the sense of community that exists within this peer group, Chanura Kol has created advocacy groups to deal with challenges faced by female injecting drug users. Photographer: Prashant Panjiar

Alliance India understands the power of community participation and engagement. In partnership with the Manipur-based local NGO, Social Awareness Service Organisation (SASO), the Chanura Kol project has established four Core Advocacy Groups to help women who inject drugs, many of whom are sex workers.

Each advocacy group, comprised of 10-15 members consisting of female injecting drug users, sex workers or their pimps, serves to address stigma and discrimination faced by women who inject drugs as well the frequently reported cases of violence experienced by them. Group members have received training on advocacy and documentation and, since the establishment of the groups in early 2011, have responded close to 100 cases of violence, harassment and extortion by women who inject drugs.

The reported incidents that these advocacy groups have responded to included domestic violence and harassment by sexual partners and security forces. The latter are notorious for extorting money particularly from female injecting drug users who engage in sex work. Each of the reported incidents was responded to within 48 hours during which time the advocacy groups provided support to those affected and their families.

Group members also held sensitization and advocacy meetings with those involved in perpetrating the violence. Although these advocacy groups were initiated last year, SASO has implemented the creation of support groups since 2007 in keeping with its belief that these groups play an important role in garnering community involvement and family support, facets that are integral to the recovery of vulnerable women who inject drugs.

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India HIV/AIDS Alliance in partnership with SASO, implements the Chanura Kol project in Manipur. Funded by the Elton John AIDS Foundation, the project serves to expand interventions to decrease HIV transmission and reduce drug relapse among female injection drug users (FIDUs).

Women Out Loud: New UNAIDS/UNWomen Publication Cites Our Chanura Kol Project

UNAIDS and UN Women recently released Women Out Loud, a new report on women living with HIV and the key role that they play in ending the epidemic. A UNAIDS feature on the document’s release notes the following:

In a new report, entitled Women Out Loud, UNAIDS explores the impact of HIV on women and the instrumental role women living with the virus are playing to end AIDS. It includes the latest data and commentary from some of the leading advocates on women and HIV.

The report includes the voices of some 30 women living with HIV who have given their personal insights into how the epidemic is affecting women and on how women are actively working to reduce the spread and impact of AIDS.

HIV is continuing to have a disproportionate effect on the lives of women. It is still the leading cause of death for women of reproductive age, and gender inequalities and women’s rights violations are persistent in rendering women and girls more vulnerable to HIV and preventing them from accessing essential HIV services…

Marginalised women remain the most impacted by HIV

Sex workers and people who use drugs are particularly vulnerable to HIV. When sex is exchanged for money or drugs, women often exert little influence over a partner’s condom use. Female sex workers are 13.5 times more likely to be living with HIV than other women. Some countries reported an HIV prevalence of more than 20% among female sex workers in capital cities. Studies conducted in nine European Union countries have indicated on average a 50% higher prevalence of HIV among women who inject drugs than in men who inject drugs.

On page 21 of the report in the chapter on people who use drugs, the following point is made: “Women who use drugs are widely reported to experience disproportionate levels of stigma and discrimination, often compounded during pregnancy, and as mothers.” One of the three references for this observation is In the Shadows, the baseline findings report from our Chanura Kol project.

India HIV/AIDS Alliance is grateful to UNAIDS and UN Women for this citation of our work. Many thanks to the Chanura Kol team and particularly to our implementing partners, SASO and Shalom, for their many contributions to the report and to the project overall. To read more about our baseline findings, click here or on the report cover below.

In the Shadows: Chanura Kol Baseline Report_Alliance India 2011

Chanura Kol is funded by the Elton John AIDS Foundation and serves to expand interventions to decrease HIV transmission and reduce drug relapse among women who inject drugs. Based on a holistic and sustainable approach, the project was initiated in 2010 to address the root causes of vulnerability and the primary causes of relapse post-detoxification for women who inject drugs in India’s northeastern state of Manipur, many of whom are also sex workers. Chanura Kol provides these women with long-term shelter, creates opportunities for income generation outside of sex work, and helps them rebuild family relationships.

Chanura Kol is one of a handful of efforts in the region to address the distinct needs of women who inject drugs and reduce their vulnerability to HIV. To learn more, please see a recent slide show about the project:

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Join us for the World AIDS Day All-India Run & Cultural Event! (Sunday, 2 December 2012 in New Delhi)

World AIDS Day 2012 All-India Run and Cultural Event
***8am-2pm (***PLEASE note EARLIER starting time!)
Sunday, 2 December 2012

New Delhi

Organized by: India HIV/AIDS Alliance

Co-sponsored by: Population Council; Citibank; UNDP; Centre for Advocacy & Research (CFAR); Delhi Frontrunners; and Blind Relief Association

RSVP: Please let us know if you’ll join us. Click here!

All-India Run: Participants will include people affected by the epidemic, their friends and families, community members, students and other stakeholders motivated to raise awareness of HIV in India, including the private sector. At least 500 participants are expected to participate in the run, and medals will be awarded to the top finishers in the men’s, women’s and transgender categories.

Members of affected communities have also been invited to speak and serve as judges for the run. Representatives from a range of stakeholders have also been invited, including NACO, UN agencies, international donors and NGOs, along with Alliance India implementing partners and beneficiary communities from all over India.

Activities will begin at 8am at Safdarjung Tomb. The run will start around 9am and will follow Lodhi Road, ending at the Blind Relief Association (aka Delhi Blind School), near the Oberoi Hotel. The Cultural Event will take place immediately following the race on the ground of Delhi Blind School and will last until 2pm. (For detailed route information, please see map below.)

Starting Line:
Safdarjang Tomb, Lodi Estate
(At the intersection of Safdarjang Road and Aurobindo Marg)

Metro Station: Jor Bagh

Finish Line:
Blind Relief Association (aka Delhi Blind School)
Lal Bahadur Shastri Marg
Lodhi Road H.O.

(Near Oberoi Hotel)

Cultural Event: Immediately following the run, the Cultural Event will take place at Delhi Blind School. Celebrating life and creativity in the face of the epidemic, the cultural event will consist of music and drama performances. The jazz and rock bands invited have members from communities affected by the epidemic. Co-sponsor Population Council will organize a skit presentation between music acts to highlight issues of at-risk populations. Lunch will be available. In addition, stalls will be set up by sponsors and other national and international organisations, including Population Council, Citibank, and UNDP, to present their work addressing HIV/AIDS and supporting communities.

This event is open to the public. There is no fee for participation. Participants are encouraged to wear red or white, but all will be welcomed. 

Jamia Millia Islamia, Indira Gandhi National Open University, Bhim Rao Ambedkar College, and Amity University are collaborating with Alliance India to provide volunteers for the event and organise student participation.

If you have any questions, please email us at: worldaidsday@allianceindia.org

Poster: Help get the word out about this event. Print out our poster and display it in your community. Thanks!

Map of World AIDS Day All-India Run Route and Cultural Event Location

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Alliance India’s World AIDS Day 2012 Objectives
  • To raise awareness on the need for continued support to address HIV among high-risk groups
  • To celebrate the diversity of affected communities with a focus on living lives free from stigma and discrimination
  • To acknowledge and encourage stakeholders, including government, civil society and the private sector, to intensify efforts to ensure a continuum of care services for affected communities
India HIV/AIDS Alliance

Based in New Delhi, Alliance India was founded in 1999 as a non-governmental organization operating partnership with civil society and communities to support sustained responses to HIV in India. Complementing the Indian national program, Alliance India works through capacity building, technical support and advocacy to strengthen delivery of effective, innovative, community- based interventions to key populations affected by the epidemic. The organization’s programs focus on those most vulnerable to HIV, with a particular emphasis on marginalized populations, such as men who have sex with men, people who use drugs, transgenders, and sex workers.

World AIDS Day Background

World AIDS Day has been observed since 1988. HIV/AIDS has become one of the defining health and development issues of our time. Low- and middle-income nations, even those with increasingly powerful economies like India, still face serious shortfalls in resources for AIDS. Stigma and discrimination toward those affected by the epidemic continue to create significant barriers to effective responses. Two-thirds of those who require antiretroviral treatment to live healthy lives still do not have access to these life-saving drugs. Investment in programming for high-risk populations such as men who have sex with men, sex workers, people who use drugs, and transgenders continue to be grossly insufficient. Worldwide HIV has infected an estimated 34 million people. In India, the National AIDS Control Organisation estimates overall adult HIV prevalence at 0.31%, which translates into roughly 2.4 million people living with HIV in India.

2012 Global Theme for World AIDS Day

The theme for World AIDS Day as chosen by UNAIDS and its partners is Getting to Zero: Zero New HIV Infections, Zero Discrimination and Zero AIDS Related Deaths. World AIDS Day advocacy will focus on ensuring universal access to services including prevention, care, support and treatment and of fulfilling human rights.

In the Midst of Sisters, a New Bud Blossoms

The Chanura Kol project realises the importance of creating a sense of closeness and community between the women it works with such as those pictured in this photo. A number of women feel that the knowledge, and emotional and moral support they have received from their newfound community of sisters has proven to be a great source of strength for them. (Photo : Prashant Panjiar)

Anouba Mayol means ‘new bud’ in Meitei, the official language of my home state, Manipur. Anouba Mayol is also the name of the support group I belong to. I am 29 years old, and like the other eight women in my support group, I am living with HIV and was widowed due to drug use, HIV and AIDS.

When I met my husband a few years ago, I was struck by how handsome he was. He worked in a small family owned photo-studio, and we were very happy in each other’s company. About a year after we got married, he started complaining of frequent chest pains. One day, he left home with his family members and I later learned they had taken him to Guwahati to get treated for his chest pain. It was hard to shake off the feeling that I wasn’t getting the whole story.

I finally persuaded one of my husband’s close friends to tell me what he knew. He swore me to secrecy and revealed that my husband was HIV positive and had been injecting drugs for a while. The news absolutely crushed me but I didn’t disclose what I knew to my husband or my family. Eventually, my husband passed away and his family blamed me for his death. They tortured and threatened me, and forced me to move back to my parents’ home. I haven’t visited my husband’s home since then.

Life dealt me an even larger blow when my daughter and I tested positive for HIV. Depression seemed to take over my life and I couldn’t sleep at night from an overwhelming fear of dying. During this time, I was approached by a peer educator from the Social Awareness Service Organisation (SASO) who counseled and assured me that the organization would provide any support that my daughter or I needed. It was during this time that I felt motivated to join Anouba Mayol, a support group where all the members learned from each other’s life experiences and gained information on sexually transmitted infections, prevention of parent to child transmission, and the importance of positive living. Gradually, as our group members gained a stronger sense of confidence and self-reliance, we started holding meetings by ourselves with no outreach worker or peer educator present.

With the support of SASO, our group also initiated a few income generation activities. I was given INR 1,000 to make silk thread. Each member of our group also contributes INR 10 each month to the group fund, which is used for loans on a rotational basis.

The change that I have experienced in my life because of my support group has been invaluable – we are like a group of sisters who are always there for each other in times of need. I now feel empowered and will do everything in my power to lead a healthy and long life especially for my daughter who also receives nutritional and educational support from SASO.

Anouba Mayol – I feel like the name of our support group symbolizes the new sense of hope that my daughter and I have been gifted with. After a very long time, I feel happy when I think about what lies ahead for both of us.

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The India HIV/AIDS Alliance in partnership with SASO, implements the Chanura Kol project in Manipur. This project is funded by the Elton John AIDS Foundation and serves to expand interventions to decrease HIV transmission and reduce drug relapse among female injection drug users (FIDUs).