Wlll Wlll 8alblr 8alblr Þasha help flahL Þasha help flahL AluS ?? AluS ??

8ackaround 8ackaround ÞSl lndla ÞSl lndla Plv/AluS ln lndla Plv/AluS ln lndla
kev lssues kev lssues Analvsls Analvsls Concluslon Concluslon
11 22 33
44 33 66
8ackaround 8ackaround 11
ln !ulv 1981 Lhe flrsL ma[or recoanlLlon of
Plv/AluS occurred when 1he new ?ork 1lmes
reporLed an ouLbreak of rare form of cancer known as
kaposl Sarcoma amona aav men
ln Los Anaelesţ CallfornlaŦ
1he uŦS CenLers for ulseases ConLrol esLabllshed
four prlmlLlve rlsk facLors for AluSť
W Male homosexuallLv
W urua abuse
W PalLlan orlaln
W Pemophllla A
ln 1983ţ 8oberL Callo of Lhe uŦS
naLlonal Cancer lnsLlLuLe conflrmed
LhaL Plv caused AluS
ln 1984ţ Luc MonLaanler of
lrance's ÞasLeur lnsLlLuLe
successfullv lsolaLed whaL was
laLer called Lhe human
lmmunodeflclencv vlrus (Plv)Ŧ

3
1
13
2
23
3
1982 1984 1986 1988 199 1992 1994 1996 1998 2
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LsLlmaLed Worldwlde Plv Þrevalenceţ 198Ŵ2
SubŴSaharan Afrlca
Asla/Þaclflc
WesLern Pemlsphere
LxhlblL 1
SubŴSaharan Afrlcaţ
72Ʒ
LaLln Amerlcaţ

norLh Amerlcaţ 2Ʒ
Carlbbeanţ 1Ʒ
AusLralla/new
Zealandţ Ƽ1Ʒ
SouLh/SouLheasL
Aslaţ 13Ʒ
LasL Asla/Þaclflc 2Ʒţ

LasLern
Lurope/CenLral
Aslaţ 2Ʒ
WesLern
Luropeţ 1Ʒ
norLh
Afrlca/Mldddle
LasLţ 1Ʒ
ulsLrlbuLlon of Clobal Plv/AluS lnfecLlons bv
Ceoaraphlc 8ealon ln 22
LxhlblL 2
ln 2
SouLh Afrlca had Lhe
laraesL numbers of
people llvlna wlLh
Plv/AluS of anv
counLrv ln Lhe world
(4Ŧ2 mllllon)
ÞSl lndla ÞSl lndla
22
ÞSl was a nonproflL
nCC based on
WashlnaLonţ uŦC
founded ln 197
under Lhe name
populaLlon Servlceţ lncŦ
ln 1973 Lhe name was offlclallv
chanaed Lo ÞopulaLlon
Servlces lnLernaLlonal
A leadlna alobal healLh oraanlzaLlon wlLh
proarams LaraeLlna malarlaţ chlld survlvalţ
Plv Ǝ reproducLlve healLh
Worklna ln parLnershlpwlLhln Lhe
publlc and prlvaLe secLors
Þrovldes llfeŴsavlna producLsţ cllnlcal servlces
and behavlor chanae communlcaLlons
ln 1987ţ ÞSl beaan lLs efforLs aaalnsL Lhe rlslna
Plv/AluS epldemlc ln Afrlca bv launchlna Lhe
Þrudence brand of male condoms ln Lhe
uemocraLlc 8epubllc of ConaoŦ
ÞSl Þroarams ln Afrlca
AbsLlnence
A delav of sexual
relaLlons promoLed Lo
vouna people noL veL
sexuallv acLlve
MuLual
fldellLv
ÞromoLed Lo sLable
couples as Lhelr flrsL
llne of defense aaalnsL
Plv lnfecLlon
Condom
use
1araeLed aL hlahŴrlsk
aroups such as
commerclal sex
workers and Lhelr
cllenLsţ mlaranLs
workersţ Lruckersţ
lnLravenous drua
usersţ and oLhersŦ
volunLarv
counsellna
and LesLlna
An lnLervenLlon LhaL
hlsLorlcallv resulLed ln
lncreased condom use
and parLner reducLlonţ
wheLher cllenLs LesLed
poslLlve or neaaLlve
for PlvŦ
Plv/AluS ln lndla Plv/AluS ln lndla 33
ulsease Þrevalence and
8ouLes of 1ransmlsslon
Plv/AluS 1reaLmenL and
ÞrevenLlon ln lndlať
1986Ŵ22
ulsease Þrevalence and
8ouLes of 1ransmlsslon
ln 1986 Ŷ Plv llrsL case ln Sex worker
from Chennal
1Ʒ of populaLlon 1 bllllon ln 22
no 2 ln Lhe world afLer SouLh Afrlca
now had reached almosL 3 mllllon




86Ʒ
ÞerlnaLal
8lood 1ransfuslon
lnLravenous urua use
unldenLlfled
Sexual
Plv/AluS Lransmlsslon ln lndla Plv/AluS Lransmlsslon ln lndla
LxhlblL 4
87ţ7Ʒof Plv lnfecLlons were ln Lhe aae aroup of
13 Lo 44 vears
1he raLlo of male cases Lo female cases 3ť1
1he raLlo of urban Lo rural 8ť1
1rends ln Lransmlsslon were Loward areaLer
female and rural exposure Lo PlvŦ
lndlan sLaLes caLeaorlzed prevalence sLaLesť
Plah prevalence sLaLes
Plv prevalence raLes exceedlna 3Ʒ amona hlahŴrlsk aroups and exceedlna
1Ʒ amona anLenaLal womenŦ
ModeraLeŴprevalence sLaLes
Plv prevalence raLes exceedlna 3Ʒ amona hlahŴrlsk aroups buL less Lhan
1Ʒ amona anLenaLal womenŦ
LowŴprevalence sLaLes
Plv prevalence raLes less Lhan 3Ʒ amona hlahŴrlsk aroups and less Lhan
1Ʒ amona anLenaLal womenŦ
LxhlblL 3
Map of Plv 8lsk Croup SeverlLv bv lndlan SLaLe
W Maharastra and 1am|| Nadu accounLed for no
less Lhan 2/3 of lndla Plv/AluS casesŦ
W Mumba| conLalned Lhe |argest concenLraLlon of
Plv lnfecLlonsŦ
W 1he tota| number of people ln lndla could
skvrockeL Lo m||||on over Lhe nexL flve vearsŦ
Plv/AluS 1reaLmenL
and ÞrevenLlon ln
lndlať 1986Ŵ22
nACC(naLlonal AluS ConLrol CraanlzaLlon) was
creaLed ln 1992 bv Lhe CovernmenL of lndla's
MlnlsLrv of PealLh Lo coordlnaLe
LreaLmenL and prevenLlon acLlvlLles
aL a naLlonal levelŦ
Þroaramsť
1 AluS ÞrevenLlon and ConLrol Þro[ecL
(AÞAC) ln 1amll nadu
W locus on hlahŴrlsk LransmlLLers of Plv
W Speclflcallv bv lnLroduclna and relnforclna prevenLlve
behavlor
W ÞromoLlna Lhe sale and use of condoms
W ÞromoLlna oLher safeŴsex pracLlces
W Lnhanclna servlces and counsellna
Þroaramsť
2 ÞrevenLlon proarams on Lhe arowlna
Plv/AluS LhreaL ln Mumbalţ Lhe caplLal
MaharasLa
W LsLabllsh relaLlonshlp wlLh Lhe sex worker
W 8ulld awareness of Plv/AluS and Lhe healLh rlsks
assoclaLed wlLh Lhe dlsease
W Lncouraae prevenLlve behavlor
W uemonsLraLe correcL condom usaae when posslble
ln 22ţ nACC launched Lhe Second naLlonal
AluS ConLrol Þroaram (nACÞŴll) funded bv Lhe
World 8ankţ uSAluţ and Lhe 8rlLlsh ueparLmenL for
lnLernaLlonal uevelopmenLţ amona oLhersŦ
ÞSl soon drafLed a proposal Lo uSAlufor fundlna
of an amblLlous proaram lnLended Lo reduce
Plv prevalence ln lndla's 12 ma[or porL
communlLlesŦ
CperaLlon LlahLhouse
Plv/AluS prevenLlon behavlor chanae wlLh an |ntegrated and |ntens|ve
approach LhaL has produced |mprovements |n behav|orţ att|tudes
and know|edge amona hlah rlsk menŦ
Imp|emented by Þ5I/Ind|a wlLh fundlna from Lhe uŦSŦ Aaencv for
lnLernaLlonal uevelopmenL (uSAlu)
lncreaslna safer sexua| behav|ors on Lhe parL of hlahŴrlsk adulL males ln
twe|ve port c|t|es across lndlaŦ
locused on h|gh r|sk adu|t ma|es because of Lhelr poLenLlal Lo lnfecL Lhelr
wlves and alrlfrlends ln Lhe aeneral populaLlonŦ
kandla
Mumbal
vashl
Coa
Manalore
Cochln
1uLlcorln
Chennal
vlzaa
Þaradeep
CalcuLLa
Paldla
LxhlblL 8
Ma[or Þort C|t|es of Ind|a
CperaLlon LlahLhouse Cb[ecLlve
lncreased reported
condom use amona
LaraeL populaLlons
uecreased number of
sex acts wlLh nonŴ
reaular parLners
lncreased correct 51I
d|agnos|s and
treatment amona
LaraeL populaLlons
lncreased Lhe
ava||ab|||ty of condom
ln ouLleLsŦ
Lnv|ronment sh|ft|ng
so Lhev able Lo Lalk
franklv and lnLelllaenLlv
abouL Plv/AluS)
5|gn|f|cant po||cy
abouL prevenLlonţ careţ
and supporL from porL
manaaemenLŦ
11 22 33
44 33 66
Plv/AluS 8lsk ÞercepLlon
W Plv was vlewed as a dlsease affecLlna onlv cerLaln
aroups aL Lhe frlnae of lndlan SocleLv llke sex workerŦ
W ÞercepLlon LhaL prosLlLuLe were assoclaLed wlL a hlah
rlsk of PlvŦ
escr|pt|on Va|ue
Plah personal rlsk percepLlon wlLh a sex workerŦ 74Ʒ
Plah personal rlsk percepLlon wlLh an unpald (noncommerclal) parLnerŦ 18Ʒ
Plv rlsk wlll noL decrease wlLh expenslve sex worker 32Ʒ
Plv rlsk wlll noL decrease wlLh healLhv sex worker 34Ʒ
Plv rlsk wlll noL decrease wlLh lnconslsLenL condom use 43Ʒ
CbsLacles Lo SafeŴSex ÞracLlces
1 1rust|ng/know|ng a g|r| Ŵ Lhe bellef LhaL condom use ls
noL necessarv lf Lhe parLner has few or no oLher sexual parLners
2 Lack of p|easure Ŵ Lhe bellef LhaL condom reduce sexual
pleasure
3 5he |ooks hea|thy Ŵ Lhe bellef LhaL phvslcal appearance ls a
slan of wheLher or noL a parLner has an S1l
4 Loya|ty to one or two partners Ŵ Lhe bellef LhaL havlna
onlv one or Lwo reaular parLners a Llme was ofLen vlewed as a low
rlskŦ
3 Lack of prep|ann|ng Ŵ Lhe clalm LhaL ls dlfflculL Lo plan for
Lhe use of condoms ln advanceŦ
ÞSl declded Lo explore Lhe use of a
massŴmedla campalan as a
componenL of lLs
communlcaLlons sLraLeav for
CperaLlon LlahLhouseŦ
Campalan Cb[ecLlves
1 1o lncrease Lhe percepLlon of Plv/AluS rlsk from unproLecLed sex
wlLh non reaular parLners bv personallzlna Lhe messaae and
creaLlna empaLhv Lhrouah ldenLlflable realŴllfe slLuaLlons
(Coalť ALLlLudlnal Chanae)
2 1o aeneraLe dlscusslon abouL Plv/AluS amona Lhe LaraeL
populaLlons and oplnlon leaders ln order Lo faclllLaLe
undersLandlna and knowledae acqulslLlon
(Coalť Chanae Soclal norms)
3 1o moLlvaLe people Lo access ÞSl's Plv/AluS Pelp Llne and vC1
servlces
(Coalť 8ehavloral Chanae)
1he lnsLrucLlons ln Lhe communlcaLlons brlef
lncluded Lhe followlna Lhree auldlna prlnclplesť
W uon'L preach
W no flnaer waaalna
W CommunlcaLlon should be nondldacLlc or
should noL appear as Lhouah Lhev are Leachlna
1he brlef was senL Lo Lowe LlnLasţ
ChalLra Leo 8urneLLţ and ÞSl lndla's
currenL aaencvţ Callvv Ǝ MaLherţ as
well as several lesserŴknown aaenclesŦ
LIk Þ5n
8alblr Þasha
A flcLlonal characLerŦ
SLarLed wlLh Leasers asklnaţ ºWlll 8alblr Þasha aeL AluS?"
1he nexL phase conveved kev messaaes on Plv LhaL would
cause Lhe LaraeL audlence Lo quesLlon Lhelr own behavlorŦ
Lncouraaed people Lo call Lhe Plv helpllne for lnformaLlonŦ
kev kev lssues lssues
44
Wlll 8alblr Þasha help
flahL AluS?
% Ceneral AluS awareness and dlseases rlsk
percepLlon /LaraeL parLlcular barrlers Lo
use of Condom/some comblnaLlon of
boLh?
locus
lssue
% Pow cusLomlzed Lhe flrsL phase should be
Lo Mumbal's lanauaae and culLure?
ScalablllLv
% Mass medla was a rlskv lnvesLmenL
requlred hlah cosL and no auaranLee of
successŦ
8lskv
SLraLeav SLraLeav 33
choose mass
medla campalan
launch mass
medla campalan
ln several sLaaes
CommunlcaLlna Mlx
% ÞuL Lhe messaae ln red llahL dlsLrlcL
% ln bus shelLers and lLs busţ Lraln sLaLlon and lLs Lraln
% ÞosLer ln newspaper
% ÞuL Lhe messaae ln behlnd Lhe Lruck
81L
% Commerclal break ln Lelevlslon and clnema
% Soap opera ln Lelevlslon
% lndependenL movle abouL Plv/AluS
% 8roadcasL on radloŦ
A1L
5tep
lnLroduce 8alblr
Þasha lcon Lo
communlLv so lL
become Lhev dallv
Lalk abouL ºWlll
8alblr Þasha aeL
AluS?"
5tep
SLarLlna flrsL
campalan lndoor
and ouLdoor
campalan Lo make
people concern
uslna condomsŦ
5tep
1he second Lheme
campalan abouL
Lhe posslblllLv
lnfecLed Plv/AluS
Lhrouah chanalna
parLnerŦ
5tep
4
1he Lhree Lheme
campalan make a
relaLlonshlp wlLh
communlLv bv
moLlvaLlna Lhem
call Plv/AluS
helpllneŦ
Concluslon Concluslon 66
8alblr Þasha wlll help aaalnsL AluS lf 8alblr Þasha
can communlcaLed properlv wlLh
Mumbal's culLure
ÞSl's communlcaLlon should comblnaLlon of
aeneral AluS awareness and dlsease rlsk
percepLlons and parLlcular barrlers
condom use
use Mumbal's
lanauaae
use lndlan
carLoon
use approprlaLe
color comblnaLlon
Lhanks for aLLenLlonŦŦ anv quesLlons?

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