Kodague DAPCU Response to the Theme- Comprehensive HIV/AIDS Services to the HIV Positive Migrants

1.        Prevention & Early Detection:

In Karnataka is Kodagu District is a rural region with most of the economy based on agriculture, plantations and forestry. Coffee processing is a major economic contributor. Most of the people are engaged in coffee plantation work, which is the backbone of this economy. The major industries are Coffee Curing industries, Spices, Honey and Wax products. In recent years, tourism has begun to play a role in the economy, which has let to mushrooming of hotels and hence has attracted significant number of migrants from across the state and country.As Kodagu  is largely a coffee growing district, it attracts large number of estate workers from across the state and sometime from other states. 

• In the present situation, there are lots of Migrant population in the District. Most of them come as labourers to work in plantation and construction sites. from Orissa, West Bengal, Assam, U.P, Chathisgad, Rajasthan, Delhi, Andhra Pradesh, Tamil Nadu, Kerala  & Bellary, Chamarajnagar & other  parts of Karnataka.
• Most of them come to work, leaving their family in their own native, where there may be a chance of High Risk Behavior.
• HIV positive cases are found in the ICTC Centre’s & most of them are illiterates & lack Health education including HIV-AIDS & STI.
• In order to prevent further infection & also to provide care, treatment & services to the infected, the need of HIV-AIDS awareness along with the services were felt in the Kodagu District.
• Asha KiranaTI-NGO is working for migrant workers at the construction sites & in the Plantation Sector.
• In this regard  In co-ordination with DAPCU, Asha Kiran TI-NGO & Concerned heads of the site,  Special Health Check-up camps were held with awareness on HIV-AIDS, STI , Dental Check-up & General Health were held in different Estates  & Migrant Sites. So that we can create awareness on HIV-AIDS among the migrant workers and also we reduce the risk of transmission. Those who are found positive can be identified at the earliest to provide proper treatment, care & support.

2.        Linking  to ART, Treatment Adherence, Follow-up of MIS & LFU:

• Those found Positive are linked to the ART Centre at the earliest with proper counselling by the ICTC & ART Counsellor.
• Continuous follow-up is done through the outreach workers of TI-NGO, when the leave the District on work they will be transferred out to the nearest ART Centre. 

3.        PPTCT services:

• As per the PPTCT Guideline all the Registered ANC’s are referred for HIV Counselling & Testing services. And the Positive Clients are  linked to the ART at the earliest & will be given necessary PPTCT services
• In Kodagu sometimes we get clients from out of Districts (either Parents House or Husband’s House or the native of those Districts) like Mysore, Dakshina Kannada, Mandya etc. Such cases will be informed to the concerned District, for follow-up for delivery, treatment & MB Pair follow-up.
• Some time we get cases from other District for Delivery & further follow-up , such cases will be provide proper care, treatment & Support. 

4.        Challenges in Providing HIV/AIDS services to the Migrant Clients:

• It is difficult to link them to ART, especially if their stay in the Place is for a short period
• Language barrier if the client is from North Eastern States where they will not knowing any other language other than their mother tongue.
• Poor Adherence & Follow-up for treatment & more chances of MIS & LFU of out of state Clients. 
• Difficulty in tracing the clients from out of state as they are migrants they will not going back to their native instead they will go to different site on work.