The KAS Foundation is functioning since 2003 in India with an objective of to bring about financial, social and economic empowerment in rural/urban as a community development financial institution to extent micro finance assistance to small groups who need to improve their economic condition. It has got a social component to involve itself with needy groups like seva at Jagannatha Temple, Puri, drug de-addiction, support to visually handicapped and support to Akshaya Patra Foundation who is providing mid day meals to Govt. school children and HIV/AIDS affected persons etc.

The organization has started a branch in Jeypore since 2006 of Koraput District. It is reliably learnt that more than 500 HIV/AIDS affected persons are living with in town and rural areas facing social economic problems and also to receive the antiretroviral treatment (ART) from the distance centers like Visakhapatnam, Vizianagaram both situated in Andhra Pradesh and Berhampur (Orissa) because no such facilities are available in the un-divided Koraput districts. There is a scope for KAS Foundation to come forward and solve the existing problems of the people living with HIV/AIDS at this junction.

Koraput comes under the medium vulnerable group of the high risk sexual behavior as per the secondary data. It is also quite evident from different studies that commercial Female Sex Workers (FSWs) in and around Jeypore and the industrial belts of the region and also in the many pockets of Koraput practice high risk behavior without precaution and preventive mechanism for HIV/AIDS.

Truckers & Migrant Labours are the bridge population known for their high risk sexual behavior with commercial Female Sex Workers resulting in their vulnerability to HIV / AIDS /STD. Those who acquire STI/HIV are at double jeopardy. Not only are they infected and their families affected but also these HIV positive people serve as a conduit for HIV to move from high prevalence areas in cities to the remote hinterland.

National AIDS Control Organization (NACO) Report (Mar’05) says that there are about 5.1 million HIV infected persons in the country with Prevalence Rate (PR) of about 0.5%. The PR of the State is also 0.5. As per the Feb’06 (starting from 2002) report of Orissa State AIDS Control Society (OSACS), Koraput is the third highest district in terms of numbers of HIV +VE thereby it comes under the high vulnerable group. The unofficial figure of HIV infected cases in the district is quite alarming. The neighboring district Andhra Pradesh from where there is always in and out migration, which attributes to the increasing trend of the infection. It was also observed that in and out migration which usually linked with AP, Chhatishgarh, MP and Maharastra is another problem in this region contributing to increase in HIV infection.

Comparing the no of cases as per VCCTC Report (Feb’ 06), Koraput contributes 6% of the total caseload of Orissa. 11.5% of the blood samples examined in Koraput are found positive whereas, it is 9% in the State level. The numbers of STI cases in the district are also increasing every year. There is a huge increase of 300% of STI cases from 2001 to 2005. It is found 4% of the patients in OPD cases are having STD symptomatics in 2005 while it was 1% in 2001. The rate at all Orissa level is 3.5% in 2005. In terms of awareness, the need assessment says that 10 - 20% got knowledge about RTI/STI, but many of them don’t know the details of sign and symptoms, as about 5% of the respondents know about the signs and symptoms. It may be noted here that Koraput is mineral reach inviting lots of industries and also many industries are functioning like NALCO and Paper mills other than Aeronautics unit.

● Polygamy and also Practice of premarital sex.
● Unaware about safe sex.
● Many of them have Multiple sexual partners
● Most of the target populations are mobile in nature especially the bridge group
● Alcoholism and peer pressure are also contributing factor to high risk behavior

These can be broadly divided into:-

1. Access to treatment of opportunistic infections
2. Access to antiretroviral treatment
3. Palliative care for terminally ill patients
4. Complementary home based or community based care.

1. Nutrition/Hygiene/stress reduction/contraception
2. Full information
3. Retain self esteem, dignity and respect of others
4. Positive emotional stability and Enabling future planning

1. Social welfare needs
2. Income support through social security etc
3. Shelter/Housing, equal access to existing provision
4. Care for dependent children
5. Legal assistance and prevention against discrimination

● Poor health care services especially on RTI/STI and STD
● Less reporting of STD cases, especially in the case of female
● Large scale Mobility because of livelihood generating health problems
● Social Stigma for the destitute and other vulnerable groups
● Widespread dependence on quacks and traditional healers
● Non availability of condoms at affordable price for those involved in HRB
● Usually, women use to work harder than male and also as daily laborers

Truckers practice high-risk multi partnership sex with CSWs. In view of the nature of their job that keeps them away from home for months together. Majority of them being illiterate, ignorant and low paid, their health and risk perception from STD/HIV is low that prompts them to adopt high-risk sexual behaviors.

Migrant Laborers, mostly the dwellers of slums are illiterate & are engaged in occupations like wage labour, rickshaw/trolley pulling and in construction work etc. Absence of traditional mechanism of self-control, rootless ness, in stabilization, poor access to information & services are the factors that encourage multi partnership sex among married & unmarried male & female. These practices are largely covert & unnoticeable. Hence the persons who practice such behavior are unidentifiable with unfortunate consequences of their needs being unknown unmet. Because they are uncommunicative, this compounds the whole problem.

Besides truckers and migrant population, Jeypore has a concentration of commercial sex workers mainly non-brothel based. The sex workers are drawn mostly from the rural tribal villages to feed to the growing need of sex soliciting by the business community and truckers. Some of the sex workers mostly from Parbatipuram area of Andhra Pradesh are mobile by nature that rotate and fuel sex tourism adding to the gravity of the situation.

The level of HIV/AIDS awareness in slum areas is also low. However, almost 70-80% knows about the condom but its use is low. The table below gives the picture of sexual behaviors.

The estimates of the PLWHA are around 3-5 million as of mid 1998. For the purpose of extrapolation for different stages, the following assumptions may be made :-

● 50% are asymptomatic and hence will remain undetected.
● 10% will develop Tuberculosis
● 20% will heave acute HIV illness within one year
● 10% will develop chronic illness
● 10% will die within one year.

The profession indicates their mode of income. However, most of the group of about 70 to 80% found to be in the range of Rs. 1000/- to Rs. 4000/- income per month. Moreover, all of them belong to lower economic status. But many of them are not satisfied with their job excepting a few those are in the transport. But the existing economy was found to be the only choice for them.

Significantly, it was also found that more than 50% on very rare occasion go to their native place.

Prevention and control of STD/HIV/AIDS in the community by bringing change in behavior through health promotion & education & the provisions of appropriate facilities and services.

To increase the level of knowledge about HIV/AIDS/STD in the community.
To provide preventive & curative STD care & counseling services for reduction of sexually transmitted discuses.
To create an Enabling Environment advocating positive & nondiscriminatory attitude

Behavior change communication (BCC):
Focusing on providing information on a one-to –one basis often through Peers or those who have close affinity to the populations being addressed.
STD Care and counseling:
Addressing the technical and attitude of providers and ensuring quality care (partner notification, drugs, counseling and condom provisions)

Provision of STI care includes diagnostic, cultivate and preventive services. The essential components of STI care are:-

● Syndromes Management of STI
● Health Education
● Condom Promotion
● Partner notification
● Referral to 2nd line services and follow-up

The STI services ensure standardized and quality care by qualified doctors Training of private health care providers on STI care constitutes the STI programme component.