HIV AIDS Chartbook Karnataka 2004

HIV AIDS Chartbook Karnataka 2004



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HIV/AIDS
in
KARNATAKA
Situation and Response
Population .oundation of India
y¯y®¼È㌵°ý®w¬ y¹ºlµ°ý®w¬ By¬ Cºm‡®±
Karnataka State AIDS Prevention Society
N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i
India-Canada Collaborative HIV/AIDS Project
Cºm‡®±-Nµw®l® š®œ®N¯Š®u® HX¬.J.ï./Il¬é ‡µ²°cwµ
Population Reference Bureau
y¯y®¼È㌵°ý®w¬ ŠµyµŠµw¬é …²ãŠµ²°
N®w¯ÁhN®u®ªå
HX¬.J.ï./Il¬é
›ÚrS®r î®±q®±Ù y®ärO䇵±
December 2004
mšµº…Š¬, 2004

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HIV/AIDS
in
KARNATAKA
Situation and Response
N®w¯ÁhN®u®ªå
HX¬.J.ï./Il¬é
›ÚrS®r î®±q®±Ù y®ärO䇵±

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TABLE O. CONTENTS
y®‹ïm
.oreword -------------------------------------------------------------------- 3
Preface ----------------------------------------------------------------------- 4
The Situation:
HIV/AIDS in Karnataka -------------------------------------------------- 5
Measuring the Extent of the Epidemic ------------------------------- 6
Investigating How HIV Spreads -------------------------------------- 11
The Dynamics of Sex Work -------------------------------------------12
The Response:
Reaching Sexual Networks --------------------------------------------20
.ocussed Prevention ----------------------------------------------------21
STI Strategy ---------------------------------------------------------------22
Testing for HIV Infection ------------------------------------------------23
Care and Support --------------------------------------------------------24
Additional Programme .eatures ------------------------------------- 25
Definition of Terms ------------------------------------------------------- 26
2
î®±±w®±Ým ------------------------------------- 3
îµ²u®© ¯q®± --------------------------------- 4
›ÚrS®r:
N®w¯ÁhN®u®ªå HX¬.J.ï./Il¬é ----------------------- 5
Šµ²°S®u® y®ä¯oî®w®±Ý A¡µ‡®±±î®¼u®± -------------------- 6
HX¬.J.ï. œ®Š®l®±î®¼u®w®±Ý r¢‡®±±î®¼u®± ----------------- 11
Œµ¶ºTN® rه®± Š®²y®Šµ°ýµS®¡®± ---------------------- 12
y®ärO䇵±:
Œµ¶ºTN® b¯©S®¡®w®±Ý q®©±y®¼î®¼u®± --------------------- 20
Nµ°ºvä°N®³q® N¯‡®±ÁN®äî®±S®¡®± ------------------------ 21
Œµ¶ºTN® Šµ²°S®S®¡® N®±‹q¯u® N¯‡®±ÁN®äî®±S®¡®± -------------- 22
HX¬.J.ï. y®‹°£µ ------------------------------ 23
BŠµ¶Nµ î®±q®±Ù „µº…© ---------------------------- 24
N¯‡®±ÁN®äî®±u® Cq®Š® Aºý®S®¡®± ----------------------- 25
î¯ãPµãS®¡®± ----------------------------------- 26

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.OREWORD
FOREWORD
Karnataka is one of the six HIV/AIDS high prevalence States
in India. Recent data confirm that this epidemic is not
confined to any region or class, is found both in urban and
rural areas, and in all strata of the society.
HIV/AIDS control and prevention activities need to
be evidence-based. Karnataka has done many scientific
efforts in this regard. As a result, today, in Karnataka, we
are able to design programmes based on prevalence of HIV/
AIDS, and the various social, cultural, geographic, economic
and other factors associated with it.
The HIV/AIDS situation in Karnataka as well as
the collaborative response from the Government and Non-
Governmental agencies and organizations have been
brought out in this chartbook jointly by the Karnataka State
AIDS Prevention Society (KSAPS), the India-Canada
Collaborative HIV/AIDS Project (ICHAP), the Population
.oundation of India (P.I), and the Population Reference
Bureau (PRB). I hope that this chartbook will be useful to all
who are involved in the fight against HIV/AIDS.
î®±±w®±Ým
3

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PRE.ACE
îµ²u®© ¯q®±
This chartbook is intended to inform a wide audience on the
situation of HIV/AIDS in Karnataka and the state’s response to the
spread of this deadly disease. A chartbook of this type serves
multiple purposes: to collect the latest data and research from a
variety of sources and to put them in one accessible publication;
and to do so in a clear and concise manner.
The chartbook is divided into two parts. The first describes the
level of infection in the state and the manner in which it spreads.
The second provides details on the state’s programmes to confront
the disease and the evidence-based planning that underlies them.
Karnataka has faced the threat of HIV and addressed it with
strategies to counter its spread. Recently, a shift in strategies from
one which targets specific groups at risk of contracting HIV to one
that works with all aspects of sexual networks has been
implemented. Data suggest that no population or district has
escaped vulnerability to HIV and this strategy intends to challenge
HIV wherever it may strike.
Abstinence or a single, uninfected partner will remain the method
of choice for many, but the fact remains that the risk of HIV is not
confined to those with high-risk behaviour. It has moved into the
general population.
This bilingual chartbook has been produced jointly by the
Population .oundation of India, New Delhi, the Karnataka State
AIDS Prevention Society, the India-Canada Collaborative HIV/AIDS
Project, and the Population Reference Bureau, Washington, DC.
Information is a key component in preventing HIV and we sincerely
hope that this publication will play a valuable role in this effort. This
project was funded through the generosity of the Bill & Melinda
Gates .oundation.
December 2004
A.R. Nanda
Executive Director
Population .oundation of India
D Nµ¶zm‡®±± N®w¯ÁhN®u®ªå HX¬.J.ï./Il¬é w® ›ÚrS®r î®±q®±Ù œ®Š®l®±rي®±î® D ¯Š®N®
Šµ²°S®NµÊ Š¯cãu® y®ärO䇵±‡®±w®±Ý î¯ãy®N®î¯T r¢š®©± y®ä‡®±rݚ®±q®Ùuµ. „µ°Šµ „µ°Šµ
î®±²©S®¢ºu® AºO-Aºý®S®¡®w®±Ý Kºuµ° y®äN®hou®ªå š®º£y®Ùî¯T š®±©„®î¯T
uµ²Šµ‡®±±î®ºqµ ¯l®±î®¼u®± Cºs®œ® Nµ¶zm‡®± î®±²© EuµÛ°ý®.
D Nµ¶zm‡®±± HŠ®l®± „¯S®S®¡®ªåuµ. îµ²u®© „¯S®î®¼ Š¯cãu®ªå HX¬.J.ï. šµ²°ºOw®
y®ä¯o î®±q®±Ù Au®± œ®Š®l®±rي®±î® ‹°r‡®±w®±Ý î®pÁš®±q®Ùuµ. HŠ®l®wµ‡®± „¯S®î®¼ D
Šµ²°S®î®w®±Ý Hu®±‹š®©± œ®ï±âNµ²ºmŠ®±î® N¯‡®±ÁN®äî®±S®¡®± î®±q®±Ù AS®¡® Bu¯Š®î¯TŠ®±î®
š¯£¯Èãu¯‹q® ‡µ²°cwµ‡®±w®±Ý ïš®±q®Ùuµ.
N®w¯ÁhN®î®¼ œ®Š®l®±rي®±î® HX¬.J.ï.‡®± Bq®ºN®î®w®±Ý Hu®±‹š®±rÙuµ î®±q®±Ù Au®±
œ®Š®l®±î®¼u®w®±Ý q®lµS®hÔ©± œ®©î¯Š®± ‡µ²°cwµS®¡®w®±Ý œ®ï±âNµ²ºmuµ. HX¬.J.ï./Il¬éw®±Ý
œµ²ºu®±î® š¯u®ãqµS®¡®± œµX¯ÏTŠ®±î® Nµ©îµ½ºu®± xvÃÁÇ®Õ S®±ºy®¼S®¡®w®±Ý S®±‹î®¾¯l®uµ°
Œµ¶ºTN® b¯©S®¡® H©å î®±±QS®¢S®² š®º…ºvÛu® N¯‡®±ÁN®äî®±î®w®±Ý w®lµš®±rÙuµ. Š¯cãu®
‡®¾¯î®¼uµ° dŒµå As®î¯ cw®qµ HX¬.J.ï. šµ²°ºOw® Ay¯‡®±u® œµ²Š®T©å Hw®±Ýu®w®±Ý
AºO Aºý®S®¡®± qµ²°‹š®±q®Ùîµ î®±q®±Ù Š¯cãu® N¯‡®±ÁN®äî®± ‡µ²°cwµ‡®±² HŒµåªå
HX¬.J.ï. šµ²°ºOw® š¯u®ãqµS®¢îµ‡µ²° B H©å N®lµS®¡®ªå‡®±² Au®w®±Ý Hu®±‹š®©±
y®ä‡®±rݚ®±rÙuµ.
Œµ¶ºTN® š®º‡®±î®± î®±q®±Ù šµ²°ºN®± C©åu® INµ¶N® š®ºS¯r‡µ²l®wµ
š®º…ºu®î®xÝh±ÔNµ²¡®±ëu®± œ®©î¯Š®± cw®Š® B‡µ±Ê‡®¾¯u®Š®², HX¬.J.ï. šµ²°ºOw®
By®q®±Ù Nµ°î®© By®q®Ùw®±Ý œµYϚ®±î® w®l®î®¢Nµ‰±Š®±î®î®Š®ªå ¯q®ä ›°ï±q®î¯T©å
Hw®±Ýu®± š®q®ã. Au®± š¯î®¾¯w®ã cw®Š®ªå‡®±² œ®Š®l®±rÙuµ.
HŠ®l®² „¯ǵS®¡®ªåŠ®±î® (N®w®Ýl® î®±q®±Ù CºTåǬ) D Nµ¶zm‡®±w®±Ý y¯y®¼È㌵°ý®w¬
y¹ºlµ°ý®w¬ By¬ Cºm‡®±, w®î® uµœ®ª, N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i,
Cºm‡®¾¯-Nµw®l¯ š®œ®‡µ²°S®u® HX¬.J.ï./Il¬é ‡µ²°cwµ, î®±q®±Ù y¯y®¼È㌵°ý®w¬
ŠµyµŠµw¬é …²ãŠµ²°, S®Ôw¬ m›†A® Kh±Ô y®ä‡®±q®Ývºu® œµ²‘®q®‘®Œ¯Tuµ.
HX¬.J.ï. q®l®±S®h±Ôå ¯Ÿr‡®±± Kºu®± î®±±Qã y¯q®äî®w®±Ý š®±q®Ùuµ î®±q®±Ù D
výµ‡®±ªåw® y®ä‡®±q®ÝS®¢Sµ D Nµ¶zm‡®±± Aî®±²©ãî¯u® y¯q®äî®w®±Ý š®±q®Ùuµ Hºu®±
„Â¯ï› uµÛ°îµ. D ‡µ²°cwµSµ u®w®š®œ¯‡®±î®¼ †Œ¬ Hºl¬ îµ±ªºl¯ Sµ°g¬é
y¹ºlµ°ý®w¬xºu® uµ²Š®Ouµ.
mšµº…Š¬, 2004
H.BŠ¬. w®ºu®
HOéN®±ãiî¬ lµ¶ŠµN®ÔŠ¬
y¯y®¼È㌵°ý®w¬ y¹ºlµ°ý®w¬ By¬ Cºm‡®±
4
…²ãŠµ²°

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HIV/AIDS IN KARNATAKA
N®w¯ÁhN®u®ªå HX¬.J.ï./Il¬é
With 53 million people as of the
2001 Census, Karnataka is India’s
ninth most populous state. It is also
one of the country’s six high HIV/
AIDS-prevalence states. The others
are Andhra Pradesh, Maharashtra,
Manipur, Nagaland, and Tamil
Nadu.
This chartbook provides a brief
description of the HIV/AIDS
situation in Karnataka and the
state’s response towards the
prevention of the disease.
The annual sentinel surveillance
programme is the main source of
data regarding HIV infections in
Karnataka. The other data sources
include the number of cases that
tested positive in either Voluntary
Confidential Counselling and
Testing Centres (VCTCs) and
Prevention of Parent to Child
Transmission (PPTCT) Centres,
AIDS cases reported by the District
Nodal Officers, and special surveys
carried out in the state.
Based on the sentinel surveillance
data, it is estimated that, in 2004,
over 500,000 adults in Karnataka
are infected with HIV.
†°u®Š®
Bidar
S®±©àS®Á
†b¯y®¼Š®
Bijapur
Gulbarga
„¯S®©Nµ²°gµ
„µ¡®S¯º Bagalkot
Š¯‡®±X®²Š®±
Raichur
Belgaum
Nµ²y®Þ¡®
u¯Š®î¯l®
Dharwad S®u®S®
Gadag
Koppal
…¡¯ë‹
Eq®ÙŠ® N®w®Ýl®
Uttar
Kannada
œ¯îµ°‹
Bellary
Haveri u¯î®oSµŠµ
þî®îµ²S®Ì
Davanagere
Yq®äu®±S®Á
q®±î®±N®²Š®±
Tumkur
Chittradurga
Shimoga
YN®Êî®±S®¡®²Š®±
El®±z Chikmagalur
Udupi
q®±î®±N®²Š®±
Tumkur
Nµ²°Œ¯Š®
Kolar
u®£o N®w®Ýl®
œ¯š®w®
Hassan
Dakshina
î®±ºl®ã
„µºS®¡®²Š®± w®S®Š®
Bangalore Urban
Kannada
Nµ²l®S®±
Kodagu
Mandya „µºS®¡®²Š®± S¯ä¯ºq®Š®
Bangalore Rural
îµ±¶š®²Š®±
Mysore
X¯î®±Š¯cw®S®Š®
Chamarajanagar
Map not to scale
Districts having a prevalence of 1 percent or more among antenatal
care clinic attendees, Karnataka sentinel surveillance, 2004
N®w¯ÁhN® šµºiwµŒ¬ š®îµÁ¶©w¬é-2004Š®ªå y®äš®î® y®½î®Á BŠµ²°S®ãNµ°ºu®äS®¢Sµ „µ°i x°mu®
î®±Ÿ¡µ‡®±Š®ªå HX®.J.ï. šµ²°ºOw® y®ä¯o 1 As®î¯ 1Oʺu® œµX®±Ï y®ärý®q® CŠ®±î® dŒµåS®¡®±
Over 500,000 Cases of HIV/AIDS in Karnataka in 2004
(assuming 1.5 percent infection rate among adults)
N®w¯ÁhN®u®ªå 2004Š®ªå 5 ©£®N®²Ê œµX®±Ï cw®Š®± HX¬.J.ï./Il¬éw®±Ý œµ²ºvu¯ÛŠµ
(®±š®ÊŠ®ªå HX¬.J.ï. šµ²°ºOw® y®ä¯o š®±î®¾¯Š®± 1.5 y®ärý®q® Hº…±u®Š® Bu¯Š®u® îµ±°Œµ)
w®î®±â Š¯cã 2001wµ‡®± cw®S®or‡®± y®äN¯Š®
š®±î®¾¯Š®± 53 u®ý®©£® cw®š®ºPµã‡®±w®±Ý
œµ²ºvuµ. „¯Š®q®u®ªå‡µ±° Kº„®q®Ùwµ‡®± Ar
uµ²l®Ö Š¯cãîµx›Nµ²ºmuµ. Aǵ԰ A©å,
N®w¯ÁhN®î®¼ HX¬.J.ï./Il¬é œµX¯ÏTuµ Hºu®±
HxݛNµ²ºl® „¯Š®q®u® BŠ®± Š¯cãS®¡®ªå Kºu®±.
Cºs®œ® Cq®Š® Š¯cãS®¡®±: î®±œ¯Š¯Ç®ó, Bºu®ä
y®äuµ°ý®, q®ï±¡®±w¯l®±, î®±py®¼Š® î®±q®±Ù
w¯S¯Œ¯ãºl¬.
D Nµ¶zm‡®±± N®w¯ÁhN®u®ªå î¯ãy®N®î¯T
œ®Š®l®±rي®±î® HX¬.J.ï./Il¬é w® ›ÚrS®r
î®±q®±Ù Cu®w®±Ý q®lµS®h±Ôî® výµ‡®±ªå Š¯cã
w®lµš®±rي®±î® y®ä‡®±q®ÝS®¡®w®±Ý ïš®±q®Ùuµ.
Š¯cãu®ªå HX¬.J.ï./Il¬é ›ÚrS®r‡®±
N®±‹q¯u® AºOAºý®S®¡®± î®±±Qãî¯T Ju®±
î®±²©S®¢ºu® ©„®ãî¯S®±q®Ùîµ: (1) y®ärî®Ç®Á
w®lµš®±rي®±î® šµºiwµŒ¬ š®îµÁ¶©w¬é
(Sµ²q®±Ùy®m›u® BŠµ²°S®ã Nµ°ºu®äS®¡®ªå w®lµš®±î®
y®‹°£®nµ) (2) š®æ‡®±ºyµä°‹q®
By®Ùš®î®¾¯Œµ²°X®wµ î®±q®±Ù y®‹°£¯Nµ°ºu®ä
(ï.›.i.›.) S®¡®± (3) q®ºuµq¯‰±S®¢ºu®
î®±N®Ê¢Sµ šµ²°ºN®± q®lµS®h±Ôî® Nµ°ºu®ä
(z.z.i.›.i.) S®¡®± (4) dŒ¯å wµ²°lµŒ¬
AvÃN¯‹S®¢ºu® Il¬é Šµ²°TS®¡® N®±‹q¯u® ®v,
î®±q®±Ù (5) Š¯cãu®ªå w®lµ›u® ïýµ°Ç®
Au®㇮±w®S®¡®±.
2004 Š®ªå y®½Šµ¶›u® šµºiwµŒ¬ š®îµÁ¶©w¬é
AºO Aºý®S®¡® Bu¯Š®u® îµ±°Œµ Š¯cãu®ªå
š®±î®¾¯Š®± 5 ©£®N®²Ê œµX®±Ï cw®Š®± HX¬.J.ï.
šµ²°ºN®w®±Ý œµ²ºvu¯ÛŠµ Hºu®±
Aºu¯c±î®¾¯l®Œ¯Tuµ.
5

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MEASURING THE EXTENT O. THE EPIDEMIC
Šµ²°S®u® y®ä¯oî®w®±Ý A¡µ‡®±±î®¼u®±
Since India lacks complete
reporting on vital events such as
deaths and the occurrence of
diseases, the extent of HIV
infection in the country is monitored
through a sentinel surveillance
programme. Surveillance is carried
out annually by the Karnataka State
AIDS Prevention Society (KSAPS),
which tests for infection at
designated sentinel sites following
the methods prescribed by the
National AIDS Control Organization
(NACO).
Testing for infection is conducted
among populations at higher risk,
represented by patients at sexually
transmitted disease (STD) clinics;
intravenous drug users (IVDUs)
who often share needles; female
sex workers (.SWs); and men who
have sex with men (MSMs).
Populations at lower risk are
represented by women attending
antenatal clinics (ANCs). Pregnant
women attending antenatal clinics
are assumed to have the same risk
of sexual transmission of HIV as
any other sexually active general
population.
HIV prevalence levels ranged from
1.5 percent among women at ANC
clinics to 21.6 percent among
.SWs in 2004.
Summary of HIV Sentinel Sites in Karnataka
2003 and 2004
N®w¯ÁhN® šµºiwµŒ¬ š®îµÁ¶Œµw¬é 2003 î®±q®±Ù 2004 Š® š¯Š¯ºý®
2003
Number Percent
of Sites Positive
šµºiwµŒ¬ šµ²°ºOŠ®±î®î®Š®
Nµ°ºu®äS®¡® ýµ°N®l¯
š®ºPµã y®ä¯o
2004
Number Percent
of Sites Positive
šµºiwµŒ¬ šµ²°ºOŠ®±î®î®Š®
Nµ°ºu®äS®¡® ýµ°N®l¯
š®ºPµã y®ä¯o
Antenatal Clinics:
y®äš®î® y®½î®Á BŠµ²°S®ã Nµ°ºu®äS®¡®±
District Hospitals
27
dŒ¯å Bš®ÞqµäS®¡®±
.irst Referral Units
27
y®š¬Ô ŠµyµŠ®Œ¬ Nµ°ºu®äS®¡®±
Total
54
Kh±Ô
Antenatal Clinic (ages 15-24) 1
y®äš®î® y®½î®Á BŠµ²°S®ã Nµ°ºu®ä
(î®Ç®Á 15-24)
STD Clinics
7
Œµ¶ºTN® Šµ²°S® YOq¯é©‡®±S®¡®±
.emale Sex Workers
1
Œµ¶ºTN® rÙ xŠ®q® î®±Ÿ¡µ‡®±Š®±
IVDUs
1
š®²dS®¡®w®±Ý œ®ºYNµ²ºl®± Š®N®Ùw¯¡®S®¡®
î®±²©N® ¯u®N® y®u¯s®ÁS®¡®w®±Ý
šµ°ïš®±î®î®‹S¯T AŠµ²°S®ã Nµ°ºu®ä
1.3
1.6
1.5
2.5
13.4
14.4
2.8
27
1.5
27
1.6
54
1.5
1
3.3
7 15.8
1 21.6
-
-
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U®hwµS®¡® š®ºy®½oÁ ®v BS®±rÙ©åî¯u®±u®‹ºu®,
HX¬.J.ï./Il¬é w® y®ä¯oî®w®±Ý šµºiwµŒ¬
š®îµÁ¶Œµw¬éw® î®±²©N® r¢‡®±Œ¯S®±rÙuµ.
y®ärî®Ç®Á N®w¯ÁhN® Š¯cã Il¬é zäǮw¬
šµ²šµ¶i‡®±± Š¯™ó°‡®± Il¬é x‡®±ºq®äo
š®ºšµÚ‡®±± œ¯ONµ²hÔ ïu¯w®S®¡®w®Ýw®±š®‹›
S®±Š®±rš®©ÞhÔ šµºiwµŒ¬ BŠµ²°S®ã Nµ°ºu®äS®¡®ªå
š®îµÁ¶©w¬éw®±Ý w®lµš®±q¯Ù …ºvuµ. y®ärî®Ç®Á
xS®vÃy®m›u® î®±²Š®± rºS®¡® Aî®vÇ®±ªå
Sµ²q®±Ùy®m›u® y®äš®î®-y®½î®Á BŠµ²°S®ã q®y¯š®n¯
Nµ°ºu®äS®¢Sµ …Š®±î® îµ²u®© 400 î®±Ÿ¡µ‡®±‹ºu®
î®±q®±Ù Sµ²q®±Ùy®m›u® Œµ¶ºTN® Šµ²°S®S®¡®
YOq¯é©‡®±S®¢Sµ …Š®±î® îµ²u®© 250
Šµ²°TS®¢ºu® Š®N®Ùu® š¯ãºy®Œ¬S®¡®w®±Ý y®lµu®± -
Aw¯ï±N® î®±q®±Ù Aš®º…ºvÃq® y®u®ÜrS®¡®w®±Ý …¡®› -
HX¬.J.ï y®‹°£µ ¯l®Œ¯S®±q®Ùuµ.
HX¬.J.ï. šµ²°ºOw® y®‹°£µ‡®±w®±Ý By®q®±Ù
œµYϊ®±î® cw®Š®ªå - Aºu®Šµ Œµ¶ºTN® Šµ²°S®S®¡®
YOq¯é©‡®±S®¢Sµ …Š®±î®î®Š®ªå, š®²dS®¡®w®±Ý
œ®ºYNµ²ºl®± Š®N®Ùw¯¡®S®¡® î®±²©N® ¯u®N®
y®u¯s®ÁS®¡®w®±Ý qµSµu®±Nµ²¡®±ëî®î®Š®ªå, Œµ¶ºTN®
rÙxŠ®q® î®±Ÿ¡µ‡®±Š®ªå î®±q®±Ù y®¼Š®±Ç®Šµ²ºvSµ
Œµ¶ºTN® š®ºy®N®Áî®xÝh±ÔNµ²ºmŠ®±î® y®¼Š®±Ç®Š®ªå -
D y®‹°£µ‡®±w®±Ý ¯l®Œ¯S®±q®Ùuµ. y®äš®î® y®½î®Á
BŠµ²°S®ã q®y¯š®n¯ Nµ°ºu®äS®¢Sµ …Š®±î® S®†ÃÁp
î®±Ÿ¡µ‡®±Š®± Œµ¶ºTN®î¯T š®O䇮±Š¯TŠ®±î® Cq®Š®
š¯î®¾¯w®ã cw®Š®ÇµÔ° HX¬.J.ï. šµ²°ºOw®
š¯u®ãqµS®¡®w®±Ý œµ²ºvu¯ÛŠµ Hºu®± „¯Œ¯Tuµ.
MSMs
1 10.8
y®¼Š®±Ç®Šµ²ºvSµ Œµ¶ºTN® š®º…ºu®î®w®±Ý
Ch±ÔNµ²ºmŠ®±î® y®¼Š®±Ç®Š®±
Tuberculosis Site
£®‡®±Šµ²°S® BŠµ²°S®ã Nµ°ºu®ä
-
-
1 10.0 î®Ç®Á 2004Š®ªå HX¬.J.ï./Il¬éw® y®ä¯o
y®äš®î® y®½î®Á BŠµ²°S®ã q®y¯š®n¯ Nµ°ºu®äS®¢Sµ
…Š®±î® î®±Ÿ¡µ‡®±Š®ªå 1.5 y®ärý®q®vºu® Œµ¶ºTN®
1 12.5 rÙxŠ®q® î®±Ÿ¡µ‡®±Š®ªå 21.6 y®ärý®q®u®î®ŠµSµ
Cq®±Ù.
KSAPS
6

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MEASURING THE EXTENT O. THE EPIDEMIC
Šµ²°S®u® y®ä¯oî®w®±Ý A¡µ‡®±±î®¼u®±
People who have a sexually
transmitted disease (STD) are
much more likely to contract HIV
from a partner who is infected with
the virus. When 5 percent or more
of a group at high-risk for
contracting HIV (such as STD
patients) test positive, the state in
which the group is located is
considered to have a concentrated,
or medium, prevalence HIV
epidemic. HIV prevalence among
STD patients in Karnataka has, in
fact, been well above 10 percent for
the past seven years.
Percent of Patients at STD Clinics Who Tested Positive for HIV
Karnataka, 1998 - 2004
Hš¬.i.m. BŠµ²°S®ã Nµ°ºu®äS®¡®ªå Šµ²°TS®¡®ªå HX¬.J.ï. šµ²°ºOw® ýµ°N®l¯î¯Š®± y®ä¯o,
N®w¯ÁhN®, 1998-2004
17.1
14.6
14.6
15.1
15.5
13.5
13.4
1998 1999
KSAPS and NACO
2000
2001
2002
2003 2004
Note: mean values
iy®Þp: š®Š¯š®‹
Œµ¶ºTN® Šµ²°S®ïu®ÛŠµ šµ²°ºOŠ®±î® š®ºS¯r‰±ºu®
HX¬.J.ï. šµ²°ºN®w®±Ý y®lµ‡®±±î® š¯u®ãqµ‡®±±
œµX¯ÏS®±q®Ùuµ. œµYÏw® By®q®Ùw®±Ý¡®ë S®±ºzw®ªå
(Eu¯œ®Š®nµSµ, Œµ¶ºTN® Šµ²°TS®¡®±) HX¬.J.ï.
šµ²°ºOw® y®ä¯o 5 y®ärý®q® As®î®
Au®Oʺq® œµX¯Ïu¯S® B Š¯cãu®ªå HX¬.J.ï.
šµ²°ºN®± Nµ°ºvä°N®³q®î¯Tuµ As®î¯ î®±u®ãî®±
y®ä¯ou®ªåuµ Hºu®± œµ°¡®…œ®±u®±. N®¡µu® I¡®±
î®Ç®ÁS®¡®ªå N®w¯ÁhN®u®ªå Œµ¶ºTN® Šµ²°TS®¡®ªå
HX¬.J.ï. y®ä¯o 5 y®ärý®q®Oʺq®
œµX¯ÏT‡µ±° Cuµ.
And, when 1 percent or more of the
low-risk group—women attending
antenatal clinics—test positive for
HIV, the state is considered to have
a generalized, or high, prevalence
HIV epidemic. Given that the great
majority of women treated at
antenatal care clinics are not likely
to have engaged in risky sexual
behaviour, high prevalence rates of
HIV infection in this group give a
strong signal that HIV has spread
into the sexually active general
population. Indeed, HIV infection
levels have consistently been
1 percent or higher among these
women in Karnataka for the past
seven years.
Percent of Pregnant Women Who Tested Positive for HIV at
Antenatal Clinics, Karnataka, 1998 - 2004
y®äš®î®-y®½î®Á BŠµ²°S®ãNµ°ºu®äS®¡®ªå S®†ÃÁpî®±Ÿ¡µ‡®±Š®ªå HX¬.J.ï. šµ²°ºOw® ýµ°N®l¯î¯Š®±
y®ä¯o, N®w¯ÁhN® î®±q®±Ù B‡®±Û Š¯cãS®¡®±, 1998-2004
1.8
1.7
1.7
1.6
1.5
1.5
1.0
1998
1999
KSAPS and NACO
2000
2001
2002
2003
2004
Note: mean values
iy®Þp: š®Š¯š®‹
N®mîµ± By®q®Ùw®±Ý¡®ë S®±ºzw®ªå (Eu¯œ®Š®nµSµ
y®äš®î® y®½î®Á BŠµ²°S®ã q®y¯š®n¯ Nµ°ºu®äS®¢Sµ
„µ°I x°l®±î® î®±Ÿ¡µ‡®±Š®±) HX¬.J.ï.
šµ²°ºOw® y®ä¯o 1 y®ärý®q® As®î®
Au®Oʺu® œµX¯Ïu¯S® B Š¯cãu®ªå HX¬.J.ï.
šµ²°ºN®± œ®Š®muµ As®î® œµYÏw® y®ä¯ou®ªå
Hw®Ý…œ®±u®±. y®äš®î® y®½î®Á BŠµ²°S®ã q®y¯š®n¯
Nµ°ºu®äS®¢Sµ …Š®±î® î®±Ÿ¡µ‡®±Š®ªå œµX®±Ï î®±ºv
HX¬.J.ï. šµ²°ºOw® š¯u®ãqµ‡®±w®±Ý œµYϚ®…©å
Œµ¶ºTN® î®q®ÁwµS®¡®ªå qµ²l®T©åuµ°
CŠ®±î®¼u®‹ºu®, D S®±ºzw®ªå HX¬.J.ï.
y®ä¯o œµYÏuµ‡µ±ºu®Šµ Cu®± š¯î®¾¯w®ã
cw®qµ‡®±ªå‡®±² œ®Š®muµ Hº… y®ä…©
š®²X®wµ‡®±w®±Ý x°l®±q®Ùuµ. N®¡µu® I¡®±
î®Ç®ÁS®¡®ªå N®w¯ÁhN®u® Cºq®œ® î®±Ÿ¡µ‡®±Š®ªå
HX¬.J.ï. šµ²°ºOw® y®ä¯o 1
y®ärý®q®Oʺq®©² œµX¯ÏT‡µ±° Cuµ.
7

1.10 Page 10

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MEASURING THE EXTENT O. THE EPIDEMIC
Šµ²°S®u® y®ä¯oî®w®±Ý A¡µ‡®±±î®¼u®±
Comparing state data for 2003, the
percentage of sexually transmitted
disease (STD) patients in
Karnataka who tested positive for
HIV infection was well above that of
most other states. Karnataka’s rate
of over 13 percent infection in 2003
among STD patients points to a
serious epidemic. Prevalence of 5
percent or more at high-risk sites,
such STD clinics, is one standard
by which a state can be considered
“hard-hit.”
Percent of Patients at STD Clinics Who Tested Positive for HIV
Karnataka and Selected States, 2003
Hš¬.i.m. BŠµ²°S®ã Nµ°ºu®äS®¡®ªå Šµ²°TS®¡®ªå HX¬.J.ï. šµ²°ºOw® ýµ°N®l¯î¯Š®± y®ä¯o,
N®w¯ÁhN® î®±q®±Ù B‡®±Û Š¯cãS®¡®±, 2003
20.1
13.5
13.4
13.1
5.1
4.1
2.5
2.4
Andhra Maharashtra Karnataka Tamil Nadu Rajasthan Gujarat West Bengal Madhya
Pradesh
Pradesh
NACO and KSAPS
Note: mean values
iy®Þp: š®Š¯š®‹
N®w¯ÁhN®u®ªå 2003 Š®ªå Œµ¶ºTN® Šµ²°S®S®¡®
šµºiwµŒ¬ Nµ°ºu®äS®¢Sµ „µ°i x°mu®
Šµ²°TS®¡®ªå N®ºl®±…ºu® HX¬.J.ï. y®ä¯o
Cq®Š® œ®©î¯Š®± Š¯cãS®¡®ªåŠ®±î®
y®ä¯oS®¢Tºs® q®±º„¯ œµXµÏ° Cq®±Ù.
N®w¯ÁhN®u®ªåŠ®±î® 13 y®ärý®q® y®ä¯o
Šµ²°S®u® S®º†Ã°Š®qµ‡®±w®±Ý qµ²°‹š®±q®Ùuµ. Œµ¶ºTN®
Šµ²°S®S®¡® šµºiwµŒ¬ Nµ°ºu®äS®¡®ºq®œ® œµYÏw®
By®rÙw® šµ¶h±S®¡®ªå HX¬.J.ï. 5 y®ärý®q®
As®î® Au®Oʺq® œµYÏw® y®ä¯ou®ªå
Hw®±Ýu®Š® Bu¯Š®u® îµ±°Œµ Kºu®± Š¯cãî®w®±Ý
œ¯l¬Á Ÿg¬ Hw®Ý…œ®±u®±.
Similarly, the HIV infection rate
among pregnant women tested at
antenatal care clinics in Karnataka
in 2003 was well above the
1 percent guideline for designating
a state as high prevalence.
Measurement of the level of
infection in this group is given
added reliability by the large
number of sentinel sites at ANC
clinics in the state, 54 in 2003.
Percent of Pregnant Women Who Tested Positive for HIV at
Antenatal Clinics, Karnataka and Selected States, 2003
y®äš®î®-y®½î®Á BŠµ²°S®ãNµ°ºu®äS®¡®ªå S®†ÃÁpî®±Ÿ¡µ‡®±Š®ªå HX¬.J.ï. šµ²°ºOw® ýµ°N®l¯î¯Š®±
y®ä¯o, N®w¯ÁhN® î®±q®±Ù B‡®±Û Š¯cãS®¡®±, 2003
1.5
1.5
1.4
1.0
0.5
0.4
0.4
0.1
Maharashtra Karnataka Andhra Tamil Nadu Madhya
Pradesh
Pradesh
Gujarat West Bengal Rajasthan
Cuµ° ‹°r î®Ç®Á 2003Š®ªå y®äš®î® y®½î®Á
BŠµ²°S®ã Nµ°ºu®äS®¢Sµ …ºu® S®†ÃÁp
î®±Ÿ¡µ‡®±Š®ªå‡®±² HX¬.J, ï, ‡®± y®ä¯o
1 y®ärý®q®Oʺq®©² œµYÏq®±Ù. 2003Š®ªå œµYÏw®
š®ºPµã‡®± - Kh±Ô 54 - y®äš®î® y®½î®Á
BŠµ²°S®ã q®y¯š®n¯ Nµ°ºu®äS®¡®w®±Ý šµºiwµŒ¬
š®îµÁ¶©w¬é Nµ°ºu®äS®¡®w¯ÝT ¯l®Œ¯Tq®±Ù
Hw®±Ýu®± N®mîµ± By®rي®±î® š¯î®¾¯w®ã
cw®qµ‡®±ªå Aºu¯c± ¯l®Œ¯u® HX¬.J.ï.
Il¬é w® D y®ä¯o š®‹‡®¾¯TŠ®…œ®±u®±
Hw®±Ýu®NµÊ „µº…©î®w®±Ý x°l®±q®Ùuµ.
NACO and KSAPS
Note: mean values
iy®Þp: š®Š¯š®‹
8

2 Pages 11-20

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2.1 Page 11

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MEASURING THE EXTENT O. THE EPIDEMIC
Šµ²°S®u® y®ä¯oî®w®±Ý A¡µ‡®±±î®¼u®±
HIV in the General Population: Percent of Pregnant Women at
Antenatal Clinics Who Tested Positive for HIV, 2004
š¯î®¾¯w®ã cw®qµ‡®±ªå HX¬.J.ï. šµ²°ºN®±: y®äš®î®-y®½î®Á BŠµ²°S®ãNµ°ºu®äS®¡®ªå
S®†ÃÁpî®±Ÿ¡µ‡®±Š®ªå HX¬.J.ï. šµ²°ºOw® ýµ°N®l¯î¯Š®± y®ä¯o, 2004
District
dŒµå
District
Hospitals
dŒ¯å
Bš®ÞqµäS®¡®±
.irst
Referral
Units
y®š¬Ô
ŠµyµŠ®Œ¬
Nµ°ºu®äS®¡®±
Total
Kh±Ô
HIV prevalence varies substantially
across the districts of Karnataka. In
20 of the state’s 27 districts, at
least 1 percent of women attending
antenatal clinics tested positive for
HIV in 2004. Most of these districts
are located in the northern part of
the state. Testing at these hospitals
and clinics provides a reasonable
estimate of HIV prevalence in this
group, given that over 80 percent of
pregnant women in Karnataka
attend antenatal clinics. These
women are considered to be
representative of Karnataka’s
sexually active adult population.
Belgaum
„µ¡®S¯º
3.8
Koppal
Nµ²y®Þ¡®
1.8
Dharwad
u¯Š®î¯l®
1.8
Bagalkot
„¯S®©Nµ²°gµ
2.8
Bangalore (rural) „µºS®¡®²Š®± S¯ä¯ºq®Š® 2.8
Mysore
îµ±¶š®²Š®±
3.8
Gulbarga
S®±©àS®Á
2.0
Davangere
u¯î®oSµŠµ
1.0
Tumkur
q®±î®±N®²Š®±
1.3
Bijapur
†b¯y®¼Š®
2.0
Uttar Kannada Eq®ÙŠ® N®w®Ýl®
1.3
Dakshina Kannada u®£o N®w®Ýl®
2.5
Bellary
…¡¯ë‹
1.0
Raichur
Š¯‡®±X®²Š®±
1.3
Mandya
î®±ºl®ã
1.3
Gadag
S®u®S®
1.5
Udupi
El®±z
1.5
Hassan
œ¯š®w®
0.8
Charmarajnagar X¯î®±Š¯cw®S®Š®
0.8
Chikmagalur
YN®Êî®±S®¡®²Š®±
0.5
Bidar
†°u®Š®
0.8
Chitradurga
Yq®äu®±S®Á
0.8
Kodagu
Nµ²l®S®±
0.3
Kolar
Nµ²°Œ¯Š®
1.3
Bangalore (urban) „µºS®¡®²Š®± w®S®Š®
1.3
Haveri
œ¯îµ°‹
0.8
Shimoga
þî®îµ²S®Ì
0.5
4.8
4.3 HX¬.J.ï. šµ²°ºOw® y®ä¯ou®ªå Š¯cãu®
4.3
3.0 H©å dŒµåS®¡®² Kºuµ° š®î®±w¯T©å. Š¯cãu®
4.0
2.9 Kh±Ô 27 dŒµåS®¡®ªåw® 20 dŒµåS®¡®ªå 1
2.5
2.6 y®ärý®q® As®î¯ Au®Oʺq®©² œµYÏw®
2.3
2.5 y®ä¯ou®ªå 2004Š®ªå y®äš®î® y®½î®Á
1.0
2.4 BŠµ²°S®ã q®y¯š®n¯ Nµ°ºu®äS®¢Sµ „µ°i x°mu®
2.5
2.3 î®±Ÿ¡µ‡®±Š®ªå HX¬.J.ï. šµ²°ºN®±
3.3
2.1 N®ºl®±…ºvq®±Ù. CS®¡®ªå œµYÏw® dŒµåS®¡®±
1.8
0.8
1.5
0.3
1.5
1.4
1.4
1.4
Eq®ÙŠ® N®w¯ÁhN®u®ªå Cîµ. N®w¯ÁhN®u®ªå
š®±î®¾¯Š®± 80 y®ärý®q® S®†ÃÁp î®±Ÿ¡µ‡®±Š®±
y®äš®î® y®½î®Á BŠµ²°S®ã Nµ°ºu®äS®¢Sµ
1.3
1.1 „µ°ix°l®±q¯ÙŠµ Hºu®± Aºu¯c±î®¾¯l®Œ¯Tuµ.
1.0
1.1 Cu®Š® Bu¯Š®u® îµ±°Œµ Cºq®œ® Bš®Þqµä As®î¯
1.0
1.1 BŠµ²°S®ã q®y¯š®n¯ Nµ°ºu®äS®¡®ªå HX¬.J.ï.
0.8
1.1 y®‹°£µ‡®±w®±Ý ¯l®±î®¼u®Š® î®±²©N® D
0.5
1.0 S®±ºzw®ªå Cu®± HÇ®±Ô y®ä¯ou®ªåuµ
1.3
1.0 Hw®±Ýu®w®±Ý r¢‡®±±î®¼uµ° š®‹‡®¾¯u® ïu¯w®
1.3
1.0 Hw®Ý…œ®±u®±. D î®±Ÿ¡µ‡®±Š®± Œµ¶ºTN®î¯T
1.5
1.0
0.8
1.0
0.9
0.8
š®O䇮±Š¯u® y¹äl® š¯î®¾¯w®ã cw®qµ‡®±w®±Ý
y®ärxvÚ®±q¯ÙŠµ.
1.3
0.8
0.3
0.8
0.0
0.6
0.5
0.6
0.5
0.5
KSAPS
9

2.2 Page 12

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MEASURING THE EXTENT O. THE EPIDEMIC
Šµ²°S®u® y®ä¯oî®w®±Ý A¡µ‡®±±î®¼u®±
The occupation of the husbands of
women who tested positive for HIV
can provide some revealing
insights into how the disease can
spread into the general population.
Groups whose employment
requires considerable mobility or
who have contact with temporary
visitors to a city or area are
particularly vulnerable to infection.
In Karnataka, 2.2 percent of
pregnant women with husbands in
the transport industry tested
positive for HIV. The rate for wives
of agricultural and unskilled
labourers is also rather high,
showing that the disease is
distributed widely in rural and lower
socio-economic populations.
Percent of Pregnant Women Who Tested Positive for HIV at Antenatal
Clinics by Occupation of Husband, Karnataka, 2004
y®r‡®± Euµ²ã°S®u® y®äN¯Š® y®äš®î®-y®½î®Á BŠµ²°S®ãNµ°ºu®äS®¡®ªå S®†ÃÁpî®±Ÿ¡µ‡®±Š®ªå
HX¬.J.ï. šµ²°ºOw® ýµ°N®l¯î¯Š®± y®ä¯o N®w¯ÁhN®, 2004
Truck/auto/taxi driver
or cleaner
häN¬/Bgµ²°/g¯ã£ lµäȶ¬
As®î¯ Oå°w®Š¬
Hotel staff
œµ²°gµ°Œ¬ ›…àºv
Agriculture/unskilled
î®ã¯‡®±/ AN®±ý®© N¯ï±ÁN®
Industrial/factory
worker
Nµ¶S¯‹N¯/y¯N®Ô‹ Nµ©š®S¯Š®
Business
î¯ãy¯Š®
Services
šµ°îµS®¡®±
2.2
1.6
1.4
1.4
1.3
1.1
HX¬.J.ï. šµ²°ºOŠ®±î® î®±Ÿ¡µ‡®±Š® S®ºl®ºvŠ®
rÙS®¡®± D Šµ²°S®î®¼ š¯î®¾¯w®ã cw®qµ‡®±ªå
œµ°Sµ œ®Š®l®±rÙuµ Hw®±Ýu®Š® N®±‹q®± r¢š®±q®Ùuµ.
œµX¯ÏT rŠ®±S¯h CŠ®±î® As®î¯ y®hÔo,
y®äuµ°ý®S®¢Sµ …ºu® BS®ºq®±N®Šµ²l®wµ q¯q¯ÊªN®
š®º…ºu®î®w®±Ý Ch±ÔNµ²¡®±ëî®î®Š®ªå HX¬.J.ï.
šµ²°ºOw® By®q®±Ù œµYÏuµ Hw®Ý…œ®±u®±. š¯‹Sµ-
š®Š®…Š¯c± rه®±ªåŠ®±î®î®Š® y®r݇®±Š®ªå
HX¬.J.ï. šµ²°ºOw® y®ä¯o 2.2 y®ärý®q®
Cuµ Hw®±Ýu®± w®î®±â Š¯cãu®ªå‡®±² Cuµ° ‹°r
w®lµ‡®±±rÙuµ Hºu®± r¢š®±q®Ùuµ. „µ°š¯‡®±-
N®³™S®¡®ªå xŠ®q®Š¯u®î®Š® î®±q®±Ù N®±ý®©qµ‰±©åu®
N¯ï±ÁN®Š® y®r݇®±Š®ª‡®±² D šµ²°ºN®± œµYÏw®
y®ä¯ou®ªåuµ Hw®±Ýu®± D Šµ²°S®î®¼
S¯äï±°o î®±q®±Ù N®mîµ± š¯î®¾¯dN®-BtÁN®
š®ÚŠ®S®¡®ªåŠ®±î® cw®Š®ªå‡®±² y®š®‹›uµ
Hw®±Ýu®w®±Ý š®²Yš®±q®Ùuµ.
KSAPS
Low levels of education present a
formidable obstacle to programmes
designed to inform the general
population of the threat of HIV, the
means of avoiding infection, and
the dispelling of myths regarding
how it spreads. While infection
levels in Karnataka are high among
illiterates, HIV crosses most
education classes, suggesting that
a variety of approaches and
programmes are needed.
Percent of Pregnant Women Who Tested Positive for HIV at Antenatal
Clinics by Education, Karnataka, 2004
ýµ¶£®pN® š®ÚŠ®S®¡® y®äN¯Š® y®äš®î®-y®½î®Á BŠµ²°S®ãNµ°ºu®äS®¡®ªå S®†ÃÁpî®±Ÿ¡µ‡®±Š®ªå
HX¬.J.ï. šµ²°ºOw® ýµ°N®l¯î¯Š®± y®ä¯o N®w¯ÁhN®, 2004
Illiterate
Aw®£®Š®qµ
Primary
y¯äs®ï±N®
Secondary
šµNµºl®‹
1.7
1.3
1.5
Aw®Š®£®qµ î®±q®±Ù þ£®ou® Nµ²Š®qµS®¡®± HX¬.J.ï./
Il¬éw® N®±‹q®± î®±q®±Ù šµ²°ºN®w®±Ý q®lµS®h±Ôî®
ïu¯w®S®¡® N®±‹q®± š¯î®¾¯w®ã cw®qµSµ r¢›
œµ°¡®±î® î®±q®±Ù HX¬.J.ï. œ®Š®l®±î®¼u®Š® N®±‹q¯T
CŠ®±î® q®y®¼ÈÞ N®©ÞwµS®¡®w®±Ý u®²Š®î®¾¯l®±î®ºq®œ®
N¯‡®±ÁN®äî®±S®¢Sµ š¯N®Ç®±Ô Amև®±w®±Ý
q®ºuµ²l®±Öq®Ùîµ. N®w¯ÁhN®u®ªå Aw®£®Š®š®ÚŠ®ªå D
šµ²°ºN®± œµX¯ÏTuµ Hºu®Š®² Cq®Š® S®±ºy®¼S®¡®ªå
Cu®± N®mîµ±‡µ±°x©å. „µ°Šµ „µ°Šµ ‹°r‡®±
N¯‡®±ÁN®äî®±S®¡® Aî®ý®ãN®qµ‰±uµ Hw®±Ýu®w®±Ý
Cu®± š®²Yš®±q®Ùuµ.
Graduation+
y®u®ï +
0.9
KSAPS
10

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INVESTIGATING HOW HIV SPREADS
HX¬.J.ï. œ®Š®l®±î®¼u®w®±Ý r¢‡®±±î®¼u®±
In Karnataka, sexual activity is the primary transmission mode of HIV. Sex workers (SWs) and their
clients are among the most vulnerable sub-groups to HIV and are often important parts of sexual
networks. As a result, reaching SWs and their clients with effective programmes is a matter of the
utmost urgency. Understanding the pattern of sexual behaviour, especially that in the sex work
context, is particularly important for understanding HIV transmission dynamics in Karnataka.
In order to develop evidence-based plans for a comprehensive HIV/AIDS prevention programme,
Karnataka has conducted specific studies on HIV transmission. The studies include: (1) mapping of
groups and populations at greater risk, such as SWs, males, females, and Hijras and the traditional
groups at risk, such as Devadasis, Jogatis, and Jogappas in all the cities and towns of the state; (2)
a socio-behavioural survey of .SWs in 18 districts; (3) a HIV prevalence study in Bagalkot district;
and (4) a situation and needs assessment in the rural areas of Bagalkot district and in Hubli-
Dharwad Municipal Corporation Area. The India-Canada Collaborative HIV/AIDS Project (ICHAP)
and KSAPS collaborated with the Population Research Centre (PRC) in Dharwad as well as Swasti,
a health resource centre in Bangalore, to conduct these studies. Key findings of these special
studies are summarized in the following pages.
N®w¯ÁhN®u®ªå Œµ¶ºTN® O䇵±‡µ±° HX¬.J.ï. œ®Š®l®±î® î®±±Qã ¯S®Á. Au®Š®©²å œµX¯ÏT Œµ¶ºTN® rÙ xŠ®q®Š®± î®±q®±Ù A®
TŠ¯OS®¡®± HX¬.J.ï. šµ²°ºOw® By®rÙSµ K¡®S¯u® S®±ºy®¼ î®±q®±Ù Œµ¶ºTN® b¯©S®¡® Kºu®± î®±±Q㠄¯S® Hºu®² œµ°¡®…œ®±u®±.
Bu®±u®‹ºu® Eq®Ùî®± S®±oî®±hÔu® N¯‡®±ÁN®äî®±S®¡® î®±²©N® Œµ¶ºTN® rÙ xŠ®q®Š®w®±Ý î®±q®±Ù A® TŠ¯OS®¡®w®±Ý q®©±y®¼î®¼u®± Ar
Aî®ý®ãN®î¯Tuµ. N®w¯ÁhN®u®ªå HX¬.J.ï.‡®±± œµ°Sµ œ®Š®l®±rÙuµ Hºu®± r¢‡®±©± Œµ¶ºTN® w®l®î®¢NµS®¡® -Au®Š®©²å î®±±Qãî¯T Œµ¶ºTN®
î¯ãy¯Š®u® š®xÝîµ°ý®S®¡®ªå Œµ¶ºTN® w®l®î®¢NµS®¡® - N®±‹q®± r¢u®±Nµ²¡®±ëu®± Ar Aî®ý®ãN®,
š¯£-Bu¯‹q® š®î®±™Õ HX¬.J.ï./Il¬éw®±Ý q®lµS®h±Ôî® N¯‡®±ÁN®äî®±S®¡®w®±Ý Š®²zš®„µ°Nµºu®± N®w¯ÁhN®î®¼ HX¬.J.ï. œ®Š®l®±ïNµ‡®±
N®±‹q¯u® ïýµ°Ç® Au®㇮±w®S®¡®w®±Ý w®lµ›uµ. D Au®ã‡®±w®S®¡®± ‡®¾¯î®¼îµºu®Šµ: (1) Š¯cãu® H©å w®S®Š® y®hÔoS®¡®ªåŠ®±î® œµYÏw® By®rÙw®
S®±ºy®¼ î®±q®±Ù cw¯ºS®S®¡® - Œµ¶ºTN® rÙxŠ®q®Š¯u® î®±Ÿ¡µ‡®±Š®±, y®¼Š®±Ç®Š®± î®±q®±Ù Ÿcl¯ cw¯ºS®, î®±q®±Ù š¯ºy®äu¯‰±N®î¯T œµYÏw®
By®q®Ùw®±Ý œµ²ºvŠ®…œ®±u¯u® uµ°î®u¯›‡®±Š®±, bµ²°S®r‡®±Š®±, bµ²°S®y®Þw®î®Š®± îµ²u®Œ¯u®î®Š® - w®N¯ýµ‡®±w®±Ý q®‡®¾¯‹š®±î®¼u®± (2)
Š¯cãu® 18 dŒµåS®¡®ªå Œµ¶ºTN® rÙ xŠ®q® î®±Ÿ¡µ‡®±Š® š¯î®¾¯dN® î®±q®±Ù w®l®î®¢NµS®¡® š®ï±°£µ (3) „¯S®©Nµ²°gµ dŒµå‡®±ªå
HX¬.J.ï. y®ä¯ou® Au®㇮±w® (4) „¯S®©Nµ²°gµ dŒµå‡®± S¯äï±°o y®äuµ°ý®S®¡®ªå î®±q®±Ù œ®±…à¢ë-u¯Š®î¯l® w®S®Š®š®„µ‡®±
£µ°q®äS®¡®ªå š®xÝîµ°ý® î®±q®±Ù Aî®ý®ãN®qµS®¡® Au®㇮±w®. „¯Š®q®-Nµw®l¯ š®œ®‡µ²°S®u® HX¬.J.Y./Il¬é ‡µ²°cwµ (JX¯y¬) î®±q®±Ù
N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i(Nµš¯y¬é)‡®±± D Au®㇮±w®S®¡®w®±Ý cw®š®ºP¯ã š®ºýµ²°u®w¯ Nµ°ºu®ä, u¯Š®î¯l® î®±q®±Ù š®æ›Ù;
BŠµ²°S®ã š®ºy®w®²â© Nµ°ºu®ä, „µºS®¡®²Š®± C®l®± š®ºšµÚS®¡® š®œ®‡µ²°S®vºu® w®lµ›u®î®¼. î®±±ºvw® Nµ©î®¼ y®¼hS®¡®ªå D Au®㇮±w®S®¡®±
qµ²°‹›Nµ²hÔ î®±±Qã Aºý®S®¡®w®±Ý š¯Š¯ºý®u® Š®²y®u®ªå x°l®Œ¯Tuµ.
11

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THE DYNAMICS O. SEX WORK
Œµ¶ºTN® rه®± Š®²y®Šµ°ýµS®¡®±
The survey of Karnataka female
sex workers covering 1,500 women
in 18 districts revealed sharp
variations in the type of sex work
practiced between North and South.
These important differences in
health and risk behaviour must be
taken into account in any HIV
prevention programme in
Karnataka.
A majority—66 percent—of .SWs
in the North work either at home or
in brothels and began work at a
younger age than those in the
South. Sex work in the South is
characterized by various layers of
sex work operators and tends to be
more secretive.
In addition to being younger, home
and brothel-based workers are
more often found in rural areas.
Public places-based workers tend
to be older and cite poverty as the
reason for their sex work.
Percent of Female Sex Workers by Type, Karnataka, 2002
„µ°Šµ „µ°Šµ y®äN¯Š®u® Œµ¶ºTN® rÙS®¡®ªå xŠ®q®Š¯u® î®±Ÿ¡µ‡®±Š® ýµ°N®l¯î¯Š®± y®ä¯o, 2002
75
North Karnataka
Eq®ÙŠ® N®w¯ÁhN®
South Karnataka
45
u®£o N®w¯ÁhN®
8
Home
î®±wµS®¡®ªå
ICHAP
21
5
Brothel
„µ²ä°sµŒ¬S®¡®ªå
28
35
46
Lodge Dhaba/roadside Public places
Œ¯l¬ÑS®¡®ªå l¯„¯/œµu¯Û‹S®¡®ªå š¯î®ÁcxN®
š®Ú¡®S®¡®ªå
18 dŒµåS®¢ºu® Kh±Ô 1500 î®±Ÿ¡µ‡®±Š®
š¯ãºy®Œ¬w®±Ý K¡®Sµ²ºl® Œµ¶ºTN® rÙxŠ®q®
î®±Ÿ¡µ‡®±Š® š®ï±°£µ‡®±± Š¯cãu® Eq®ÙŠ® î®±q®±Ù
u®£o „¯S®S®¡® w®l®±îµ Œµ¶ºTN® rه®±ªåŠ®±î®
AS¯u® Aºq®Š®S®¡®w®±Ý HrÙ qµ²°‹›q®±. Cu®Š®ºqµ
HX¬.J.ï. q®lµS®h±Ôî® N¯‡®±ÁN®äî®±S®¡®±
BŠµ²°S®ã î®±q®±Ù By®rÙw® w®l®î®¢NµS®¡®ªåŠ®±î®
ïu®ãqµS®¡®w®±Ý S®î®±w®NµÊ qµSµu®±Nµ²¡®±ëu®±
Ar° î®±±Qã.
Eq®ÙŠ® N®w¯ÁhN®u®ªå Œµ¶ºTN® rÙ xŠ®q®
î®±Ÿ¡µ‡®±Š®± œµX¯ÏT (66 y®ärý®q®) î®±wµ‡®±ªå
As®î¯ „µ²ä°sµŒ¬S®¡®ªå Nµ©š® ¯l®±q¯ÙŠµ,
î®±q®±Ù u®£o N®w¯ÁhN®u®î®Šµ²l®wµ œµ²°ª›u®Šµ
C®± YN®Ê ®±›éw®ªå rÙSµ qµ²l®S®±q¯ÙŠµ.
u®£o N®w¯ÁhN®u®ªå Œµ¶ºTN® rه®±ªå
x‡®±ºq®äou® œ®©î¯Š®± y®u®Š®±S®¢u®±Û, S¹y®ãqµ
œµX¯ÏTuµ.
î®±wµS®¡®ªå î®±q®±Ù „µ²ä°sµŒ¬S®¡®ªå Œµ¶ºTN®
r٠¯l®±î® î®±Ÿ¡µ‡®±Š®± ®±›éw®ªå
YN®Ê¯Tu®±Û, œµX¯ÏT S¯äï±°o y®äuµ°ý®S®¡®ªå
N®ºl®±…Š®±q¯ÙŠµ. š¯î®ÁcxN® š®Ú¡®S®¡®ªå Œµ¶ºTN®
r٠¯l®±î®î®Š®± š®æ©Þ œµYÏw®
®±›éw®î®Š¯TŠ®±q¯ÙŠµ î®±q®±Ù q¯î®¼ Œµ¶ºTN®
rÙT¢‡®±©± …l®q®w®îµ° î®±±Qã N¯Š®ou®±
œµ°¡®±q¯ÙŠµ.
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THE DYNAMICS O. SEX WORK
Œµ¶ºTN® rه®± Š®²y®Šµ°ýµS®¡®±
The most common reason given by
Reason for Sex Work Reported by Female Sex Workers
Œµ¶ºTN® rÙT¢‡®±©± Nµ²hÔ î®±±Qã N¯Š®o
.SWs in Karnataka for entering sex
work was poverty, which may have
been caused by a husband’s
Karnataka, 2002
…l®q®w® - y®r‡®±± qµ²Šµu®±u®‹ºu®Œµ²° As®î¯
(percent)
Œµ¶ºTN® rÙ xŠ®q® î®±Ÿ¡µ‡®±Š®± ®v¯mu® Œµ¶ºTN® rÙT¢‡®±©± N¯Š®oS®¡®±, N®w¯ÁhN®, 2002
u®î®ãvºu®Œµ²° …ºu® …l®q®w®. u®£o
(y®ärý®q®)
N®w¯ÁhN®u®ªå š®±î®¾¯Š®± w¯©ÊŠ®ªå K…àŠ®±
abandonment or by widowhood. In
q®î®±âw®±Ý îµ²°š® ¯m As®î¯ Bšµ qµ²°‹›
the South, nearly one-fourth of
Poverty/needed extra money
…l®q®w®/œ®ou® Aî®ý®ãN®qµ
.SWs said that they had either
been cheated or lured into sex
Devadasi tradition
uµ°î®u¯› y®u®Ür 0
work, while the Devadasi tradition
Abandoned by husband
12
was the most commonly cited
S®ºl®xºu® qµ²Šµ‡®±©ÞhÔu®ÛN¯ÊT
38
32
52 Œµ¶ºTN® rÙSµ q®¡®ëŒ¯‰±q®± Hºu®Šµ Eq®ÙŠ®
N®w¯ÁhN®u®ªå uµ°î®u¯› y®u®Ür‡µ±° î®±±Qã
49 N¯Š®o Hºu®± ®v‡®¾¯Tuµ. Eq®ÙŠ® N®w¯ÁhN®
î®±q®±Ù u®£o N®w¯ÁhN®S®¡® w®l®±îµ Œµ¶ºTN®
rه®±ªåŠ®±î® î®ãq¯ãš®S®¡®±
reason in the North. The sharp
contrasts between North and South
Karnataka .SWs shows the need
Ill treatment by husband
S®ºl®xºu® ŸºšµSµ²¡®S¯Tu®±Ûu®N¯ÊT
Pay off loan
š¯© r°‹š®ªN¯ÊT
8
16
7
15
N¯‡®±ÁN®äî®±S®¡®ªå‡®±² ïu®ãqµ CŠ®„µ°N®±
Hw®±Ýu®w®±Ý š®²Yš®±q®Ùuµ.
for different strategies for sex work
Cheated/lured into sex work
interventions.
îµ²°š®vºu®/Bšµ qµ²°‹› Œµ¶ºTN® rÙSµ œ¯Ou®±Ûu®±
13
23
North Karnataka
Widowed
u®î®ãu® N¯Š®ovºu®
Other
Aw®ã N¯Š®oS®¡®±
6
11
7
18
Eq®ÙŠ® N®w¯ÁhN®
South Karnataka
u®£o N®w¯ÁhN®
.SWs in Karnataka have an
average of 7.5 clients per week.
.ixed-place workers—such as
those in brothels or those who use
dhabas—had the highest number
of clients. Because their work is
more frequently brothel-based,
.SWs in the North served a higher
average number of clients per week
(about nine) than those in the
South, who averaged about five.
ICHAP
Note: multiple reasons possible
iy®Þp: Kºu®Oʺq® œµX®±Ï N¯Š®oS®¢Š®…œ®±u®±
Female Sex Workers by Type and by Number of Weekly Clients
Karnataka, 2002
„µ°Šµ „µ°Šµ y®äN¯Š®u® Œµ¶ºTN® rÙxŠ®q® î®±Ÿ¡µ‡®±Š®ªå Kºu®± ®u®ªå …Š®±î® TŠ¯OS®¡® š®ºPµã,
N®w¯ÁhN®, 2002
Total
Kh±Ô
Brothel
„¯äsµŒ¬
Dhaba
l¯„¯Â
Home
î®±wµ
Lodge
Œ¯l¬Ñ
Public places
š¯î®ÁcxN® š®Ú¡®S®¡®±
7.5
11.2
10.2
8.2
5.6
5.6
Š¯cãu®ªåw® Œµ¶ºTN® rÙ xŠ®q® î®±Ÿ¡µ‡®±Š® N®lµ
Kºu®± ®u®ªå š®Š¯š®‹ 7.5 TŠ¯OS®¡®±
œµ²°S®±q¯ÙŠµ. Kºuµ° š®Ú¡®u®ªå Aºu®Šµ
„µ²ä°sµŒ¬, l¯„¯S®¡®ªå Œµ¶ºTN® rÙ
¯l®±î® î®±Ÿ¡µ‡®±‹Sµ CŠ®±î® TŠ¯OS®¡® š®ºPµã
Ar œµX®±Ï. „µ²ä°sµŒ¬S®¡®± œµX¯ÏTŠ®±î® Eq®ÙŠ®
N®w¯ÁhN®u®ªå Œµ¶ºTN® rÙxŠ®q® î®±Ÿ¡µ‡®±Š®±
Kºu®± ®u®ªå œµX®±Ï TŠ¯OS®¡®w®±Ý (š®Š¯š®‹
š®±î®¾¯Š®± 9) œµ²ºvu®ÛŠ®±. CSµ
œµ²°ª›u®Šµ, u®£o N®w¯ÁhN®u®ªå Œµ¶ºTN® rÙ
xŠ®q® î®±Ÿ¡µ‡®±Š®± Kºu®± ®u®ªå š®Š¯š®‹
š®±î®¾¯Š®± 5 TŠ¯OS®¡®w®±Ý œµ²ºvu®ÛŠ®±.
ICHAP
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THE DYNAMICS O. SEX WORK
Œµ¶ºTN® rه®± Š®²y®Šµ°ýµS®¡®±
Reaching sex workers with the
largest number of clients is a clear
priority in focussed HIV prevention
interventions. The proportion of
high-volume (10 or more clients
weekly) sex workers is higher in the
North (at 20 percent) than in the
South (at 7 percent). Sex workers
who seek clients in public places or
the streets have the lowest
proportion of high-volume .SWs in
the state—a likely result both of the
informal nature of their work and
the lack of agents to locate clients
for them.
Percent of Female Sex Workers with More Than 10 Clients per Week
Karnataka, 2002
®u®ªå 10Oʺq® œµX®±Ï TŠ¯OS®¡®w®±Ý œµ²ºvŠ®±î® Œµ¶ºTN® rÙ xŠ®q® î®±Ÿ¡µ‡®±Š® ýµ°N®l¯y®ä¯o,
N®w¯ÁhN®, 2002
20
20
19
14
7
8
Total
Kh±Ô
ICHAP
North
Karnataka
Eq®ÙŠ®
N®w¯ÁhN®
South
Karnataka
u®£o
N®w¯ÁhN®
Home
î®±wµ
Brothel/lodge/ Public places
dhaba
š¯î®ÁcxN®
„µ²ä°sµŒ¬/
š®Ú¡®S®¡®±
Œ¯l¬Ñ/l¯„¯
HX¬.J.ï. q®lµS®h±Ôî® Nµ²ä°mðN®³q®
N¯‡®±ÁN®äî®±S®¡®ªå Ar œµX®±Ï TŠ¯OS®¡®w®±Ý
œµ²ºvu® Œµ¶ºTN® rÙxŠ®q®Š®w®±Ý q®©±y®¼î®¼uµ°
Kºu®± Bu®ãqµ‡®¾¯S®±q®Ùuµ. œµX®±Ï TŠ¯OS®¡®w®±Ý
(Aºu®Šµ ®NµÊ 10 As®î¯ œµYÏw®
TŠ¯OS®¡®w®±Ý) œµ²ºvu®î®Š® y®ä¯o Eq®ÙŠ®
N®w¯ÁhN®u®ªå (20 y®ärý®q®) u®£o
N®w¯ÁhN®Oʺq® (7 y®ärý®q®) œµX®±Ï. †°vS®¡®ªå
î®±q®±Ù Cq®Š® š¯î®ÁcxN® y®äuµ°ý®S®¡®ªå Œµ¶ºTN®
r٠¯l®±î®î®Š®ªå ®NµÊ œ®q®±Ù As®î¯
œµYÏw® TŠ¯OS®¡®w®±Ý œµ²ºvŠ®±î®î®Š® y®ä¯o
q®±º„¯ N®mîµ±. …œ®±Ç®: D š®xÝîµ°ý®u®
rه®±ªåŠ®±î® Aw¹y®X¯‹N®qµ î®±q®±Ù
TŠ¯OS®¡®w®±Ý rÙ xŠ®q®‹Sµ šµ°‹š®©±
š®œ¯‡®±î®¾¯l®±î® u®Œ¯å¢S®¢©åvŠ®±î®¼u®± Cu®NµÊ
N¯Š®oS®¡¯TŠ®…œ®±u®±.
How much sex work is accounted
for by high-volume .SWs?
Statewide, only 14 percent of sex
workers accounted for 48 percent
of the total number of interactions.
Reaching these workers and their
clients will have a substantial
impact on the epidemic. Even
among workers in public places and
in the streets, the proportion of
client interactions is relatively high,
with 8 percent of these .SWs
accounting for 34 percent of the
group’s total clients. Still, just over
one-half of sex work clients are
entertained by a large number of
low-volume .SWs. Contacting
these workers remains a key goal
of the programme.
Percent of Commercial Sex Interactions Contributed by Female Sex
Workers with More Than 10 Clients per Week, Karnataka, 2002
î¯ãy¯‹N® Œµ¶ºTN® O䇵±S®¡®ªå ®u®ªå 10Oʺq® œµX®±Ï TŠ¯OS®¡®w®±Ý œµ²ºvŠ®±î® Œµ¶ºTN® rÙ xŠ®q®
î®±Ÿ¡µ‡®±Š® ýµ°N®l¯y®ä¯o, N®w¯ÁhN®, 2002
56
48
61
52
34
26
Total
Kh±Ô
ICHAP
North
Karnataka
Eq®ÙŠ®
N®w¯ÁhN®
South
Karnataka
u®£o
N®w¯ÁhN®
Home Brothel/lodge/ Public places
î®±wµ
dhaba
š¯î®ÁcxN®
„µ²ä°sµŒ¬/
š®Ú¡®S®¡®±
Œ¯l¬Ñ/l¯„¯
œµX®±Ï TŠ¯OS®¡®w®±Ý¡®ë Œµ¶ºTN® rÙ xŠ®q®
î®±Ÿ¡µ‡®±Š®± Kh±Ô î¯pc㠌µ¶ºTN® O䇵±S®¡®
HÇ®±Ô y®ä¯oî®w®±Ý y®ärxvÚ®±q¯ÙŠµ?
Š¯b¯ãu®ãºq® Kh±Ô î¯pc㠌µ¶ºTN®
O䇵±S®¡®ªåw® 48 y®ärý®q® O䇵±S®¡®± Nµ°î®© 14
y®ärý®q® rÙxŠ®q®Š®wµ²Ý¡®Sµ²ºmq®±Ù. Cºs®œ®
rÙxŠ®q®Š®w®±Ý, TŠ¯OS®¡®w®±Ý q®©±y®¼î®¼u®‹ºu®
HX¬.J.ï. šµ²°ºN®± œ®Š®l®±î®¼u®Š® îµ±°Œµ
š¯N®Ç®±Ô y®‹n¯î®±S®¡®w®±Ý š¯vÚ®…œ®±u®±.
†°vS®¡®ªå î®±q®±Ù Cq®Š® š¯î®ÁcxN®
y®äuµ°ý®S®¡®ªåŠ®±î® rÙxŠ®q®Š®ªå‡®±² œµX®±Ï
TŠ¯OS®¡®w®±Ý œµ²ºvŠ®±î®î®Š® y®ä¯o
N®mîµ±‡µ±°x©å; 8 y®ärý®q® rÙxŠ®q®Š®± 34
y®ärý®q® î¯pc㠌µ¶ºTN® O䇵±S®¡®ªå
„¯S®î®Ÿš®±q¯ÙŠµ. Bu®Š®², œµYÏw®
y®ä¯ou®ªåŠ®±î® N®mîµ± TŠ¯OS®¡®w®±Ý¡®ë Œµ¶ºTN®
rÙxŠ®q® î®±Ÿ¡µ‡®±Š®± Au®ÁOʺq®©² œµX®±Ï
î¯pc㠌µ¶ºTN® O䇵±S®¡®ªå „¯S®î®Ÿš®±q¯ÙŠµ.
Cºs®œ® rÙxŠ®q®Š®w®±Ý q®©±y®¼î®¼u®²
N¯‡®±ÁN®äî®±u® Kºu®± î®±±Qã S®±‹‡®¾¯Tuµ.
14

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THE DYNAMICS O. SEX WORK
Œµ¶ºTN® rه®± Š®²y®Šµ°ýµS®¡®±
There is strong evidence that a
substantial proportion of .SWs in
Karnataka are mobile, both within
the state and among states.
Mobility is likely to increase the
vulnerability of these .SWs to HIV
infection, through dislocation and
working in unfamiliar environments
over which they have little control.
Moreover, the movement of sex
workers, particularly to and from
areas with high prevalence, could
lead to a more rapid expansion of
HIV. The survey indicated that
nearly 20 percent of .SWs in the
North have worked in another
state—a figure that likely
understates the true situation, since
the survey could not include
women who were absent.
The low literacy levels of sex
workers can pose significant
obstacles in communicating safe-
sex messages to sex workers. In
virtually every category of .SW in
Karnataka, the level of illiteracy
was found to be approximately 80
percent. Illiteracy is a particular
problem for programmes aimed at
.SWs in the more informal sector,
such as public places, dhabas, and
roadsides. .or these groups of
women, the challenges are twofold:
locating the sex worker and then
providing proper counselling and
services for protecting themselves.
Migrant Status of Female Sex Workers, by Region, Karnataka, 2002
(percent)
šµ œµ²°S®±î® Œµ¶ºTN® rÙxŠ®q® î®±Ÿ¡µ‡®±Š®, y¯äºq¯î®Š®± ýµ°N®l® y¯ä¯o, N®w¯ÁhN®, 2002
(y®ärý®q®)
18
13
18
12
North Karnataka
Eq®ÙŠ® N®w¯ÁhN®
South Karnataka
u®£o N®w¯ÁhN®
9
7
Ever worked in any Ever worked outside
other Karnataka district
Karnataka
N®w¯ÁhN®u® Cq®Š® dŒµåS®¡®ªå N®w¯ÁhN®u® œµ²Š®Sµ Hºu¯u®Š®²
Hºu¯u®Š®² r٠¯mu®î®Š®±
r٠¯mu®î®Š®±
Ever worked
in Mumbai
î®±±º„¯‰±‡®±ªå Hºu¯u®Š®²
r٠¯mu®î®Š®±
ICHAP
Literacy and Education Levels of Female Sex Workers, by Type
Karnataka, 2002
(percent)
„µ°Šµ „µ°Šµ y®äN¯Š®u® Œµ¶ºTN® rÙ xŠ®q® î®±Ÿ¡µ‡®±Š®ªå A£®Š®qµ î®±q®±Ù ýµ¶£®pN® š®ÚŠ®S®¡®±
N®w¯ÁhN®, 2002
(y®ärý®q®)
2
1
10
13
15
7
6
13
16
22
88
86
80
77
63
Home
î®±wµ
ICHAP
Brothel
„¯äsµŒ¬
Lodge Dhaba/roadside Public places
Œ¯l¬Ñ
l¯„¯/œµu¯Û‹S®¡®± š¯î®ÁcxN® š®Ú¡®S®¡®±
SSLC and higher
Hš¬.Hš¬.HŒ¬.›.+
Less than SSLC
<Hš¬.Hš¬.HŒ¬.›.
Illiterate
Aw®£®Š®qµ
N®w¯ÁhN®u® Œµ¶ºTN®î®³rÙxŠ®q® î®±Ÿ¡µ‡®±Š®ªå
š¯N®Ç®±Ô cw®Š®± Š¯cãu®ªå î®±q®±Ù Š¯cãS®¡®
w®l®±îµ rÙS¯T š®Ú¡¯ºq®‹š®±q¯ÙŠµ. D ‹°r
š®Ú¡¯ºq®‹q® î®±Ÿ¡µ‡®±Š®± q®î®±â
x‡®±ºq®äoS®¢©åu® „µ°Šµ „µ°Šµ Ay®‹Yq®
y®‹š®Š®S®¡®ªå rÙ¯l®„µ°N¯S®±î®¼u®‹ºu®
HX¬.J.ï. šµ²°ºOSµ K¡®S¯S®±î® š¯u®ãqµS®¡®±
œµX®±Ï. Cu®² A©åuµ, Œµ¶ºTN® rه®±ªå
xŠ®q®Š¯u®î®Š®± HX¬.J.ï. œµX¯ÏTŠ®±î®
y®äuµ°ý®S®¢Sµ œµ²°T …Š®±î®¼u®‹ºu® D šµ²°ºN®±
„µ°S®wµ œ®Š®l®…œ®±u®±. š®îµÁ°£®nµ‡®± y®äN¯Š®,
Eq®ÙŠ® N®w¯ÁhN®u® š®±î®¾¯Š®± 20 y®ärý®q®
Œµ¶ºTN® rÙxŠ®q® î®±Ÿ¡µ‡®±Š®± „µ°Šµ²ºu®±
Š¯cãu®ªå Œµ¶ºTN® rه®±w®±Ý ¯mu¯ÛŠµ. D
š®îµÁ°£®nµ‡®±ªå DS¯S®Œµ° „µ°Šµ Š¯cãS®¡®ªå
r٠¯l®±rي®±î® î®±Ÿ¡µ‡®±Š®± šµ°Š®uµ°
CŠ®±î®¼u®‹ºu® D y®ä¯o Cu®Oʺq®©²
œµX¯ÏTuµ Hw®Ý…œ®±u®±.
Œµ¶ºTN® rÙxŠ®q®Š®ªå œµYÏw® y®ä¯ou®ªåŠ®±î®
Aw®£®Š®qµ‡®±± ASµ š®±Š®£q® Œµ¶ºTN® O䇵±S®¡®
…SµÌ r¢› œµ°¡®±î®ªå y®äî®±±Qî¯u® Amև®±w®±Ý
q®Š®…©åu®±. Š¯cãu® y®är‡µ²ºu®± ‹°r‡®±
Œµ¶ºTN® rÙ xŠ®q® î®±Ÿ¡µ‡®±ªå‡®±² š®±î®¾¯Š®±
80 y®ärý®q® Aw®£®Š®š®Ú‹u¯ÛŠµ. Au®Š®©²å
ïýµ°Ç®î¯T š¯î®ÁcxN® š®Ú¡®S®¡®ªå, l¯„¯S®¡®ªå
î®±q®±Ù œµu¯Û‹S®¡®ªå rÙ¯l®±î®
î®±Ÿ¡µ‡®±Š®w®±Ý q®©±y®¼î®¼u®ªå Aw®£®Š®qµ‡®±±
Kºl®± y®äî®±±Q š®î®±šµã‡®±w®±Ý
q®ºuµ²l®Ö…œ®±u®±. D S®±ºy®w®±Ý q®©±y®¼î®¼u®Š®ªå
HŠ®l®± î®±±Q㠚®î®±šµãS®¡®± …ºuµ²u®S®…œ®±u®±:
Œµ¶ºTN® rÙxŠ®q®Š®w®±Ý S®±Š®±rš®±î®¼u®± î®±q®±Ù
q®î®±âw®±Ý q¯îµ° Š®£›Nµ²¡®ë©± ASµ š®‹‡®¾¯u®
š®î®¾¯Œµ²°X®wµ î®±q®±Ù šµ°îµS®¡®w®±Ý
Ku®Tš®±î®¼u®±.
15

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THE DYNAMICS O. SEX WORK
Œµ¶ºTN® rه®± Š®²y®Šµ°ýµS®¡®±
Recognition of the presence of a
sexually transmitted disease (STD)
is a vitally important component in
avoiding HIV. About 40 percent of
.SWs surveyed did not know how
to recognize any symptom of STD
in themselves, and over one-half
would not be able to recognize one
in a male client. Misconceptions
regarding STDs are widespread. It
is imperative to provide easily
accessible, good-quality STD
services to female sex workers and
their clients.
How prevalent is paid sex in
Karnataka? In many face-to-face
survey interviews, clients are likely
to underreport their frequency of
visits to a sex worker. In the
situation-needs assessment in
Bagalkot district, the polling-booth
method was used so that all
responses were completely
unlinked and anonymous. In this
assessment, 17 percent of married
men reported that they had ever
visited a sex worker, compared with
9 percent of unmarried men. In
part, the somewhat older age of the
married respondents accounts for
their higher proportion.
Percent of Female Sex Workers Reporting Knowledge of Sexually
Transmitted Disease Symptoms, Karnataka, 2002
Œµ¶ºTN® Šµ²°S® ©£®oS®¡® N®±‹q¯u® A‹ïw® y®äN¯Š® Œµ¶ºTN® rÙxŠ®q® î®±Ÿ¡µ‡®±Š® ýµ°N®l®y®ä¯o,
N®w¯ÁhN®, 2002
Knows female symptoms:
î®±Ÿ¡µ‡®±Š®ªåN®ºl®±…Š®±î® ©£®oS®¡®±
Does not know any symptoms
‡®¾¯î® ©£®oS®¡®w®²Ý r¢v©å
Knows only one symptom
Kºuµ° ©£®oî®w®±Ý r¢vu¯ÛŠµ
11
Knows 2+ symptoms
HŠ®l®Oʺq® œµX®±Ï ©£®oS®¡®w®±Ý r¢vu¯ÛŠµ
Knows male symptoms:
y®¼Š®±Ç®Š®ªå N®ºl®±…Š®±î® ©£®oS®¡®±
Does not know any symptoms
‡®¾¯î® ©£®oS®¡®w®²Ý r¢v©å
Knows only one symptom
Kºuµ° ©£®oî®w®±Ý r¢vu¯ÛŠµ
13
Knows 2+ symptoms
HŠ®l®Oʺq® œµX®±Ï ©£®oS®¡®w®±Ý r¢vu¯ÛŠµ
ICHAP
39
50
53
34
Percent of Male Respondents (ages 15-49) in Bagalkot Project Area
Who Reported Ever Having Paid Sex, 2003
š®ï±°£µ‡®±ªå ‡µ²°cw¯ £µ°q®äu®ªå y®¼Š®±Ç®Š®± (®±š®±é 15-49) œ®oNµ²h±Ô Œµ¶ºTN®
š®º…ºu®S®¡®xÝh±ÔNµ²ºmu®±Ûu®w®±Ý ®v¯mu®±Ûu®±, 2003
17
9
ICHAP
Married men
ïq® y®¼Š®±Ç®Š®±
Unmarried men
Aïq® y®¼Š®±Ç®Š®±
HX¬.J.ï.‡®±w®±Ý q®lµS®hÔ©±
Œµ¶ºTN®Šµ²°S®S®¡®w®±Ý S®±Š®±rš®±î®¼u®± Ar î®±±Qã
Hw®Ý…œ®±u®±. š®îµÁ°£®nµ‡®±ªå „¯S®î®Ÿ›u®
š®±î®¾¯Š®± 40 y®ärý®q® Œµ¶ºTN® rÙxŠ®q®
î®±Ÿ¡µ‡®±Š®± î®±Ÿ¡µ‡®±Š®ªå N®ºl®±…Š®±î® Œµ¶ºTN®
Šµ²°S®S®¡® ©£®oS®¡®w®±Ý œµ°Sµ S®±Š®±rš®…œ®±u®±
Hw®±Ýu®w®±Ý r¢v©å. Œµ¶ºTN® Šµ²°S®S®¡®
N®±‹q¯u® q®y®¼ÈÞ N®©ÞwµS®¡®± q®±º„¯ cw®Š®ªåuµ.
Œµ¶ºTN® rÙxŠ®q®‹Sµ î®±q®±Ù A® TŠ¯OS®¢Sµ
Œµ¶ºTN® Šµ²°S®S®¡® N®±‹q¯u® ¯Ÿr î®±q®±Ù
š®±©„®î¯T uµ²Šµ‡®±…©å Eq®Ùî®± S®±oî®±hÔu®
Œµ¶ºTN® Šµ²°S® šµ°îµS®¡®wµ²Ýu®Tš®±î®¼u®± Ar
Aî®ý®ãN®î¯Tuµ.
N®w¯ÁhN®u®ªå î¯pc㠌µ¶ºTN® O䇵±S®¡®± HǮԊ®
î®±iÔSµ w®lµ‡®±±q®Ùuµ? …œ®¡®Ç®±Ô î®±±P¯-î®±±R
š®ºu®ý®Áw®S®¡®ªå TŠ¯OS®¡®± Œµ¶ºTN®
rÙxŠ®q®Š¯u®î®‹Sµ HÇ®±Ô š¯‹ „µ°i
Nµ²l®±q¯ÙŠµ Hw®±Ýu®w®±Ý Aq®ãºq® N®mîµ±
y®ä¯ou®ªå ®v ¯l®±q¯ÙŠµ. „¯S®©Nµ²°gµ
dŒµå‡®±ªå w®lµ›u® š®xÝîµ°ý® î®±q®±Ù Aî®ý®ãN®qµS®¡®
Au®㇮±w®î®¼ Liw® y®u®Ür‡®±w®±Ý …¡®›q®±. Lh±
œ¯N®±î®¼u®Š® î®±²©N® q®î®±â Œµ¶ºTN® w®l®î®¢NµS®¡®
N®±‹q®± ®v ¯l®±î®¼u®‹ºu® x°mu®
¯Ÿr‡®±± Aw¯ï±N®î¯TŠ®±q®Ùuµ. D
Au®㇮±w®u®ªå 17 y®ärý®q® ïq® y®¼Š®±Ç®Š®±
î®±q®±Ù 9 y®ärý®q® Aïq® y®¼Š®±Ç®Š®± q¯î®¼
K⇮¾¯u®Š®² Œµ¶ºTN® rÙxŠ®q®Š¯u®î®Š®ªå
œµ²°Tu®ÛŠ®± Hºu®± ®v¯mu¯ÛŠµ. ïq®
y®¼Š®±Ç®Š®± š®Š¯š®‹ œµX®±Ï
®±›éw®î®Š¯Tu®±Ûu®‹ºu® A®ªå D
w®l®î®¢Nµ‡®±± œµYÏw® y®ä¯ou®ªå
®v‡®¾¯Tuµ.
16

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THE DYNAMICS O. SEX WORK
Œµ¶ºTN® rه®± Š®²y®Šµ°ýµS®¡®±
The amount of reported risky
behaviour in Bagalkot district—
along with incomplete knowledge of
HIV and its causes—makes it
unsurprising that HIV prevalence in
Bagalkot was found to be high. HIV
prevalence in rural areas of the
district is about 50 percent higher
than in urban areas. These
disparities are undoubtedly similar
to those in many other rural districts
in the state. Prevalence among
males is about 35 percent higher
than among females.
Percent of Survey Respondents Infected with HIV
Bagalkot Project Area, Karnataka, 2003
š®ï±°£µ‡®±ªå „¯S®î®Ÿ›u®î®Š®ªå HX¬.J.ï. šµ²°ºOw® ýµ°N®l®y®ä¯o,
„¯S®©Nµ²°gµ ‡µ²°cw¯ £µ°q®ä, N®w¯ÁhN®, 2003
3.6
3.3
2.9
2.5
2.4
Total
Kh±Ô
ICHAP
Male
y®¼Š®±Ç®Š®±
Female
›ô°‡®±Š®±
Urban
residents
Rural
residents
w®S®Š® y®äuµ°ý®u®ªå S¯äï±°o y®äuµ°ý®u®ªå
š®±î®Š®±
š®±î®î®Š®±
œµYÏw® y®ä¯ou®ªå ®v‡®¾¯u® Aš®±Š®£q®
Œµ¶ºTN® š®º…ºu®S®¡®± î®±q®±Ù HX¬.J.ï. î®±q®±Ù
Au®± œ®Š®l®±î®¼u®Š® N®±‹q®± š®ºy®½oÁî¯u®
r¡®±î®¢Nµ C©åvŠ®±î® „¯S®©Nµ²°gµ dŒµå‡®±ªå
HX¬.J.ï. šµ²°ºOw® y®ä¯o œµX¯ÏTuµ
Hw®±Ýu®± Bý®Ï‡®±ÁN®Š®î¯u®uµÛ°w®©å. dŒµå‡®±
S¯äï±°o y®äuµ°ý®S®¡®ªå HX¬.J.ï. šµ²°ºOw®
y®ä¯o w®S®Š®y®äuµ°ý®S®¢Sµ œµ²°ª›u®Šµ
š®±î®¾¯Š®± 50 y®ärý®q® œµX®±Ï Cuµ. y®¼Š®±Ç®Š®ªå
HX¬.J.ï. šµ²°ºOw® y®ä¯o
î®±Ÿ¡µ‡®±Š®ªåTºs® š®±î®¾¯Š®± 35 y®ärý®q®
œµX®±Ï Cuµ. Š¯cãu® E¢u® S¯äï±°o
dŒµåS®¡®ªå‡®±² Cuµ° ›Úr‰±uµ Hw®±Ýu®Š®ªå
š®ºý®‡®±ï©å.
Overall, 56 percent of the
respondents in Bagalkot had
neither heard of nor seen a
condom. .ourteen percent had
heard of condoms but had not seen
one, while the remaining 30 percent
had seen a condom. Male
respondents were more likely to
have seen one. The proportions of
respondents who had never seen
nor heard of condoms were higher
in rural areas, especially among
females.
Knowledge of the Condom Reported by Survey Respondents
Bagalkot Project Area, Karnataka, 2003
š®ï±°£µ‡®±ªå „¯S®î®Ÿ›u®î®Š®± ®v¯mu® N¯ºlµ²°º N®±‹q¯u® r¡®±î®¢Nµ,
„¯S®©Nµ²°gµ ‡µ²°cw¯ £µ°q®ä, N®w¯ÁhN®, 2003
Percent
y®ärý®q®
56
14
30
Total
Kh±Ô
27
50
14
69
83
13
59
16
37
15
11
6
Urban male Urban female Rural male Rural female
w®S®Š®u®ªåw® y®¼Š®±Ç®Š®± w®S®Š®u®ªåw® ›ô°‡®±Š®± S¯äï±°o y®¼Š®±Ç®Š®± S¯äï±°o ›ô°‡®±Š®±
š®ï±°£µ‡®±ªå „¯S®î®Ÿ›u®î®Š®ªå Kg¯ÔŠµ 56
y®ärý®q® cw®Š®± N¯ºlµ²°ï±w® N®±‹q®± Nµ°¢©å
As®î¯ N¯ºlµ²°î®±w®±Ý wµ²°m©å, 14 y®ärý®q®
cw®Š®± N¯ºlµ²°ï±w® N®±‹q®± Nµ°¢u¯ÛŠµ Bu®Šµ
wµ²°m©å, î®±q®±Ù E¢u® 30 y®ärý®q® cw®Š®±
N¯ºlµ²°î®±w®±Ý wµ²°mu¯ÛŠµ. ›ô°‡®±‹Sµ
œµ²°ª›u®Šµ œµYÏw® y®ä¯ou® y®¼Š®±Ç®Š®±
N¯ºlµ²°î®±w®±Ý wµ²°mŠ®±î® š®º„®î®ïuµ.
N¯ºlµ²°ï±w® N®±‹q®± Nµ°¡®uµ° CŠ®±î® As®î¯
N¯ºlµ²°î®±w®±Ý wµ²°l®uµ° CŠ®±î®î®Š®
y®ä¯o S¯äï±°o y®äuµ°ý®u®ªå, Au®Š®©²å
î®±Ÿ¡µ‡®±Š®ªå œµX®±Ï.
Neither heard nor seen
Nµ°¢©å As®î¯ wµ²°m©å
ICHAP
Heard of/Not seen
Nµ°¢u¯ÛŠµ Bu®Šµ wµ²°m©å
Have seen a condom
N¯ºlµ²°ºw®±Ý wµ²°mu¯ÛŠµ
17

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THE DYNAMICS O. SEX WORK
Œµ¶ºTN® rه®± Š®²y®Šµ°ýµS®¡®±
The use of condoms during risky
sexual behaviour provides essential
protection for both partners against HIV
infection. But only consistent and
correct use gives complete protection.
According to the 2001 Behavioural
Surveillance Survey (BSS) conducted
by NACO, regular condom use in
Karnataka is well below what is
needed, leaving large segments of the
state’s population vulnerable.
According to the BSS, about 8 percent
of Karnataka males reported that they
had had sex with a non-regular partner
in the previous year.
Percent Condom Use by Female Sex Workers, Karnataka, 2001
Œµ¶ºTN® rÙ xŠ®q® î®±Ÿ¡µ‡®±Š®ªå N¯ºlµ²°º …¡®Nµ, N®w¯ÁhN®, 2001
(y®ärý®q®)
Last sex act:
Nµ²wµ‡®± Œµ¶ºTN® O䇵±
With paying clients
73.4
œ®o Nµ²l®±î® TŠ¯OS®¡µ²ºvSµ
With non-paying partners
58.6
œ®o Nµ²l®uµ° CŠ®±î® š®ºS¯rS®¡µ²ºvSµ
Consistently in last 30 days:
N®¡µu® 30 vw®S®¡®ªå y®ärš¯‹‡®±²
With paying clients
œ®o Nµ²l®±î® TŠ¯OS®¡µ²ºvSµ
With non-paying partners
œ®o Nµ²l®uµ° CŠ®±î® š®ºS¯rS®¡µ²ºvSµ
55.7
33.7
NACO, 2001 BSS
Œµ¶ºTN® O䇵±‡®±ªå N¯ºlµ²°ï±w® …¡®Nµ‡®±±
C…àŠ®± š®ºS¯rS®¢S®² HX¬.J,ï, šµ²°ºOw®
±u®Ü Š®£®nµ‡®±w®±Ý x°l®±q®Ùuµ. Bu®Šµ, y®är
Œµ¶ºTN® O䇵±‡®±ªå š®‹‡®¾¯T N¯ºlµ²°î®±w®±Ý
…¡®š®±î®¼u®‹ºu® ¯q®ä š®ºy®½oÁ Š®£®nµ‡®±±
uµ²Šµ‡®±±q®Ùuµ. 2001Š®ªå Š¯™ó°‡®± Il¬é
x‡®±ºq®äo š®ºšµÚ‡®± î®r‰±ºu® w®lµš®©ÞhÔ
w®l®î®¢NµS®¡® š®ï±°£µ‡®± y®äN¯Š® N®w¯ÁhN®u®ªå
y®är„¯‹ N¯ºlµ²°î®±w®±Ý …¡®š®±î®î®Š®
y®ä¯o N®mîµ±. Cu®‹ºu¯T Š¯cãu® œµYÏw®
cw®Š®± Œµ¶ºTN® šµ²°ºN®±S®¢Sµ q®±q¯ÙS®±î®
š®º„®î®ïuµ. Cuµ° š®ï±°£µ‡®± y®äN¯Š®
N®w¯ÁhN®u® š®±î®¾¯Š®± 8 y®ärý®q® y®¼Š®±Ç®Š®±
N®¡µu® Kºu®± î®Ç®Áu®ªå A® P¯‡®±º
š®ºS¯rS®¡®©åu® „µ°Šµ‡®±î®Šµ²ºvSµ Œµ¶ºTN®
š®º…ºu®î®w®±Ý œµ²ºvu®ÛŠ®± Hºu®± ®v
¯mu¯ÛŠµ.
Over one-half of sex worker clients
interviewed in the BSS were married
and living with a spouse. These clients
act as a “bridge,” bringing HIV infection
to their wife or other partner. Wives
who become infected can then pass
HIV to their unborn child during
pregnancy, delivery, or breastfeeding.
This risk can be reduced by
treatment—but only if these mothers
recognize their HIV-positive status.
Marital and Partner Status of Clients of Female Sex Workers
Karnataka, 2001
Œµ¶ºTN® rÙxŠ®q® î®±Ÿ¡µ‡®±Š® TŠ¯OS®¡® N® î®±q®±Ù š®ºS¯rS®¡® ›Úr
N®w¯ÁhN®, 2001
54.6
35.3
5.6
2.2
Married, lives
with spouse
ïq®Š®±, y®r݇µ²ºvSµ
š®±rÙu¯ÛŠµ
NACO, 2001 BSS
Married, lives
with other
partner
ïq®Š®±, „µ°Šµ
š®ºS¯r‡µ²ºvSµ
š®±rÙu¯ÛŠµ
Not married,
lives with
a partner
Aïq®Š®±,
š®ºS¯r‡µ²…àŠµ²ºvSµ
š®±rÙu¯ÛŠµ
Not married,
does not live
with any partner
Aïq®Š®±, ‡®¾¯î®
š®ºS¯r‡µ²ºvS®²
š®±rÙ©å
Œµ¶ºTN® rÙxŠ®q®Š® TŠ¯OS®¡®ªå Au®ÁOʺq®©²
œµX®±Ï î®±ºv ïq®Š¯Tu®±Û q®î®±â
y®r݇®±Šµ²ºvSµ „¯¡µæ ¯l®±rÙu¯ÛŠµ. D
TŠ¯OS®¡®± HX¬.J.ï. šµ²°ºN®w®±Ý q®î®±â
y®r݇®±‹Sµ As®î® Cq®Š® Œµ¶ºTN® š®ºS¯rS®¢Sµ
œ®Š®l®…©å “šµ°q®±îµ” S®¡®± Hºu®Šµ
q®y¯ÞS®Œ¯Š®u®±. D ‹°r šµ²°ºOSµ²¡®S¯u®
y®r݇®±Š®± œ®±h±Ôu®Šµ²¡®Sµ° q®î®±â î®±S®±ïSµ
S®„¯ÁµÚ‡®±ªå‡µ±° As®î¯ y®äš®î® N¯©u®ªå
As®î¯ Huµœ¯©± N®±mš®±î®¼u®Š® î®±²©N®
HX¬.J.ï. šµ²°ºN®w®±Ý x°l®…œ®±u®±. „¯ï°
q¯‡®±ºvŠ®± q®î®±âªå HX¬.J.ï. šµ²°ºN®w®±Ý
îµ²u®Œµ° S®±Š®±r›Nµ²ºl®Šµ, D šµ²°ºN®±
q¯‰±‰±ºu® î®±S®±ïSµ œ®Š®l®±î® š®º„®î®î®w®±Ý
‡µ²°S®ã YOqµé‡®± î®±²©N® N®mîµ±
¯mNµ²¡®ë…œ®±u®±.
18

3 Pages 21-30

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3.1 Page 21

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The Response
y®ärO䇵±
19

3.2 Page 22

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REACHING SEXUAL NETWORKS
Œµ¶ºTN® b¯©S®¡®w®±Ý q®©±y®¼î®¼u®±
Under the National AIDS Control Programme II (NACP-II), a key aspect of the HIV prevention strategy has been its evidence-based
design. The programme prioritizes higher-risk HIV areas, adapting specific prevention activities appropriate to local patterns of sex work.
The number of Targetted Intervention (TI) programmes implemented by NGOs was increased from 12 in 2000 to 30 in 2004. The TIs are
designed to encourage safe sex behaviour among groups that are at greater risk of HIV such as migrant workers, truck drivers, and sex
workers.
The TIs have now moved into a more far-reaching geographic strategy. The programme has expanded from interventions that target
specific groups to one which reaches all strata of society. Intensive efforts are concentrated in high-risk areas, or “hotspots.” Programme
features include intensive peer-based outreach, quality STD and health services, availability of condoms, and the creation of an enabling
environment. Community mobilization and participation for planning and implementation will be a crucial element.
A Geographic Approach - Working with Sexual Networks,
Not Just Sex Workers
„¹Sµ²°¢N® î®±q®±Ù Nµ°ºvä°N®³q® N¯‡®±ÁN®äî®±: Nµ°î®© Œµ¶ºTN® rÙy®Š®Š®©åuµ° š®ºy®½oÁ Œµ¶ºTN®
b¯©S®¡µ²ºvSµ N¯‡®±ÁN®äî®±î®w®±Ý w®lµš®±î®¼u®±.
Š¯™ó°‡®± Il¬é x‡®±ºq®äo ‡µ²°cwµ‡®± HŠ®l®wµ° œ®ºq®u®ªå N®w¯ÁhN® Š¯cãu® HX¬.J.ï. q®lµS®h±Ôî® ‡µ²°cwµ‡®± ïýµ°Ç®qµ‡µ±ºu®Šµ - š¯£¯Èãu¯Š®ïŠ®±î® N¯‡®±Á‡µ²°cwµ‡®±w®±Ý œ¯ONµ²ºmu®±Ûu®±.
N¯‡®±ÁN®ä HX¬.J.ï. œ®Š®l®±î® š®º„®î®î®¼ œµX¯ÏTŠ®±î® y®äuµ°ý®S®¢Sµ Bu®ãqµ x°l®±q®Ùuµ î®±q®±Ù Œµ¶ºTN® rه®±ªåŠ®±î® š¯Úx°‡®± ïu®ãqµSµ q®N®Êºqµ HX¬.J.ï. q®lµS®h±Ôî® X®h±î®iNµS®¡®w®±Ý
A¡®î®m›Nµ²¡®±ëq®Ùuµ. Š¯cãu®ªå š®Š®N¯Šµ°q®Š® š®ºšµÚS®¡® î®±²©N® w®lµš®±rي®±î® EuµÛ°þq® î®±u®ãºq®Š®u® N¯‡®±ÁN®äî®±S®¡® š®ºPµã î®Ç®Á 2000 Š®ªåu®Û 12 ‹ºu® 2004Š®ªå Kh±Ô 30NµÊ œµYϚ®Œ¯Tuµ.
œ®©î¯Š®± š¯î®¾¯dN®-BtÁN® œ¯S®² rÙ y®Š® N¯Š®oS®¢ºu¯T By®rÙSµ K¡®S¯S®…œ®±u¯u®ºq®œ® cw® š®î®±±u¯‡®±S®¢Sµ (Eu¯œ®Š®nµSµ, šµ N¯ï±ÁN®Š®±, häN¬ X¯©N®Š®±, As®î¯ Œµ¶ºTN®
rÙy®Š®Š®±) š®±Š®£q® w®l®î®¢NµS®¡® î®±²©N® HX¬.J.ï. šµ²°ºOSµ q®±q¯ÙS®±î® š®º„®î®î®w®±Ý N®mîµ±Sµ²¢š®±î®¼uµ° D N¯‡®±ÁN®äî®±S®¡® î®±±Qã EuµÛ°ý®î¯Tuµ.
y®äš®±Ùq® Š¯cãu®ªå EuµÛ°þq® î®±u®ãºq®Š® N¯‡®±ÁN®äî®±S®¡®± „¹Sµ²°¢N® î®±q®±Ù Nµ°ºvä°N®³q® N¯‡®±ÁN®äî®±S®¡¯T Š®²y®¼Sµ²¡®±ërÙîµ. D ‹°r xvÁÇ®Õ S®±ºy®¼S®¡®w®±Ý EuµÛ°þ›u®Û î®±u®ãºq®Š®
N¯‡®±ÁN®äî®±S®¡®w®±Ý Kºu®± „¹Sµ²°¢N® y®‹vÇ®±ªåŠ®±î® š®î®¾¯cu® H©å S®±ºy®¼S®¢S®² ًš®Œ¯S®±rÙuµ. HX¬.J.ï. œ®Š®l®±î® œµYÏw® š®º„®î®ïŠ®±î® y®äuµ°ý®S®¡®ªå (“œ¯g¬š¯Þg¬” S®¡®ªå) šµ²°ºOw®
By®rÙSµ²¡®S¯S®…œ®±u¯u®, Œµ¶ºTN® š®º…ºu®S®¡®ªå „¯S®î®Ÿš®±î® H©å S®±ºy®¼S®¢S®² Nµºvä°N®³q® šµ°îµS®¡®w®±Ý š®ªåš®Œ¯S®±q®Ùuµ. Cºs®œ® N¯‡®±ÁN®äî®±u®ªå K¡®Sµ²¡®±ëî® Aºý®S®¡®±: œµX®±Ï
y®‹n¯î®±N¯‹Sµ²¢š®©ÞhÔ š®œ®î®rÁS®¡® î®±²©N® q®©±y®¼î®¼u®±, S®±oî®±hÔu® Œµ¶ºTN® Šµ²°S®S®¢Sµ YOqµé î®±q®±Ù Cq®Š® BŠµ²°S®ã šµ°îµS®¡®±, N¯ºlµ²°î®±±S®¡®± š®±©„®î¯T uµ²Šµ‡®±±î®ºqµ ¯l®±î®¼u®±,
î®±q®±Ù N¯‡®±ÁN®äî®±u® Aw®±Ç¯Õw®NµÊ š®²N®Ùî¯u® î¯q¯î®Š®oî®w®±Ý xï±Áš®±î®¼u®±. š®î®±±u¯‡®± š®ºU®hwµ‡®± î®±²©N® ‡µ²°cwµ‡®± Š®X®wµ î®±q®±Ù b¯‹Sµ²¢š®±î®ªå š®î®±±u¯‡®±u® „¯Tq®æî®w®±Ý œµYϚ®±î®¼u®±
D N¯‡®±ÁN®äî®±u® î®±±Qã Aºý®î¯Tuµ.
20

3.3 Page 23

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.OCUSSED PREVENTION
Nµ°ºvä°N®³q® N¯‡®±ÁN®äî®±S®¡®±
KSAPS implements focussed
preventions in 9 districts with
NACO as the main source of
funding.
The CIDA-funded ICHAP has
demonstration projects in two
districts, Bagalkot and Dharwad.
In Bagalkot, a rural intervention
project covers all 620 villages in six
talukas and a sex work project
covers 2,700 sex workers. The
Dharwad project is an urban
prevention and care programme.
NGOs and a sex workers collective
partner in these projects.
The Karnataka Health Promotion
Trust (KHPT) implements focussed
prevention projects in 16 districts
using the geographic approach.
KHPT is funded by the Bill &
Melinda Gates .oundation and is a
partnership between the Karnataka
Government and the University of
Manitoba in Canada. The KHPT
project—Sankalp—is implemented
by NGO partners, each in one or
more districts. ICHAP provides
technical and management support
and supervisions to NGOs
supported by NACO/KSAPS. This
system, implemented by Swasti,
supports KSAPS to monitor
interventions programmes
effectively.
Focussed Prevention Programmes in Karnataka, 2004
N®w¯ÁhN®u®ªå Nµ°ºvä°N®³q® HX¬.J.ï. q®lµS®h±Ôî® N¯‡®±ÁN®äî®±S®¡®±, 2004
N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i‡®±±
œ®©î¯Š®± š®Š®N¯Šµ°q®Š® š®ºšµÚS®¡® š®œ®‡µ²°S®uµ²ºvSµ 9
dŒµåS®¡®ªå Nµ°ºvä°N®³q® q®lµS®h±Ôî® N¯‡®±ÁN®äî®±î®w®±Ý
b¯‹Sµ²¢š®±rÙuµ. D dŒµåS®¡® N¯‡®±ÁN®äî®±S®¢Sµ
u®w®š®œ¯‡®±î®¼ w¯ãNµ²°vºu® uµ²Šµ‡®±±rÙuµ.
†°u®Š®
Bidar
S®±©àS®Á
†b¯y®¼Š®
Bijapur
Gulbarga
„¯S®©Nµ²°gµ
„µ¡®S¯º Bagalkot
Š¯‡®±X®²Š®±
Raichur
Belgaum
u¯Š®î¯l®
Dharwad S®u®S®
Gadag
Nµ²y®Þ¡®
Koppal
…¡¯ë‹
Eq®ÙŠ® N®w®Ýl®
Uttar
Kannada
œ¯îµ°‹
Bellary
Haveri u¯î®oSµŠµ
þî®îµ²S®Ì
Davanagere
q®±î®±N®²Š®±
Yq®äu®±S®Á Tumkur
Chittradurga
Shimoga
YN®Êî®±S®¡®²Š®±
El®±z Chikmagalur
Udupi
q®±î®±N®²Š®±
Tumkur
Nµ²°Œ¯Š®
Kolar
u®£o N®w®Ýl®
Dakshina
Kannada
œ¯š®w®
Hassan
î®±ºl®ã
Mandya
„µºS®¡®²Š®± w®S®Š®
Bangalore Urban
„µºS®¡®²Š®± S¯ä¯ºq®Š®
Bangalore Rural
Nµ²l®S®±
Kodagu
îµ±¶š®²Š®±
Mysore
X¯î®±Š¯cw®S®Š®
Chamarajanagar
KHPT/BMG.
Nµ.HX¬.z.i./†.Hº.d.Hy¬.
KSAPS/NACO
Nµ.Hš¬.A.z.Hš¬./Hw¬.H.›.K.
ICHAP/CIDA
J.›.HX¬.A.z./›.J.m.H.
Map not to scale
›°l¯u® u®w®š®œ¯‡®±vºu® JX¯y¬ „¯S®©Nµ²°gµ î®±q®±Ù
u¯Š®î¯l® dŒµåS®¡®ªå y¯äq®ã£N® ‡µ²°cwµS®¡®w®±Ý
w®lµš®±rÙuµ. „¯S®©Nµ²°gµ y¯äq®ã£N® ‡µ²°cwµ‡®±±
dŒµå‡®± 6 q¯©²åN®±S®¡®ªåŠ®±î® H©å 620 œ®¢ëS®¡®ªå
b¯‹Sµ²¢š®Œ¯u® š®î®±S®ä S¯äï±°o ‡µ²°cwµ î®±q®±Ù
š®±î®¾¯Š®± 2700 Œµ¶ºTN® rÙxŠ®q® î®±Ÿ¡µ‡®±Š®w®±Ý
q®©±y®¼î® Œµ¶ºTN® rÙy®Š® ‡µ²°cwµ‡®±w®±Ý
K¡®Sµ²ºmuµ. u¯Š®î¯l®u®ªåŠ®±î® ‡µ²°cwµ‡®±±
HX¬.J.ï./Il¬é q®lµS®h±ÔïNµ î®±q®±Ù AŠµ¶NµS®¡®
Aºý®S®¡®w®±Ý Kºu¯T›Nµ²ºl® š®î®±S®ä w®S®Š® ‡µ²°cwµ.
JX¯y¬w® D ‡µ²°cwµS®¡®w®±Ý N¯‡®±Áq®Š®Sµ²¢š®±î®ªå
š®Š®N¯Šµ°q®Š® š®ºšµÚS®¡®± î®±q®±Ù Kºu®± Œµ¶ºTN® rÙxŠ®q®
î®±Ÿ¡µ‡®±Š® š®ºU®hwµ‡®±² y¯Œµ²Ìºmîµ.
N®w¯ÁhN® š®N¯ÁŠ® î®±q®±Ù Nµw®l¯u® ¯xgµ²°„¯
ïý®æïu¯ã©‡®±S®¡® š®œ®„¯Tq®æu® N®w¯ÁhN® BŠµ²°S®ã
š®ºî®u®Áw® (N®w¯ÁhN® œµŒ¬Ù y®äîµ²°ý®w¬ häš¬Ô -–
Nµ.HX¬.z.i.)  †.Hº.d.Hy¬.w® u®w®š®œ¯‡®±vºu®
16 dŒµåS®¡®ªå „¹Sµ²°¢N® Nµ°ºvä°N®³q®
N¯‡®±ÁN®äî®±î®w®±Ý w®lµš®±rÙuµ. Nµ.HX¬.z.i.‡®± D
‡µ²°cwµ - š®ºN®©Þ - î®w®±Ý š®Š®N¯Šµ°q®Š® š®ºšµÚS®¡®± -
y®är‡µ²ºu®² Kºu®± As®î¯ œµYÏw® dŒµåS®¡®ªå -
b¯‹Sµ²¢š®±rÙîµ. JX¯zw® š®œ¯‡®±vºu® w¯ãNµ²°/
Nµ°š¯ãy¬éS®¡® „µº…© y®lµvŠ®±î® š®Š®N¯Šµ°q®Š® š®ºšµÚS®¢Sµ
q¯ºräN® î®±q®±Ù îµ±°ªæX¯Š®n¯ „µº…©î®w®±Ý x°l®±î®
„µº…© î®±q®±Ù îµ±°ªæX¯Š®n¯ î®ãµÚ‡®±w®±Ý
Š®Yš®Œ¯Tuµ. D î®ãµÚ‡®±w®±Ý b¯‹Sµ²¢š®±rي®±î® š®æ›Ù
‡®±± Nµ°š¯ãy¬é w®lµš®±rي®±î® ‡µ²°cwµS®¢Sµ „µº…©
x°l®±q®Ùuµ î®±q®±Ù ‡µ²°cwµ‡®± N¯‡®±ÁS®r‡®±w®±Ý
ï°£š®±î®ªå š®œ¯‡®± ¯l®±rÙuµ.
21

3.4 Page 24

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STI STRATEGY
Œµ¶ºTN® Šµ²°S®S®¡® N®±‹q¯u® N¯‡®±ÁN®äî®±S®¡®±
The main objectives of the sexually
transmitted infection (STI) strategies are
to (1) increase accessibility to quality care,
(2) improve the health care behaviour of
SWs and their clients, and (3) increase
condom availability and use. .orty STI
clinics have been modernized as a part of
the National Programme II.
Through a joint initiative of KSAPS and
ICHAP, statewide training of STI care
providers has begun involving nine
Regional Resource Training Centres and
St. John’s Medical College as Training of
Trainers Centre. .ocussed prevention
programmes in all districts will establish
clinics for SWs and their regular partners.
STI franchised clinics, primarily for male
patients, will be established statewide by
Population Services International (PSI)
with funding from BMG..
The free condom distribution programme
is also now underway in Karnataka,
conducted by the Reproductive and Child
Health Project and by NGO focussed
prevention programmes. In addition,
social marketing of condoms has begun.
Condoms will be made available in non-
traditional outlets, particularly in rural
areas where there has always been a
critical shortage. In four districts, a pilot
condom social marketing programme
through fair-price shops has been
initiated. Condom vending machines are
being installed in Bangalore as a pilot
programme.
Regional Resource Training Centres, Karnataka, 2004
y¯äuµ°þN® š®ºy®w®²â© q®Š®„µ°r Nµ°ºu®äS®¡®±, N®w¯ÁhN®, 2004
Š¯cãu® Œµ¶ºTN® Šµ²°S®S®¢Sµ š®º…ºvÛu® N¯‡®±Á-
‡µ²°cwµ‡®± EuµÛ°ý®S®¡®± î®±²Š®±: (1) S®±oî®±hÔu®
YOqµéS®¡®± š®±©„®î¯T uµ²Šµ‡®±±î®ºqµ ¯l®±î®¼u®± (2)
†°u®Š®
Bidar
Œµ¶ºTN® rÙy®Š®Š® î®±q®±Ù A® TŠ¯OS®¡®ªå BŠµ²°S®ã
šµ°îµS®¡®w®±Ý y®lµ‡®±±î®ºqµ ¯l®±î®¼u®±, î®±q®±Ù (3)
N¯ºlµ²°ï±w® uµ²Šµ‡®±±ïNµ î®±q®±Ù …¡®Nµ‡®±w®±Ý
œµYϚ®±î®¼u®±. Hw¬.H.›.z. ‡®± HŠ®l®wµ° œ®ºq®u®ªå
S®±©àS®Á
Š¯cãu® 40 Œµ¶ºTN® Šµ²°S® YOq¯é Nµ°ºu®äS®¡®w®±Ý
†b¯y®¼Š® Gulbarga
Bu®±x°N®‹š®Œ¯Tuµ.
Bijapur
JX¯zw® š®œ®‡µ²°S®vºu®. šµ°ºg¬ b¯w® u®ãO°‡®±
„¯S®©Nµ²°gµ
„µ¡®S¯º Bagalkot
Š¯‡®±X®²Š®±
Raichur
î®±œ¯ïu¯ã©‡®±u® wµ°q®³q®æu®ªå y¯äuµ°þN® q®Š®„µ°r
š®ºy®w®²â© Nµ°ºu®äS®¡® î®±²©N® Š¯b¯ãu®ãºq® Œµ¶ºTN®
Belgaum
u¯Š®î¯l®
Dharwad S®u®S®
Gadag
Nµ²y®Þ¡®
Koppal
…¡¯ë‹
Eq®ÙŠ® N®w®Ýl®
Uttar
Kannada
Bellary
œ¯îµ°‹
Haveri u¯î®oSµŠµ
þî®îµ²S®Ì
Davanagere
Yq®äu®±S®Á
q®±î®±N®²Š®±
Tumkur
Chittradurga
Shimoga
YN®Êî®±S®¡®²Š®±
El®±z Chikmagalur
Udupi
q®±î®±N®²Š®±
Tumkur
Nµ²°Œ¯Š®
Kolar
u®DK£oaaknN®wsn®hÝal®idnNaaµK²old®SH®a±agœsu¯sša®wn®Mîµ±y¶šMs®²îoa®Šr±®ºne±ld®ãyaChXa¯m„îBµ®±ºaBa„ŠS¯µr®naºa¡c®gSn²j®aw¡ag®Š®nS²®la®±oŠaŠl®Sr®og¯±eraäweî®RrS®®¾¯UuŠ®ºrraqb®Šla® n
Šµ²°S®S®¢Sµ YOqµé‡®±w®±Ý x°l®±î® u®ãŠ® q®Š®„µ°r
N¯‡®±ÁN®ä y¯äŠ®º„®î¯Tuµ. Š¯cãu®ªåw® y®äî®±±Q
9 u®ãO°‡®± N¯Œµ°c±S®¡®w®±Ý y¯äuµ°þN® q®Š®„µ°r
š®ºy®w®²â© Nµ°ºu®äS®¡®w¯ÝT S®±Š®±r›, AS®¡® î®±²©N®
u®ãŠ® q®Š®„µ°r‡®±w®±Ý x°l®Œ¯S®±rÙuµ. Nµ°ºvä°N®³q®
N¯‡®±ÁN®äî®±S®¡®± y®är dŒµå‡®±ªå‡®±² Œµ¶ºTN® rÙ
y®Š®Š®± î®±q®±Ù A® P¯‡®±º TŠ¯OS®¢Sµ
BŠµ²°S®ãNµ°ºu®äS®¡®w®±Ý š¯Úzš®Œ¯S®±rÙuµ.
†.Hº.d.Hy¬.w® u®w®š®œ¯‡®±vºu® y¯y®¼È㌵°ý®w¬
š®ïÁš®š¬ Cºhw¯ãÁý®w®Œ¬ (z.Hš¬.J.) Š¯b¯ãu®ãºq®
y®¼Š®±Ç®‹S¯T ïþÇ®Õî¯u® Œµ¶ºTN® Šµ²°S® YOq¯é
Nµ°ºu®äS®¡®w®±Ý š¯Úzš®±rÙuµ.
Š¯c㠚®ºq¯wµ²°q®ÞrÙ î®±q®±Ù î®±N®Ê¡® BŠµ²°S®ã ‡µ²°cwµ
œ¯S®² š®Š®N¯Šµ°q®Š® š®ºšµÚS®¡®± N¯‡®±ÁS®q®Sµ²¢š®±rي®±î®
Nµºvä°N®³q® ‡µ²°cwµS®¡® î®±²©N® N¯ºlµ²°ºS®¡® EYq®
Map not to scale
ïq®Š®n¯ N¯‡®±ÁN®ä î®±±ºu®±î®Šµ‡®±±rÙuµ. Cu®Š®
bµ²qµSµ N¯ºlµ²°ºS®¡® š¯î®¾¯dN® ¯Š¯h
M.R. Medical College, Gulbarga
Hº.BŠ¬. u®ãO°‡®± î®±œ¯ïu¯ã©‡®±, S®±©àS®Á
J.J.M. Medical College, Davanagere
bµ.bµ.Hº. u®ãO°‡®± î®±œ¯ïu¯ã©‡®±, u¯î®oSµŠµ
y¯äŠ®º„®î¯Tuµ. ‡®¾¯î®q®²Ù N¯ºlµ²°ºS®¡®
J.N. Medical College, Belgaum
bµ.Hw¬. u®ãO°‡®± î®±œ¯ïu¯ã©‡®±, „µ¡®S¯º
Kasturba Medical College, Manipal
N®š®²Ù„¯Á u®ãO°‡®± î®±œ¯ïu¯ã©‡®±, î®±py¯©
Nµ²Š®qµ‰±Š®±î® S¯äï±°o y®äuµ°ý®S®¡®ªå
š¯ºy®äu¯‰±N®î®©åu® ïq®Š®n¯ î®±²©S®¡®ªå
Vijayanagara Institute of Medical Sciences
Kempe Gowda Institute of Medical
Sciences, Bangalore
N¯ºlµ²°ºS®¡®± uµ²Šµ‡®±±î®ºqµ ¯l®Œ¯S®±rÙuµ. w¯©±Ê
(VIMS), Bellary
ï.J.Hº.Hš¬., …¡¯ë‹
Karnataka Institute of Medical Sciences,
Hubli
N®w¯ÁhN® CxéÉÔh²ãg¬ By¬ îµ±mN®Œ¬ šµ¶w®éw¬, œ®±…à¢ë
Nµºyµ°S¹l® CxéÉÔh²ãg¬ By¬ îµ±mN®Œ¬ šµ¶w®éš¬, „µºS®¡®²Š®± dŒµåS®¡®ªå y®mq®Š® AºS®mS®¡® î®±²©N® N¯ºlµ²°ºS®¡®
Governernment Medical College, Mysore
š®N¯Á‹° u®ãO°‡®± î®±œ¯ïu¯ã©‡®±, îµ±¶š®²Š®±
Bangalore Medical College, Bangalore
„µºS®¡®²Š®± îµ±mN®Œ¬ N¯Œµ°c±, „µºS®¡®²Š®±
š¯î®¾¯dN® ¯Š¯h N¯‡®±ÁN®ä y¯äŠ®º„®î¯Tuµ.
y®ä‡µ²°S¯q®âN®î¯T „µºS®¡®²Š®± w®S®Š®u®ªå N¯ºlµ²°º
¯Š¯h ‡®±ºq®äS®¡®w®±Ý š¯Úzš®Œ¯Tuµ.
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TESTING .OR HIV IN.ECTION
HX¬.J.ï. y®‹°£µ
Given the importance of voluntary and
confidential testing for HIV, there are now
78 testing centres at the taluka level,
supported by NACO, the State
Government, and ICHAP. Two
counselors—one male and one female—
are normally posted at each centre for
testing and confidential counselling. The
fee for a visit is Rs.10, which is waived for
poor patients.
Prevention of Parent-to-Child
Transmission (PPTCT) Centres
Testing pregnant women who might be at
risk of HIV is a critical component of the
anti-HIV programme. Upon their consent,
women are tested for infection; a
nevirapine tablet is given to the HIV-
positive mothers during labour and
delivery and to their child soon after birth.
The number of PPTCT centres has been
increased to 85 in 2004, up from 40 in
2002-2003. As with VCTCs, the state
trains counsellors, grampanchayat
members, and health workers for PPTCT
centres in order to bring HIV awareness to
the widest possible audience.
The counsellors in VCTC and PPTCT
Centres receive technical support from a
team of experts under the guidance of the
National Institute of Mental Health and
Neuro Sciences (NIMHANS), KSAPS, and
ICHAP.
Voluntary Confidential Counselling and Testing Centres
Karnataka, 2004
(Total of 78)
š®æ‡®±º z䰋q® By®Ù š®î®¾¯Œµ²°X®wµ î®±q®±Ù y®‹°£¯Nµ°ºu®äS®¡®±, N®w¯ÁhN®, 2004
(Kh±Ô 78)
†°u®Š®
Bidar
S®±©àS®Á
š®æ‡®±º yµä°‹q® î®±q®±Ù S¹y®ã y®‹°£µ‡®± y¯äî®±±Qãqµ‡®±w®±Ý
S®î®±x› Š¯cãu® dŒ¯å î®±q®±Ù q¯©²N®±S®¡®ªå y®äš®±Ùq®
Kh±Ô 78 š®æ‡®±º yµä°‹q® By®Ù š®î®¾¯Œµ²°X®wµ î®±q®±Ù
y®‹°£¯Nµ°ºu®ä (ï.›.i.›.) S®¡®± w¯ãNµ²°, Š¯c㠚®Š®N¯Š®
î®±q®±Ù JX¯zw® š®œ®‡µ²°S®vºu® š¯Úzq®Sµ²ºmîµ.
y®är‡µ²ºu®± ï.›.i.›.‡®±ªå‡®±² C…àŠ®± -K…à y®¼Š®±Ç®
î®±q®±Ù K…à î®±Ÿ¡µ - By®Ù š®î®¾¯Œµ²°X®N®Š®± Cu®±Û A®±
S¹y®ã š®î®¾¯Œµ²°X®wµ î®±q®±Ù y®‹°£¯ šµ°îµS®¡®w®±Ý
x°l®±q¯ÙŠµ. Kºu®± „µ°iSµ 10 Š®²y¯‰±S®¡® ý®±©Êïu®ÛŠ®²
…l®î®‹Sµ EYq®î¯T šµ°îµS®¡®w®±Ý x°l®Œ¯S®±q®Ùuµ.
†b¯y®¼Š®
Bijapur
„¯S®©Nµ²°gµ
„µ¡®S¯º Bagalkot
Belgaum
Gulbarga
Š¯‡®±X®²Š®±
Raichur
q®ºuµ-q¯‰±‡®±‹ºu® î®±S®±ïSµ šµ²°ºN®±
œ®Š®l®±î®¼u®w®±Ý q®lµS®h±Ôî® (z.z.i.›.i.) Nµ°ºu®äS®¡®±
q®ºuµ-q¯‰±‡®±‹ºu® î®±N®Ê¢Sµ šµ²°ºN®± œ®Š®l®±î®¼u®± 15
î®Ç®ÁS®¡® Nµ¡®y®hÔ î®±N®Ê¡®ªå HX¬.J.ï. šµ²°ºN®±
u¯Š®î¯l®
Dharwad S®u®S®
Gadag
Nµ²y®Þ¡®
Koppal
…¡¯ë‹
Eq®ÙŠ® N®w®Ýl®
Bellary
œ®Š®l®±ïNµ‡®± Aq®ãºq® y®äî®±±Q ¯S®Áî¯Tuµ. S®†ÃÁp
î®±Ÿ¡µ‡®±Š®w®±Ý y®‹°£›, A®ªå HX¬.J.ï. šµ²°ºN®±
Cu®ÛŠµ Au®± î®±S®±ïSµ œ®Š®l®u®ºqµ q®lµS®h±Ôu®±
Uttar œ¯îµ°‹
Kannada Haveri u¯î®oSµŠµ
Davanagere
HX¬.J.ï. ±u®Ü N¯‡®±ÁN®äî®±S®¡® Kºu®± î®±±Qãî¯u®
AºS®îµw®Ý…œ®±u®±. KzÞNµ²ºl® î®±Ÿ¡µ‡®±Š®ªå šµ²°ºOw®
þî®îµ²S®Ì
Shimoga
Yq®äu®±S®Á
q®±î®±N®²Š®±
Tumkur
Chittradurga
YN®Êî®±S®¡®²Š®±
y®‹°£µ‡®±w®±Ý ¯m, šµ²°ºN®± Cuµ Hºu®± N®ºl®±…ºu®ªå,
ASµ œµ‹Sµ wµ²°ïw® š®î®±‡®±u®ªå î®±q®±Ù œµ‹Sµ‡®±
š®î®±‡®±u®ªå œ¯S®² œ®±iÔu¯£®o î®±S®±ïSµ wµîµŠ®zw¬
El®±z Chikmagalur
Udupi
q®±î®±N®²Š®±
Tumkur
Nµ²°Œ¯Š®
Kolar
œ¯š®w®
„µºS®¡®²Š®± w®S®Š®
u®£o N®w®Ýl® Hassan
Dakshina
î®±ºl®ã
Kannada
Mandya
Bangalore Urban
„µºS®¡®²Š®± S¯ä¯ºq®Š®
Bangalore Rural
Nµ²l®S®±
Kodagu
îµ±¶š®²Š®±
Mysore X¯î®±Š¯cw®S®Š®
Nµ²l®Œ¯S®±î®¼u®±. Š¯cãu®ªå 2002-2003Š®ªå Kh±Ô 40
z.z.i.›.i. Nµ°ºu®äS®¢u®ÛŠµ, AS®¡® š®ºPµã 2004Š®ªå
85NµÊ œµYϚ®Œ¯Tuµ.
ï.›.i.›. î®±q®±Ù z.z.i.›.i. Nµ°ºu®äS®¡®ªåŠ®±î® By®Ù
š®î®¾¯Œµ²°X®N®‹Sµ q¯ºräN® „µº…©î®w®±Ý Š¯™ó°‡®±
Chamarajanagar
¯w®›N® BŠµ²°S®ã î®±q®±Ù w®Š®ïb¯Ów®S®¡® š®ºšµÚ(x¯êw¬é),
N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i î®±q®±Ù
JX¯zw® ¯S®Áu®ý®Áw®u®ªåŠ®±î® Kºu®± By®Ù
Map not to scale
š®î®¾¯Œµ²°X®w¯ y®‹pq®Š® q®ºl®u® î®±²©N® x°l®Œ¯S®±rÙuµ.
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CARE AND SUPPORT
BŠµ¶Nµ î®±q®±Ù „µº…©
Care and support programmes are also implemented by KSAPS. In order to provide care and support to men, women, and children with
HIV/AIDS, many care centres have been established that are run by the NGOs.
In order to lengthen the life-span of persons with HIV/AIDS and to improve their quality of life, the national anti-retroviral therapy program
has been implemented in Karnataka.
The network of persons living with HIV/AIDS, KNP+, has been established in the state, and counselling and other care and support
services are being provided to them. Such networks are being formed in districts as well.
The Global .und has approved the fourth round of funding for comprehensive care and support and anti-retroviral programmes in selected
states, including Karnataka. Under the NGO consortium, the Population .oundation of India, New Delhi, is the Principal Recipient of the
.und to carry out activities. The programmes will begin in 2005.
N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i‡®±± Š¯cãu®ªå BŠµ¶Nµ î®±q®±Ù „µº…©u® N¯‡®±ÁN®äî®±S®¡®w®²Ý œ®ï±âNµ²ºmuµ. HX¬.J.ï./Il¬é œµ²ºvŠ®±î® y®¼Š®±Ç®Š®±, î®±Ÿ¡µ‡®±Š®± œ¯S®²
î®±N®Ê¢Sµ BŠµ¶Nµ î®±q®±Ù „µº…© x°l®©± œ®©î¯Š®± BŠµ¶Nµ Nµ°ºu®äS®¡®w®±Ý š¯Úz›, AS®¡®w®±Ý w®lµš®©± š®Š®N¯Šµ°q®Š® š®ºšµÚS®¢Sµ „µº…©î®w®±Ý x°l®±rÙuµ.
HX¬.J.ï./Il¬é Sµ²¡®S¯u® î®ãOÙS®¡® d°î®w¯î®vÇ®±w®±Ý œµYϛ A® …u®±Ow®ªå Kºu®± S®±n¯q®âN® …u®Œ¯î®nµS®¡®w®±Ý x°l®Œµ²°š®±S® Š¯™ó°‡®± Bºi-‹gµ²ä°îµ¶Š®Œ¬ YOqµé
N¯‡®±ÁN®äî®±î®w®±Ý N®w¯ÁhN® Š¯cãu®ªå‡®±² w®lµš®Œ¯S®±rÙuµ.
HX¬.J.ï./Il¬é CŠ®±î® î®ãOÙS®¡® KN®²Êh Nµ.Hw¬.z.+ w®±Ý Š¯cãu®ªå š¯Úz›, ASµ By®Ù š®î®¾¯Œµ²°X®wµ î®±q®±Ù BŠµ¶Nµ-„µº…©S®¡® šµ°îµS®¡®w®±Ý N®ªÞ›Nµ²l®Œ¯S®±rÙuµ. Cºq®œ®
dŒ¯å®± KN®²ÊhS®¡®w®²Ý Š®Yš®Œ¯S®±rÙuµ.
ïý®æ xvà (Sµ²å°…Œ¬ y®ºl¬) ‡®±± „¯Š®q®u®ªå N®w¯ÁhN®î®w®²Ý šµ°‹ Nµ©î®¼ B‡®±Û Š¯cãS®¡®ªå š®î®±S®ä BŠµ¶Nµ î®±q®±Ù „µº…© œ¯S®² Bºi-‹gµ²ä°îµ¶Š®Œ¬ N¯‡®±ÁN®äî®±S®¡® w¯©Êwµ‡®±
BrSµ u®w® š®œ¯‡®±î®w®±Ý x°l®©± KzÞNµ²ºmuµ. š®Š®N¯Šµ°q®Š® š®ºU® š®ºšµÚS®¡® KN®²Êhu®ªå y¯y®¼È㌵°ý®w¬ y¹ºlµ°ý®w¬ By¬ Cºm‡®¾¯, w®î® uµœ®ª‡®±± D N¯‡®±ÁN®äî®±S®¡®w®±Ý b¯‹Sµ
Sµ²¢š®±î® N¯‡®±ÁN®äî®±N¯ÊT u®w®š®œ¯‡®±î®w®±Ý y®lµvuµ. 2005Š®ªå N¯‡®±ÁN®äî®±S®¡®± y¯äŠ®º„®Sµ²¡®ëªîµ.
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ADDITIONAL PROGRAMME .EATURES
N¯‡®±ÁN®äî®±u® Cq®Š® Aºý®S®¡®±
o The state has adopted a comprehensive Information Education and Communication Programme. The main objectives of this
programme are: to create an enabling environment, to reduce the stigma and discrimination towards HIV/AIDS, to increase the
utilization of HIV/AIDS related services, and to increase the awareness among the general public about HIV/AIDS.
o KSAPS, in collaboration with the state education and health departments, is implementing a School AIDS Programme.
o KSAPS has given due importance to blood safety programmes to ensure a safe blood supply.
o KSAPS has given training to the Anganwadi workers on HIV/AIDS throughout the state.
o KSAPS has trained Panchayat members on HIV/AIDS.
o KSAPS has trained field level health workers on HIV/AIDS.
o Tele-counselling services are established in VCTCs.
o The Transport Corporation of India (TCI) is implementing the Healthy Highway Project with financial support from BMG..
o Š¯cã Kºu®± š®î®±S®ä š®ºy®N®Á š®ºî®œ®w® N¯‡®±ÁN®äî®±î®w®±Ý œ®ï±âNµ²ºmuµ. D N¯‡®±ÁN®äî®±u® î®±±Qã S®±‹S®¡®±: š®î®¾¯cu®ªå HX¬.J.ï./Il¬é N®±‹q¯T CŠ®±î® N®¡®ºN® î®±q®±Ù
q¯Š®q®î®±ã N®mîµ± ¯l®©± „µº…©u¯‡®±N® î¯q¯î®Š®oî®w®±Ý N®ªÞš®±î®¼u®±, HX¬.J.ï./Il¬é š®º…ºvÛu® BŠµ²°S®ã šµ°îµS®¡® …¡®Nµ‡®±w®±Ý œµYϚ®±î®¼u®±, î®±q®±Ù cw®Š®ªå HX¬.J.ï./
Il¬é N®±‹q¯u® r¡®±î®¢Nµ‡®±w®±Ý œµYϚ®±î®¼u®±.
o N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i‡®±± Š¯cã þ£®o î®±q®±Ù BŠµ²°S®ã CŒ¯PµS®¡® y¯Œµ²Ì¡®±ëïNµ‡µ²l®wµ ý¯Œ¯ Il¬é þ£®o N¯‡®±ÁN®äî®±î®w®±Ý w®lµš®±rÙuµ.
o N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i‡®±± Š®N®Ù š®±Š®£®qµ N¯‡®±ÁN®äî®±NµÊ Au®ãqµ x°muµ.
o N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i‡®±± Š¯b¯ãu®ãºq® AºS®w®î¯m N¯‡®±ÁN®qµÁ‡®±‹Sµ HX¬.J.ï./Il¬é N®±‹q¯u® q®Š®„µ°r.
o N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i‡®±± y®ºX¯‡®±r š®u®š®ãŠ®±S®¢Sµ HX¬.J.ï./Il¬é N®±‹q¯u® q®Š®„µ°r.
o N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i‡®±± £µ°r䰇®± BŠµ²°S®ã N¯‡®±ÁN®q®Á‹Sµ HX¬.J.ï./Il¬é N®±‹q¯u® q®Š®„µ°r.
o ï.›.i.›. Nµ°ºu®äS®¡®ªå gµªyµ½°w¬ w® î®±²©N® By®Ù š®î®¾¯Œµ²°X®wµ‡®± šµ°îµ.
o †.Hº.d.Hy¬.w® u®w®š®œ¯‡®±vºu® g¯äw¬éyµ½°g¬Á N¯yµ½Á°Šµ°ý®w¬ By¬ Cºm‡®¾¯ N¯‡®±ÁS®q® Sµ²¢š®±rي®±î® œµªÛ œµ¶îµ° ‡µ²°cwµ.
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DE.INITION O. TERMS
Devadasi: Traditionally, young girls are dedicated as Devadasis to the temple of the Goddess Yellamma (Renuka Temple of Saundatti),
and sometimes to the local temples of Khandoba and Hanuman, in order to fulfill the vows taken by their families. The practice is most
prevalent in Northern Karnataka. Originally, the main tasks of Devadasis consisted of performing sacred functions such as lighting the
lamp, serving the deity through dance as well as providing sexual gratification to the main priests of the deity. With the passage of time,
this traditional system has evolved into commercial sex work.
Jogathi: Some women also dedicate themselves to the Goddess Yellamma after they have married and have children, living their lives
by begging, typically on Tuesdays and .ridays. Though the relationship of Jogathis to sex work is not very clear, it is believed that they,
too, are vulnerable to sex work.
Jogappa: Similar to women who dedicate themselves to Goddesses, Jogappas are men who dedicate themselves to a particular God.
Some may also dress as women and have sex with other men. The linkages of this group with commercial sex is not very clear.
Hijras: Eunuchs who may also engage in sex work.
Type of Sex Worker:
Home-based: SWs who work at their place of usual residence and do not go out to solicit clients. Clients come to the SW and a pimp or a
broker may procure them.
Brothel-based: The SW works in a place other than the place of her usual residence, under a Gharwali or an agent who receives part of
her earnings. A brothel generally has more than one sex worker. Clients come to the brothel, or the clients are brought into the brothel
through a network of pimps and brokers. The SW is available at the brothel most of the time.
Hotel/Lodge-based: The SW stays in a lodge or hotel and practices sex work there. She is usually employed by the hotel or lodge and
does not have to go out to bring the clients. Instead, clients come to her or are brought to her by a network of pimps and brokers.
Dhaba-based: SWs employed by dhabas, resting places on highways for long-distance truckers and motorists.
Public places-based: The SW solicits clients in public places such as streets, parks, railway stations, bus stands, market places, and
cinema halls. The clients may later be entertained in lodges, homes, brothels, or public places.
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î¯ãPµãS®¡®±
uµ°î®u¯›: š¯ºy®äu¯‰±N®î¯T, uµ°ï ‡µ±©åî®±âw® S®±mSµ (š¹ºu®rه®± Šµ°o±N¯uµ°ï‡®± S®±m) As®î¯ š¯Úx°‡®±î¯u® Qºlµ²°… As®î® œ®w®±î®¾¯w¬ uµ°î®Š® S®±mSµ N®±h±º…u®
œ®Š®Nµ‡®±w®±Ý r°‹š®©± š®oØ î®‡®±›éw® œ®±l®±T‡®±Š®w®±Ý Kzޚ®±q¯ÙŠµ. D y®u®Ür‡®±± œµX¯ÏT Eq®ÙŠ® N®w¯ÁhN®u®ªå N®ºl®±…Š®±q®Ùuµ. î®±²©q®» S®±m‡®±ªå v°y® œ®X®±Ïu®±, w®³q®ãu® î®±²©N®
uµ°î®‹Sµ šµ°îµ š®ªåš®±î®¼u®± î®±q®±Ù uµ°î®Š® Ÿ‹‡®± AX®ÁN®‹Sµ Œµ¶ºTN® šµ°îµ x°l®±î®¼u®± îµ²u®Œ¯u®î®¼S®¡µ° uµ°î®u¯›‡®±Š® î®±±Qã N¯‡®±ÁS®¡¯Tu®Û. N¯© EŠ®¢u®ºqµ D š¯ºy®äu¯‰±N®
y®u®Ür‡®±± Œµ¶ºTN® rه®¾¯T Š®²y®¼Sµ²ºmuµ.
bµ²°S®r: Nµ©î®¼ î®±Ÿ¡µ‡®±Š®±, î®±u®±îµ‡®¾¯T î®±N®Ê¡¯u® w®ºq®Š®, uµ°ï ‡µ±©åî®±âxSµ q®î®±âw®±Ý AzÁ›Nµ²ºl®±, š¯u¯Š®oî¯T î®±ºS®¡®î¯Š® î®±q®±Ù ý®±N®ä®S®¡®ªå †Ã£µ„µ°m d°î®w®î®w®±Ý
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š¯î®ÁcxN® š®Ú¡®S®¡®ªå rÙy®Š®Š®±: Š®šµÙ-†°vS®¡®ªå, y¯N®±ÁS®¡®ªå, Šµ¶Œµæ° šµÔ°Ç®w¬S®¡®ªå, …š¬ š¯ÔÉãºl¬S®¡®ªå, ¯NµÁ°h±S®¡®ªå, î®±q®±Ù ›wµî®¾¯ t‡µ±°hŠ®±S®¡® š®±q®Ùî®±±q®Ù
TŠ¯OS®¡®w®±Ý œ®±l®±ONµ²ºl®± r٠¯l®±î®î®Š®±. TŠ¯OS®¡®± ›OÊu® w®ºq®Š® A®w®±Ý Œ¯l®±ÑS®¡®ªå‡µ²°, î®±wµS®¡®ªå‡µ²°, „µ²ä°sµŒ¬S®¡®ªå‡µ²°, As®î¯ š¯î®ÁcxN® š®Ú¡®S®¡®ªå‡µ±°
Š®ºdš®…œ®±u®±.
27

3.10 Page 30

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28

4 Pages 31-40

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4.1 Page 31

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.or additional copies of this chartbook, please contact the Karnataka State AIDS Prevention
Society at the address below:
Karnataka State AIDS Prevention Society (KSAPS)
4/13, Crescent Road, High Grounds, Bangalore 560001
India-Canada Collaborative HIV/AIDS Project
4/13-1, Crescent Road, High Grounds, Bangalore 560001
Population .oundation of India
B-28, Qutab Institutional Area, Tara Crescent, New Delhi 110 016
Population Reference Bureau
1875 Connecticut Ave., NW, Suite 520, Washington, DC 20009
.unding was provided through the generosity of the Bill & Melinda Gates .oundation
Printed in India by Ajanta Offset & Packagings Ltd., Delhi.
D Nµ¶zm‡®± y®ärS®¢Sµ N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i‡®±w®±Ý D Nµ¡®Tw® š®u®ªå š®ºy®OÁ›:
N®w¯ÁhN® Š¯cã Il¬é zäý®w¬ šµ²šµ¶i (Nµ°š¯ãy¬é)
4/13, Nµäšµºg¬ Š®šµÙ, œµ¶ S¹äºl¬é, „µºS®¡®²Š®± 560 001
Cºm‡®±-Nµw®l® š®œ®‡µ²°S®u® HX¬.J.ï./Il¬é ‡µ²°cwµ
4/13-1, Nµäšµºg¬ Š®šµÙ, œµ¶ S¹äºl¬é, „µºS®¡®²Š®± 560 001
y¯y®¼È㌵°ý®w¬ y¹ºlµ°ý®w¬ By¬ Cºm‡®±
†-28, N®±q®„¬ CxéÉÔh²ãý®©w¬ I‹‡®±, q¯Š¯ Nµäšµºg¬, w®î® uµœ®ª 110 016
y¯y®¼È㌵°ý®w¬ ŠµyµŠµw¬é …²Šµ²°, 1875 N®wµÝOÔN®g¬ Aîµw®²ã, Hw¬.l®…±å. š®²ãg¬ 520 î¯þºS®Ôw¬
m.›. 2009
u®w® š®œ¯‡®±î®¼ †Œ¬ Hºl¬ îµ±ªºl¯ Sµ°g¬é y¹ºlµ°ý®w¬w® Eu¯Š®q®æu®ªå uµ²Š®Ouµ.
î®±±väq®î¯u®u®±Û „¯Š®q®u®ªå: Acºq¯ By¬šµg¬ Aºl¬ y¯ãNµ°dºS¬é ªï±gµl¬, w®î® uµœ®ª
29

4.2 Page 32

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HIV/AIDS
in
KARNATAKA
Situation and Response
N®w¯ÁhN®u®ªå
HX¬.J.ï./Il¬é
›ÚrS®r î®±q®±Ù y®ärO䇵±