History

The Early Years:

When we started working in 1989, our mission was straightforward: “Preventing spread of HIV in India”. Women in Chennai had been identified as infected with HIV barely a couple of years earlier, denial was in full swing, and the rights of people identified as “high risk groups” or infected with HIV were routinely abused. Services for sexual and reproductive health were ineffective, even the idea of counselling for HIV prevention was non-existent. In addition, public sentiment was hostile, NGO participation almost nil, and donor money, scarce. In 1990, we filed a public interest petition in the Madras High Court that led to the release of nearly 800 women selling sex and infected with HIV, setting a precedent against the detention of people due their HIV status.

As part of its initial work, Siaap built the capacities of 200 NGOs to take up HIV/ AIDS work in the states of Tamil Nadu, Andhra Pradesh and Karnataka.

In 1992, Siaap began working with women selling sex and truckers in and around Chennai, combining outreach with advocacy against violence. To increase access of vulnerable communities to quality STI services in the public sector, Siaap sought to marry the strengths of the public with the private sector by introducing innovative approaches.

In 1993, we started the only sexual health intervention among blind people in Asia, through the AIDS Action Foundation of the Blind (AAFOB).

Siaap tested a pilot-counselling project in Government Royapettah Hospital, Chennai between 1993 and 1996, by placing one trained counsellor in the STD clinic, to offer counselling services during outpatient hours. The conviction that counselling can be a principal strategy to bridge rights of people with their health, resulted in Siaap initiating counselling services in Tamil Nadu, Karnataka and Andhra Pradesh by recruiting and training counsellors. Selection was based on significant life experience; comfort discussing issues around sex and sexuality; and openness to learning.

1996-2001

In 1996 we collaborated with the National Commission for Women (NCW) to make recommendations addressing the concerns of women selling sex in India.

Since 1996, Siaap has helped train, place, and supervise counsellors in over 150 counselling centres and government hospitals in India.

Between 1997 and 2001 over 150 counsellors were recruited from mainstream as well as marginalized communities including women in sex work, gay and bisexual men, visually challenged and PLHAs. This network was in partnership with nodal agencies such as Belgaum Integrated Rural Development Society (BIRDS) in Karnataka, AIRTDS in Andhra Pradesh. Counselling curriculum was designed and developed by a team of trainers both from within Siaap and abroad. In order to integrate the component of supervision into all our training programmes, our staff was trained in the certificate course on ‘Supervisory Skills and Theory’ through affiliation with the Central School for Counselling Training, London. This helped Siaap set up a system of supervising counsellors in Tamil Nadu.

Selvi Memorial Illam Society (SMIS), a model project, is a community organization started in 1999 of people affected by and living with HIV. Siaap enabled SMIS to set up a comfortable and viable short-stay facility for HIV patients and/or family members accessing services at Government Hospital of Thoracic Medicine, Tambaram.

That same year, Siaap helped register its first community organization, ‘sangam’, to empower women in sex work and gay/bisexual men, strengthen their fight against the impact of HIV/AIDS, and establish a linkage to health, development, livelihood and other issues. Siaap now supports around 20 sangams throughout the state of Tamil Nadu.

In 2001, we established our first Thrift and Credit Societies for the economic empowerment of the communities we work with.

2002-2005

Siaap promoted Anbu Karangal Pengal Paadukappu Urimai Sangam in Namakkal district in 2002 to enable positive women, many of who were widows and single parents to advocate for their rights.

Siaap partnered with TANSACS and UNICEF in conceptualizing and operationalizing the PPTCT Programme (Prevention of Parent to Child Transmission) in Tamil Nadu, between 2002 and 2004.

In 2003 we set up the first model VCTC in the country in collaboration with WHO and TANSACS.

A model Community Health Voluntary Counselling Center was established at Alandur, Chennai suburb, in 2003 with high levels of untreated sexually transmitted infections (STIs). Based on this model, Siaap facilitated sangams to set up Community Voluntary Counselling Centers (CVCC).

Siaap was invited by TANSACS to monitor the PPTCT centres in the state of Tamil Nadu between 2003 and 2004. The Siaap team visited sites on a regular basis: assessed the quality of counselling and testing, adequacy of supplies/consumables, client flow management, support for PLHA and for urgent issues functioned as a bridge between the site and TANSACS for speedy redressal. Siaap assisted with monthly reviews of the counsellors along with the Project Director-TANSACS, UNICEF and provided technical inputs based on their needs.

Between 2003-2004 Siaap worked with Family Health International (FHI), to develop a set of protocols for counselling children affected by, vulnerable to, and living with HIV in India.

In 2004 we handed over program ownership to the CBOs (sangams), anticipating by at least three years India's national program calling for NGO-CBO transition. Siaap conducted a “Client Satisfaction Survey” among PPTCT clinic attendees in 2004 along with TANSACS covering 300 respondents across the state. A study on “Reasons for Low HIV Test Result Pick-up Rate by antenatal women” was also conducted among 78 counsellors from 65 PPTCT centers in Tamil Nadu during the same period.

In 2005, TANSACS partnered with Siaap for the implementation of the GFATM project in Kasthuri Bai Gandhi Hospital, Chennai

Siaap was selected by APAC in 2005 to build capacity, guide, monitor, evaluate and report about the NGO-based VCTCs and those in select private hospitals in Tamil Nadu and Pondicherry. The VCTCs were monitored on a monthly basis on the following parameters:

Compilation of data.
Coverage of clients, especially vulnerable groups such as FSW, MSM, TG, IDU, truckers, migrants.
Quality of counselling.
Adherence to national guidelines with regard to HIV counselling and testing
Documentation of counselling sessions.
Extent of networking with other agencies such as NGOs, Positive Networks, Private Hospitals/Laboratories, Government Hospitals.

Siaap also conducted a research study among counsellors in Tamil Nadu titled “Burnout amongst HIV/AIDS Counsellors in TN” using tools developed by UNAIDS (tool 3) and the Macrulnet Burnout Inventory-Human Services Survey. The study was conducted in four districts of Tamil Nadu, India in March 2005. One-hundred and sixty five HIV/AIDS counsellors from Voluntary Counselling and Testing Centres, Prevention of Parent to Child Transmission (PPTCT) centres, Blood Banks, STD clinics and those working in NGOs among chemical dependents were the subjects of this study. Siaap was selected to present this paper at the National Annual Conference of Indian Association of Clinical Psychologists held at Jaipur in 2006.

2006-Present

Siaap evaluated APAC-supported VCTCs in 2006 based on pre-determined criteria such as involvement of the Project Holder, quality of counselling, testing and documentation including data, involvement of the Medical Officer, infrastructure and other relevant parameters. All VCTCs were graded on a five-point scale and a report with recommendations was submitted to APAC.

Siaap was contracted to evaluate New Entity for Social Action (NESA) in Bangalore, working in the area of Human rights with special focus on Dalits. NESA’s HIV programmes located in the states of Tamil Nadu, Andhra Pradesh, Kerala and Karnataka. Assessment of the organisations involved, their outreach performance, impact among the community members and the integration of the HIV/AIDS activities as a part of their regular programme. Over 13 sites in Tamil Nadu and Karnataka covered by 10 organisations were evaluated during this process. The report was presented by Siaap, during the NESA’s Annual convention at Hosur.

A strategic arrangement during 2006 was the formation of a national level coalition - Sarvojana - with like-minded NGOs and CBOs to set up community managed VCTCs in their respective geographical areas. In keeping with NACP III plans, the coalition runs seven Community Voluntary Counseling & Testing Centers (CVCTC) to directly address stigma and discrimination of communities affected by HIV& AIDS; encourage early diagnosis;, and bridge needs with available services in the public and the private sector. A fundamental objective of Sarvojana is to provide a resource pool of HIV-related expertise for capacity building of state, regional and national programs.

Siaap was invited by UNICEF between October and December of 2007 to evaluate their PMTCT programme in Kyrgyzstan, Central Asia. Interviews were held with key informants, select sites were visited and a seminar was conducted with the Ministry of Health, Kyrgyzstan. A report was submitted to UNICEF with key recommendations.

The year 2009-2012 we proposed to work towards Improving HIV prevention and care among young women and men (15-29), FSW and MSM in rural Tamil Nadu. Reduce HIV prevalence through promoting gender equality, human rights and poverty reduction, and access to STI and HIV prevention and care resources. The programme will be implemented in 13 districts in Tamil Nadu with high prevalence of either STIs and/or HIV, with a strong presence of community organizations of Female Sex Workers and Men who have Sex with Men, developed and supported by these communities in partnership with SIAAP. The districts include Kanyakumari, Madurai, Nagapattinam, Pudukottai, Salem, Thanjavur, Theni, Tirunelveli, Tiruvannamalai, Tuticorin, Vellore, Erode and Krishnagiri.