Advocating for Stigma-free Healthcare for Female Sex Workers

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While conducting community consultations in East Godavari district of Andhra Pradesh, the Koshish programme team learned that female sex workers (FSWs) in the district faced numerous challenges in accessing healthcare services, including stigmatizing behaviour, discrimination, and apathy of service providers. A majority of FSWs who spoke at the consultations mentioned that counsellors at the Integrated Counselling and Testing Centre (ICTC) at the government hospital at Kakinada were highly insensitive and asked unnecessary questions while providing them services.

The advocacy coalitions set up under Koshish took note of the matter and decided to collect evidence from the community and flag the issue to relevant authorities. The team documented experiences of 50 community members and approached the Additional District Medical & Health Officer for redressal. After the initial briefing on the project and its activities, the community members shared their concerns. They narrated how clients were asked irrelevant questions by the counsellors and faced deliberate delays in testing and reports.

Appreciating the difficulties faced by FSWs, the official instructed his office to issue a circular to all ICTCs to remind them of their obligation to provide client-friendly services and not delay sample collection deliberately. He also facilitated the provision of other social security schemes and entitlements to these community members like Aadhar cards, Antyodaya cards, caste certificates and even voter registration. Later, the officer organized a review meeting with all counsellors in the district and invited Koshish partners. In the meeting, the official emphasized to the counsellors, “Key populations are to be given priority in availing health services.”

Supported by the European Union, Alliance India’s Koshish programme advocates for policies and strategies on sexual and reproductive health (SRH) and rights for people living with HIV (PLHIV) including key populations in India. The programme is implemented in Maharashtra, Tamil Nadu, Andhra Pradesh and Gujarat. The advocacy coalitions under Koshish have successfully engaged with stakeholders and identified unfulfilled SRH needs of PLHIV. With these coalitions in place, Koshish makes sure that voices of communities affected by HIV/AIDS are heard by decision makers and the problems they face every day remain at the heart of the programme’s state-level advocacy agenda.


India HIV/AIDS Alliance works closely with PLHIV in India through its Koshish programme which strengthens civil society organizations and networks that represent and work with PLHIV and other marginalized groups, such as MSM, transgenders, sex workers and IDUs, to effectively advocate for policies to improve the sexual and reproductive health and rights of PLHIV in India. This project is funded by the European Commission and is implemented in partnership with MAMTA, PWDS, VMM and CHETNA, along with state-level networks for PLHIV in Maharashtra, Tamil Nadu, Andhra Pradesh and Gujarat.

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