Renewing Abhaya’s commitment to women’s health

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A woman’s lifetime is a progression from puberty, menstruation, and possibilities of pregnancy to menopause, with a wide range of health issues in-between. India HIV/AIDS Alliance’s Abhaya project, as supported by MAC AIDS Fund, works with female sex workers to address these sexual and reproductive health (SRH) issues.

The SRH issues of sex workers are especially important because of two reasons. Firstly, sex workers in India are not in the ambit of government welfare mechanism, and thus, the only welfare platform available to them is the National HIV Programme. Notwithstanding the fact that the National HIV programme has been instrumental in creating awareness on HIV and ensuring increased HIV testing, larger health issues of women have been mostly ignored. This brings me to the second important issue, which being that due to the nature of their occupation, SRH health needs of female sex workers are more obtrusive. Abhaya works towards filling this gap so that these marginalized and stigmatised women are able to strengthen their health seeking behaviour.

An important health issue is about Human Papilloma Virus (HPV), which is a sexually transmitted virus that can cause cervical cancer and, timely detection and treatment is crucial for prevention. Through Abhaya, we educate women about cervical cancer, while counselling and linking them to HPV screening services in the form of ‘Pap Smear’ Testing, a simple and effective method to prevent or treat cancer as early as possible. However, our experience has shown that it is not easy to convince women about the Pap smear test as it requires abstinence from sexual intercourse for a day or two prior to taking the test. This means losing out on the much needed income, and thus many sex workers do not end up taking the necessary step!

One such story is of Rani, who is currently undergoing treatment for HPV. She came to Delhi at a very young age and got married when she was only 17 years. Her husband left her and got married again. She was on her own, but she did not lose her spirit. She got into sex work to support herself and her child. At times there were customers who offered to pay more for unprotected sex, and she agreed to it for the extra income. Eventually, she started having problems like an unwanted pregnancy and lower abdominal pain that persisted even after taking STI treatments. She sought help from the Abhaya counsellor and outreach workers who heard her problem and counselled her about cervical cancer and Pap test. She agreed to take the test, and was found to be HPV positive. Presently, she is undergoing treatment in the Rajiv Gandhi Delhi Cancer Hospital for HPV.

Today, being the International Day of Action for Women’s Health, the Abhaya team re-affirms its commitment to work even more determinedly to support all women and enable them to realise their health rights without any fear or discrimination.

The author of this post, Nandini Mazumdar is the Programme Officer of the Abhaya project at India HIV/AIDS Alliance in New Delhi.

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