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Session-2. Introduction to High Risk Groups (HRG). Learning Objective:. Understanding HRG and vulnerability to HIV Being sensitive to HRG needs . Common issues among HRG. Stigma and discrimination – society and health care settings Poor access to services

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session 2


Introduction to High Risk Groups (HRG)

learning objective
Learning Objective:
  • Understanding HRG and vulnerability to HIV
  • Being sensitive to HRG needs
common issues among hrg
Common issues among HRG
    • Stigma and discrimination – society and health care settings
    • Poor access to services
  • Underlying economic and socio-cultural factors
    • poverty, illiteracy, ignorance, broken homes
    • stigmatized, marginalized and criminalized by the societies
    • Violence
  • Risk reduction
    • Safe sexual practices
    • Safe injections
    • Alcohol use
health seeking behavior among hrg
Health seeking behavior among HRG
  • Most HRG report poor access to health care services.
    • Refusal to treat of persons involved in sex work or same-sex behavior
    • Specifically among MSM
      • Homophobia/biphobia/transphobia from HCP (MSM)
      • HCP trying to ‘cure’ same-sex attracted persons from ‘homosexuality’
      • Pathologizing of same-sex/bisexual orientation by HCP
    • Low self-esteem among HRG
    • Concerns about breach of confidentiality
issues relating to sex work
Issues relating to sex work
  • Divers
    • Sex work settings
    • Stakeholders
  • Sex work settings are characterized by
    • High rates of sexual partners,
    • Unsafe sex and high rates of Sexually Transmitted Infections (STIs).
  • Risk of HIV - sexual networks
    • sex workers, clients, regular partners and associated lovers, spouses and children.
  • Sex workers and clients -alcohol or injecting drug use
issues relating to msm
Issues relating to MSM
  • Vulnerability-
    • Receptive and insertive partner at risk
    • Anal sex
    • Commercial sex
    • Married
    • Taboo, stigma and discrimination
    • Alcohol, drug use and abuse
    • Social and economic issues
issues relating to idus
Issues relating to IDUs
  • Drug in take –
    • Variety of reasons and ways
  • Injection of drugs -risk of HIV transmission
  • Commonly injected drugs - heroin and other opiates, cocaine and amphetamines
  • Risk
    • Sharing of needles and equipment
    • Poverty, lack of sustainable livelihoods, exploitation, inadequate education, lack of hygienic conditions
issues relating to idus1
Issues relating to IDUs
  • Legal and ethical factors create challenges to enabling environment
  • Overlap between drug addiction and those involved in sex work
  • Prevention
    • OST
    • Needle exchange
    • Other risk reduction – chasing drugs
migrants and truckers
Migrants and Truckers
  • Away from home and family
  • Risk – multiple partners, alcohol and drug use
  • Separation from family, harsh working conditions, poverty, illiteracy or low educaton and exploitation
  • Mobility , working hours, daily wages -restricts access to service
  • This session covered issues relating to different HRG. HRG are clients the counselor’s work with. Given that these groups are marginalized and stigmatized and are highly vulnerable to HIV the counsellor should:
  • Establishing rapport with community, creating access to services and bringing about behavior change are important areas of work for a counsellor/ANM.
  • The counsellor should ensure prevention of STI/RTI and HIV.
  • Communication messages should be provided in a sensitive manner, keeping in mind local culture and language.
  • A counsellor/ANM should understand local terminology used by different groups.
  • They should be non-judgmental and sensitive to community needs.
  • Counselling should focus on information provision, skills building, self-management, problem solving, and psychological factors such as self-efficacy.