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Integrating HIV / AIDS care in family welfare services: the PSS experience.


 In India, participants of a consultative meeting in early February 1994 in Haryana State on STD (sexually transmitted disease) and AIDS prevention in family welfare programs and those at a December 1994 workshop in Jaipur State on integration of RTI (reproductive tract infections)/STD/HIV prevention activities into family welfare programs agreed on the need to broaden the scope of family welfare programs to include RTI/STD/HIV prevention and control. The meeting participants examined 4 case studies on the issue of RTI and STDs in the context of family welfare programs. One case study reviewed activities of the New Delhi-based Parivar Seva Sanstha (PSS), which provides comprehensive reproductive health services. All PSS staff have received training in HIV prevention. In Madras, PSS initiated a pilot project to integrate RTI/STD services into its mainstream family planning services. It tailored experiences of the Colombian Family Welfare Association (PROFAMILIA) to fit PSS project objectives. Formative research revealed that both men and women seek STD diagnosis and treatment services from the private sector despite the high costs and poor quality of care. Based on these findings and the PROFAMILIA experiences, PSS developed a model for integrated services for implementation, evaluation, and eventual replication. PSS has increased its focus on the use of condoms for contraception and HIV/STD prevention. All female clients now have access to standard screening, diagnosis, and treatment. PSS will create a new clinic offering reproductive health services for males. It will also develop systems for partner referral and community-based programs to provide education and motivation for family planning and RTI/STD/HIV prevention. Operational research will provide insight into the needs and perceptions of the population, process evaluation of the project, and RTI/STD/HIV control. Based on the case studies, certain ideas for future actions emerged (e.g., a major advocacy drive) as well as ideas for training, education, counseling, and social marketing and research and evaluation.
