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Indian Health Organisation’s ‘Project Saheli’ for Sex Workers – A Replicable Model

Indian Health Organisation – Project Saheli

Project Saheli
Sakhi Saheli

The Saheli Project, a peer education model for the prevention and control of HIV/AIDS among the sex workers (SWs), has been internationally acclaimed as the “BOMBAY MODEL” for HIV prevention at the 9th International AIDS Conference held in Berlin, Germany in June 1993. Initiated in 1991, this project covers 5500 casual sex workers (CSWs) in Bombay and 3500 in Pune.

Objectives

To educate casual sex worker (CSWs) on HIV/AIDS and STDs.
To systematically distribute condoms to CSWs and ascertain usage.
To teach CSWs client negotiation techniques for use of safer sex.
To empower CSWs to run the program to make it cost–effective and sustainable.
To provide health care to SWs, network for referrals, options for free/confidential HIV testing.

Components
After evaluating various approaches for condom promotion like social marketing, door–to–door vending, we opted for the "Peer education" model for our work among the SWs. The need for their empowerment, adequately supported by STD/AIDS education is vital. The organization of prostitution is multi–layered and the casual sex worker (CSW) is at the lowest end of scale lorded over by brothel managers and brothel owners.

To intervene effectively, we had to influence the entire hierarchy, with a final goal to empower CSWs to change their destiny. We have a three–tier system of peer leaders: Saheli (friend) from CSWs for 25 girls, A Tai (sister) from the brothel managers for 10 sahelies, Bai (mother) from the brothel owners for each major area.
Saheli: Rs.150/– p.m. for 1 hour daily time.
TAI: Rs.700/– p.m. for part time & Rs.1500/– p.m. for full time work.
BAI: Being usually an influential & affluent lady from their community, we do not pay nor does she expects monetary compensation.

Activities
The peer leaders are provided training on: techniques of ‘Client Negotiations’, STD/HIV prevention through personal interviews, group discussions, lectures & AV and role plays, promotion and distribution of Condoms.

They are assigned the responsibilities of educating sex workers (SWs) about HIV/AIDS, STD, safer sex, Condom distribution, escort sick girls to mobile clinics and different clinics/hospitals. When the project was initiated, the activities met with the usual cynicism, but we were certain that we would finally convince the SWs that her body, her means of livelihood and her life belonged to her.

Apart from incentives, we provide them with ‘Photo–Identity cards’. More than just an incentive, it also served as a badge of pride and provided them respectability. For the first time SWs realized that they could earn money through means. After fully knowing dangers of contracting HIV, they impart knowledge and negotiating skills to other SWs.

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