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Understanding Drug Addiction and Counseling Skills
Rukhsana Ayyub CARE 2007
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This manual has been designed for people working with drug users for the
preventions of HIV/AIDS such as counselors, field staff and trainers.
The main objective of this manual is to strengthen staff capacity to
understand addiction and its impact on the individual drug user and his
family. The manual also addresses tools and skills essential for
providing counseling to drug users at various stages of recovery.
(attachment: Pdf Drug user counseling manual). |
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Drug User at Rist to HIV
Documenting our Experience 2000- 2004
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This document describes five years experience of the HIV Program of CARE Bangladesh in working with Drug Users to prevent HIV. There is a rising trend of HIV prevalence among the injecting drug users in Bangladesh and in one area of Dhaka city the reported rate of HIV prevalence is 8.9%, indicating the start of a concentrated epidemic among this group. To contain the spread of the disease the project used a harm reduction approach consisting of services like peer education, abscess and STD treatment, condom distribution and needle-syringe exchange. The document also describes the challenges faced during the implementation of the project and the lessons learned. |
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| Transport Workers at Risk to HIV
Documenting our Experience 2000- 2004 |
This document describes four years experience of the HIV Program of CARE Bangladesh in working with the truck drivers, their helpers, rickshaw pullers and dockworkers. Transport workers are considered as possible ‘bridges' to the general population to transfer HIV and sexually transmitted infections because of their relationship to sex workers. The document elaborates three key intervention strategies of the project: partnership with labor unions, employing peer educators and outreach workers and setting up drop-in-centers, together with challenges and lessons learned. |
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| Dinajpur Safe Mother Initiative
Final Evaluation Report |
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CARE BANGLADESH : HIV DOCUMENTATION |
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The following documents represent the years of cumulative knowledge and experience of the HIV program of CARE Bangladesh. Some of these documents have been published and presented in various forums. Other documents listed are in draft form but available in soft copy for distribution and sharing. |
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List of the Resource Manuals/ Material |
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A. Best Practice |
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01: Female Sex Worker HIV Prevention Projects. Lessons learnt from Papua New Guinea, India and Bangladesh . UNAIDS Case Study 2000, UNAIDS Best Practice Collection ( UNAIDS document that uses Shakti as case study)
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This paper contains a set of case studies that emerged from a session entitled Best Practices in Female Sex Worker Projects held at the Fourth International Congress on AIDS in Asia and the Pacific in Manila , in October 1997. The case studies represent a set of experiences and lessons that might clarify for others the strengths and weaknesses typical in successful female sex worker projects and outline the real difficulties and triumphs of each of the projects . These case studies demonstrate how organisations have tried to deal with the complex problems presented to their projects in different (and sometimes similar) ways. And they exemplify some of the best efforts at preventing HIV among a diversified and highly vulnerable group of women. The three projects represent a range of situations, geographical locations, problems and solutions. Sonagachi in India and SHAKTI (implemented by CARE Bangladesh) involved brothel-based sex workers in South Asia . The Transex project worked with club or street-based sex workers in Papua New Guinea .
For details mail to: hivinfo@carebangladesh.org |
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02: Draft Guidelines for Behaviour Change Interventions to Prevent HIV, Sharing Lessons from an experience in Bangladesh . Based on the application of lessons from Sonagachi, Kolkota, Best Practice Collection from the Region, UNAIDS South Asia Inter Country Team, October 2003 ( UNAIDS document that outlines best practice on HIV prevention using example of CARE Bangladesh) |
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Bangladesh has implemented behavioural change intervention programmes for vulnerable populations for a number of years and is now documenting them as best practice. This publication outlines the experiences of CARE Bangladesh, shares ‘best practice' and provides guidelines for field managers. It can also be used as a training manual for grassroots level workers. The lessons learnt are based on five years of CARE's experience working with sex workers on HIV and AIDS prevention. Lessons are related not only to HIV prevention interventions but also general concepts related to the HIV virus and how it acts, methods of prevention and the importance of recognising the human rights of vulnerable populations. While recognising that different models can be used for behaviour change (for instance, indigenous leaders to advocate behaviour change), this manual is based on behaviour change communication through peer outreach , a strategy that has been successfully used in the Tangail brothel in Bangladesh . The experience in Tangail, which was based on earlier practices in Sonagachi , India , has led to a systemisation of the steps for intervention. This manual presents these steps to enable those who would like to work in this area to design and implement a comprehensive behaviour change intervention effectively.
For details mail to: hivinfo@carebangladesh.org |
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B. Project Brief/ Outcome / Lessons Learned |
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01 : Start-up Process Document, Brothel Based HIV/AIDS Intervention, Tangail . SHAKTI Project, CARE Bangladesh, March 2004, Prepared by A. S. M. Enamul Hoque (Draft ) (CARE Bangladesh unpublished document available in both soft and hard copy) |
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Paper outlining the initiation of CARE Bangladesh's Stopping HIV/AIDS through Knowledge and Training Initiatives (SHAKTI) Project . The project's approach was developed to form partnerships between and provide technical assistance to other NGOs, whilst developing options for various high-risk behaviour groups in Bangladesh . In order to respond to the changing needs of the HIV/AIDS epidemic in Bangladesh , the project required flexibility. As a result, within the first year of project implementation in 1995, the project had to adopt certain changes. In view of the fast changing situation in Bangladesh and newer information being gathered, the project proposal was revised and necessary changes to the document incorporated during the early part of the second year of implementation. The changed strategy aimed to develop demonstration projects for behavioural change amongst selected population groups, including commercial sex workers, street base sex workers and injecting drug users. It also aimed to reproduce such projects as far as possible via a partnership strategy through NGO and governmental support, whilst continuing staff education on HIV/AIDS for NGOs. It was hoped that the introduction of behaviour change for the aforementioned populations would be likely to provide better impact than the awareness model, originally limited to the sex worker population and truck drivers and rickshaw-pullers of Dhaka as planned in the original project proposal.
For details mail to: hivinfo@carebangladesh.org |
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02: Accessible STD Care for Street-based Sex Workers of Dhaka City : Potentials and Experience of Partnership . Swarup Sarkar, Yasmin Ahmed, Ziya Uddin, Sushena Reza, Enamul Hoque, Fazlul Karim and Maurice Bloem. Journal of Diarrhoeal Diseases Research 16(2) 1998, ICDDR, B: Center for Health and Population Research,
http://202.136.7.26/pub/publication.jsp?pubID=1177&classificationID=0 &typeClassificationID=0
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Short paper which examines the effectiveness of the partnership between the SHAKTI Project, CARE Bangladesh and the Marie Stopes Clinic Society (MSCS) in providing reproductive health care, including care for sexually transmitted diseases (STD) to street-based sex workers of Dhaka City through satellite clinics.
For details mail to: hivinfo@carebangladesh.org |
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03: Resistance to Condom Use in a Bangladesh Brothel . Carol Jenkins, Health and Population Sector Coordinator, CARE Bangladesh. Resistances to Behavioural Change to Reduce HIV/AIDS Infection, 1999, Chapter 18, 211-222, htc.anu.edu.au/pdfs/ resistances _ch 18 .pdf ( chapter from journal) |
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This paper examines the brothel component of the SHAKTI project in the town of Tangail , in the light of its own history, as well as with comparative information drawn from the National Behavioural Surveillance of 1998 . The SHAKTI Project, implemented by CARE Bangladesh, started in a 600 women brothel in Tangail in 1996. At the time of the baseline study, condom use was three per cent. Initial strategies to improve usage rates included peer education and free condom distribution, with daily registration of number of condoms per woman. In November 1998, condom use was probably around 40 per cent. Issues such as divisiveness and competition, obeying madams and landowners, pleasing the donor, and facing the police, plagued the project. The locus of resistance to change was found less frequently within the individual sex workers than in the structures surrounding them. Removing these barriers produced increased condom use and, eventually, sales of condoms from sex workers to sex workers.
For details mail to: hivinfo@carebangladesh.org |
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04: An Assessment of Risk Perceptions of STD/HIV/AIDS and Presence of Risk Behaviours among Street-based Sex Workers in Dhaka City . Swarup Sarkar, Ziya Uddin, Nazrul Islam, Sushena Reza, Enamul Haque, Fazlul Karim and Maurice Bloem. Paper presented in 7 th ASCON , Publications , Journal of Diarrhoeal Diseases Research 16(2) 1998 , ICDDR,B: Center for Health and Population Research
http://202.136.7.26/pub/publication.jsp?pubID=1178&classificationID=0& typeClassificationID=0 |
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This paper provides an overview of an assessment undertaken by CARE Bangladesh under the HIV Programme, which sought to measure the risk perceptions and presence of risk behaviours related to STIs, HIV and AIDS amongst street based sex workers in Dhaka .
For details mail to: hivinfo@carebangladesh.org |
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05. Partnerships between sex workers and Government health services for HIV prevention: Marginalized women in Bangladesh . Dr. Mausumi Amin, December 2002, Report of a WHO Consultation, 5-6 December 2002, Geneva, Switzerland,
http://www.who.int/hiv/en |
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This paper outlines how CARE Bangladesh initiated the HIV prevention work in a brothel setting along with the collaborative support from different sectors (Government, NGOs). Over time CARE B expanded partnership with Govt. health sector prioritising their area of interest like EPI (Extended Programme of Immunization), which facilitated the referral system between brothels, based intervention clinic and govt. hospital.
For details mail to: hivinfo@carebangladesh.org |
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C : Research / Base Line Survey / Monitoring Reports: |
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01: HIV/AIDS and Female Street -Based Sex Workers in Dhaka City : What about their Clients? Maurice Bloem, Enamul Hoque, Lusy Khanam, Trisna Selina Mahbuba, Moshfaqus Salehin and Shanaz Begum. From Resistances to Behavioural Change to Reduce HIV/AIDS Infection. 1999, Chapter 17, 197-210. http://htc.anu.edu.au/Old%20pages/resistances.htm ( chapter from journal) |
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This paper outlines the results of a participatory action research project called SATHI (Sex Workers and Associates Training and Health Initiatives), and gives an overview of the situation in Bangladesh with regards to HIV/AIDS and sex workers. The background of the project, the methodology and some of the findings of the research are discussed. In the conclusion, future interventions are proposed.
For details mail to: hivinfo@carebangladesh.org |
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02: Violence Against Women and HIV/AIDS: Setting the Research Agenda. Meeting Report Geneva , 23-25 October 2000, Page 30, Gender and Women's Health World Health Organisation Geneva , Switzerland ,
www.who.int/gender/ violence /VAWhiv.pdf |
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WHO convened an expert consultation entitled Violence Against Women and HIV/AIDS: Setting the Research Agenda between 23 and 25 October 2000, to take stock and learn from existing research. It was also felt necessary and timely to undertake a more wide-ranging review of what was known, what research was ongoing and what gaps existed on the intersections between violence against women (VAW) and HIV/AIDS. The report is divided into three main sections. The first section contains a summary of each presentation from the consultation. The second section summarises the discussion and the third details the recommendations and conclusions from the meeting
For details mail to: hivinfo@carebangladesh.org |
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03: Modelling the impact and cost-effectiveness of CARE-SHAKTI: An HIV Prevention Programme for Injecting Drug Users . Lorna Guinness, Anna Foss, Charlotte Watts, Said Quayyuum, Peter Vickerman, Tasnim Azim, Lilani Kumaranayake. 1999 (Draft Document in soft copy) |
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In Bangladesh , a range of HIV prevention activities are being implemented by government and NGO agencies, including CARE Bangladesh. Despite the diversity of activities, there is limited information about the costs of implementing different forms of HIV prevention activity, or assessments of how such activities influence the future course of the HIV epidemic. Such information is important, particularly given current initiatives to increase the scale and intensity of HIV prevention projects in Bangladesh . Since 1993 a multi-disciplinary team at the London School of Hygiene and Tropical Medicine (LSHTM) has been working to develop ‘ HIV Tools : a cost-effectiveness toolkit for HIV prevention' . HIV Tools consists of a set of simulation models that estimate the impact on HIV and STI transmission of different HIV prevention activities, as well as guidelines for costing different HIV prevention activities. It can be used to estimate the impact, cost and cost-effectiveness of different HIV prevention strategies in different settings. Three SHAKTI interventions are considered in this particular study: the IDU Intervention as well as the brothel based sex workers and street based sex workers interventions. This study costed the different HIV prevention projects, conducting a review of epidemiological, behavioural and intervention related data from each project, and epidemiological modelling of the potential patterns of HIV and STI transmission among the specific groups targeted by each intervention and their sexual / injecting partners.
For details mail to: hivinfo@carebangladesh.org |
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04: HIV /AIDS Support: DFID/HAPP/FHI funded project. Gap Analysis. Highlights CARE's experience from 10 years of the HIV Project. K. Vaidyanathan. 2005 (Document in soft copy) |
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A study of CARE Bangladesh's HIV Programme was conducted 2004 by HAPP, HAIF, CARE, FHI and GFATM in order to identify gaps with regards to the interventions' impact on marginalised and vulnerable groups whose behaviour put them at high risk of them contracting HIV. This paper is a record of that analysis, which acknowledged ‘gaps' within the programme's interventions as well as within the target groups covered.
For details mail to: hivinfo@carebangladesh.org |
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05: Stopping HIV/AIDS through Knowledge and Training Initiatives (SHAKTI) Project. HIV Related Situation at Tangail Brothel before Intervention . Baseline Survey, December 1996 (CARE Bangladesh document) |
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In order to initiate a brothel-based intervention amongst CSWs, as part of CARE Bangladesh's SHAKTI project, a mapping exercise was undertaken to find a brothel that would provide a good opportunity for a demonstration project. A brothel in Tangail (100 km away from Dhaka with approximate 600 CSWs) was selected as the site of the intervention. A qualitative survey was completed among the commercial sex workers, landowners, madams, and few potential clients using focus group discussion, in-depth interview and key informant interview. The survey revealed low levels of knowledge about HIV and AIDS, low condom use and a need for STI treatments. Accordingly, a clinic was opened in collaboration with local brothel community and treatment is being provided on principles of syndromic management.
For details mail to: hivinfo@carebangladesh.org |
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06: Women in need, Street based female sex workers in Dhaka city (Base line survey report) (Available in hard copy) 1997 |
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This report focused on findings of an assessment of AIDS/STD risks; risk perception and health seeking behavioral situation among street based female sex workers in Dhaka city. It was conducted in 1997 to collect data to help in the design, development and implementation of an HIV/AIDS and STD intervention program targeting the street based sex workers in Dhaka city.
For details mail to: hivinfo@carebangladesh.org |
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| 07: Base line survey report of IDUI: 1998 |
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This document focused on findings of an assessment of AIDS/STD risks; risk perception and health seeking behavioral situation among injecting drug users in Dhaka city. It was conducted in 1998 to collect data to help in the design, development and implementation of an HIV/AIDS and STD intervention program targeting the injecting Drug users in Dhaka city.
For details mail to: hivinfo@carebangladesh.org |
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08. HIV – Program monitoring and Evaluation plan/frame work (Draft) prepared by: Liza Tong, September 2003 (Document in Soft copy) |
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This document outlines some key Program M & E issues, describes changes to the log frame and motivation behind each change This is followed by some additional information on Program indicators, details on the M & E framework, a description of new tools and the process of tool design and finally establishes the timeframe for monitoring activities.
For details mail to: hivinfo@carebangladesh.org |
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D. Manuals: |
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01: Understanding Drug Addiction and Counseling Skills : Rukhsana Ayyub CARE 2005 (draft, CARE Document) |
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This manual has been designed for people working for the preventions of HIV/AIDS such as counselors, field staff and trainers. The main objective of this manual is to strengthen staff capacity to be able to understand addiction and its impact on the individual drug user and his family. The manual also addresses tools and skills essential for providing counseling to clients at various stages of recovery.
For details mail to: hivinfo@carebangladesh.org |
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