identifying at risk populations and hiv/aids referral ... - (SHOPS) project

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TABLE 10. PRIVATE HEALTH FACILITIES BY TYPE OF HIV/AIDS SERVICES Name Level HCT TB ART STIs OIs* DX RX Hema Higher clinic --- √ --- --- --- √ Dukem Medium clinic --- √ --- --- --- √ Biruk Lower clinic --- √ --- --- --- √ Hawi Biftu Diagnostic --- √ --- --- --- --- Selam Traditional Medical Center Traditional --- --- --- --- --- * OI=opportunistic infection Dukem has one public health center. It provides all HIV/AIDS-related services including chronic care, ART, and TB/HIV. The private clinics (one higher clinic, one medium clinic, one lower clinic, and a diagnostic laboratory) provide diagnostic and referral services for TB patients. None of these private health facilities provide counseling and testing and other HIV/AIDS-related services. The three clinics (higher, medium, and lower), however, do provide STI services. MARPs (truckers, FSWs, youth, and day laborers) in the town are reported to have limited knowledge about STIs including HIV and they have limited access to services. It was reported that MARPs such as FSWs and day laborers are the groups least likely to visit health facilities for problems such as STIs. It is also noted that youth and other MARPs lack friendly services; the town has no health facility that targets these groups. FSWs are also uncomfortable with health services provided at public health facilities for several reasons; the main ones are long waiting times, poor quality of services, and health providers’ negative attitude observed towards FSWs. Condom use Though condoms are widely used and easily accessible during the day, their higher price and unavailability at night makes it difficult for clients who unexpectedly need a condom. This finding means that innovative alternative distribution mechanisms for these groups are needed. HCT services Health service provision programs including HIV/AIDS services in Dukem are not targeted to the needs of MARPs. For example, the discussions with FSWs indicated that these women prefer to partake of HCT services during the afternoon, as it is the only time they have available. Moreover, most NGOs working on HIV/AIDS focus on the provision of income-generating activities (IGA) activities and other palliative care services. These agencies give very limited emphasis to the provision of HCT services in Dukem. 4.2 BISHOFTU Bishoftu is located in East Shoa zone of the Oromiya region, only 47 km east of Addis Ababa. The town has nine kebeles, and an estimated total population of more than 136, 000 (66,677 male and 69,395 female). 10
Risk setting and population Several factors put Bishoftu at an increased risk of HIV/AIDS transmission: It attracts local tourists and a good part of its population is transient, including large numbers of uniformed services members and day laborers from a number of factories and construction projects. In addition, many residents, especially women, are poor, and there is a significant number of FSWs. Abundant bars, nightclubs, recreational areas, hotels, and brothels facilitate interaction among these groups, exacerbating HIV transmission. TABLE 11. SIZE OF TARGET POPULATIONS IN BISHOFTU Target population Estimated number Commercial sex workers (CSWs) 1000 Migrant day laborers/unskilled construction workers 1500 Farm/plantation workers 2270 Fishermen 35 Uniformed government employees DK In-school youth (secondary & college) 8763 Out-of-school youth DK Petty traders/informal traders 2000 Truckers and bus drivers (entering and leaving the town) 116 Female sex workers As noted above, Bishoftu has a high concentration of bars, nightclubs, hotels, and brothels such as tella and araki bets where local brews are sold and most FSWs operate. The majority of these facilities are located in Kebeles 04, 05, and 06, along the main Addis-Adama highway. There are an estimated 800 permanent and 200 transient FSWs in Bishoftu. In addition to commercial sex being transacted in the above-mentioned sites, outdoor sex (in cars and recreational places) is reportedly becoming common, typically on the weekends, when visitors enter the town. According to the informants, FSW customers are often members of the uniformed services and day laborers. Bishoftu also has several schools and colleges with a high number of young girls enrolled. The practice of sex with very young girls (especially among older men from Addis) in exchange of money is common. TABLE 12. BARS, NIGHTCLUBS, BROTHELS (TELLA AND ARAKI BETS) WHERE FSWS OPERATE Name Ayer Woled Hotel Geberewoch Hotel Tourist Hotel Ayer Hail Hotel Tella, tej, and araki bets Tomi Bar Farmi Hotel Shuferoch Hotel Address Kebele 04 (along main road) Kebele 04 (along main road) Kebele 04 (along main road) Kebele 04 (along main road) Kebele 06 (along main road) Kebele 04 (along main road) Kebele 05 (to the West–Dukem Road) Kebele 04 (along main road) 11
Page 1: IDENTIFYING AT RISK POPULATIONS AND
Page 5: CONTENTS Acronyms .................
Page 9: ACKNOWLEDGMENTS We would like to th
Page 13 and 14: 1. BACKGROUND HIV/AIDS continues to
Page 15: 2. OBJECTIVES This assessment gathe
Page 18 and 19: 3.3 DATA COLLECTION The study had f
Page 20 and 21: FSWs believe that the persons most
Page 24 and 25: TABLE 13. STREET/KEBELES/SEFER WHER
Page 26 and 27: 4.3 ADAMA Adama is located in Easte
Page 28 and 29: TABLE 25. PLACES WHERE TRUCK AND BU
Page 30 and 31: Female sex workers There are an est
Page 32 and 33: nightclubs, and a significant numbe
Page 34 and 35: Day laborers/construction workers a
Page 36 and 37: Female sex workers Modjo has severa
Page 38 and 39: TABLE 50. NUMBER OF PUBLIC AND PRIV
Page 40 and 41: TABLE 55. TRUCKS AND MID/LONG-DISTA
Page 42 and 43: TABLE 60. SIZE OF TARGET POPULATION
Page 44 and 45: There are three NGOs providing HIV/
Page 46 and 47: TABLE 71. MAIN MARKETPLACE WHERE IN
Page 48 and 49: TABLE 76. PRIVATE HEALTH FACILITIES
Page 50 and 51: TABLE 80. TRUCKS AND MID/LONG-DISTA
Page 53 and 54: 5. DISCUSSION AND CONCLUSIONS The d
Page 55: 6. REFERENCES 1. Federal Ministry o
Page 58 and 59: Private pharmacies, drug stores/ven
Page 61 and 62: ANNEX B. NGOS WORKING IN HIV CARE A
Page 63 and 64: NGOs working in HIV care and suppor
Page 65 and 66: NGOs working in HIV care and suppor
Page 67: ANNEX C. TRUCK AND BUS COMPANIES TH

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