Plights of FSWs, FIDUs narrated
Source: The Sangai Express

Imphal, May 05 2019: For sex worker Shanti (name changed) Imphal's North AOC is her only safe haven from the brutal outside world.

According to her, even sparing a few hours for viral hepatitis screening means she has to suffer a big loss in her daily earnings as she could find multiple customers during the time slot.

Another reason Shanti cited for her reluctance to go for Hepatitis C screening was that she does not like any of her acquaintances see her in a place like ART centre or any place where Hepatitis C treatment is done.

Like Shanti, many other Female Sex Workers (FSWs) are compelled to concentrate more on hooking up customers rather than their health problems as sex trade is the only means to meet their daily needs, including required dosage of heroin they require in a day, if they happen to use drugs.

Information gathered from Nirvana Foundation, Imphal, an NGO which runs a Targeted Intervention (TI) Project Centre solely for Female Injecting Drug Users (FIDUs) at North AOC, revealed that 269 FIDUs, most of whom are also sex workers, have been registered in the said TI Project Centre.

Hijam Devlakshmi, Project Manager of the said TI Centre informed that FIDUs seldom come for health check-up as many of them do not have time to go to health care centres.

She said that 19 among the 269 FIDUs registered at the TI Centre were found HIV positive and 18 of them are undergoing Anti Retroviral Therapy (ART) .

24 FIDUs enrolled in the TI centre underwent screening for viral Hepatitis C last year and 14 of them were found positive.

Two of the HCV infected FIDUs have already undergone treatment under a free viral Hepatitis screening and treatment project, she continued.

The Project Manager then underscored the importance of bringing some changes in the general public's outlook towards FSWs and FIDUs, saying that discriminating FSWs and FIDUs will only increase the risk of spreading HIV and viral Hepatitis in the State.

She observed that discrimination and stigmatization are a huge barrier in the process of rehabilitating FIDUs and FSWs.

Many of the FIDUs and FSWs often relapse to their previous status (drug addiction) or profession (sex trade) after recovery as they found that the only way for avoiding stigmatization and discrimination is returning and mingling with their own lots, she added.

Pointing out that stigmatization and discrimination of FIDUs and FSWs by the society is also a major deterrent to seeking health care by FIDUs and FSWs, the Project Director opined that discriminating FIDUs and FSWs will ultimately affect the general population when they have sexual relation with general populace.

JNIMS Assistant Professor and Gastroenterologist Dr N Suraj noted that re-infection of viral hepatitis after treating hepatitis C is very common among IDUs.

Maintaining that National Viral Hepatitis Control (NVHC) Programme gives special thrust on minimizing re-infection of Hepatitis C, he further stressed on the need for giving special emphasis on 'hot spots' while addressing the issue of reinfection of Hepatitis C.He then asserted that stigmatization and discrimination hinder a lot in Viral Hepatitis control and prevention.

"Discrimination and stigmatization discourage many people, particularly the spouses of IDUs to come out for Hepatitis screening and treatment.

Even those persons who do not have any link with drugs or extramarital affairs but infected with viral hepatitis are being considered as people who have behavioural defects in the society", he said.

Maintaining that HCV is a "silent killer" as its signs and symptoms are usually manifested only at the late stage, the Gastroenterologist explained that the basic aim of NVHC is to screen, detect and treat those people who have been infected by viral hepatitis in the early stage.

Community Network for Empowerment (CoNE) president RK Nalinikanta highlighted the main issues concerning FIDUs in the State saying that the social adversity, high levels of stigma and poor social support characterize FIDUs.

He conveyed that the implementation of harm reduction programme/strategy for FIDUs is still poor on ground in the State and he cited multiple cases of re-infection by HCV among FIDUs in the State.

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