Behaviour Change Communication strategies for HIV/AIDS

- An impact study on sex workers in Coastal Andhra Pradesh

Objectives:
o To list the BCC strategies and check Sex workers access to understand.
o To examine whether the BCC strategies enhanced knowledge and created awareness about HIV/AIDS
and personal risk factors.
o To ascertain whether BCC strategies have led to adoption and continued use of safer sex practices.
o To assess whether BCC motivates sex workers to visit clinics for treatment of STIs and opportunistic
infections.
o To check if BCC helps care & support of HIV positives.
o To find out if BCC mobilised community members to strengthen HIV/AIDS prevention programme.

QUESTIONNAIRE (Multi-stage deliberate Sampling)

Location / Village: Mandal: Dist:

General Information:
1. Age
(1) 18 – 24 Years (2) 25 – 31 Years (3) 32 – 38 Years (4) 39 - 45 Years (5) 46 Years and above
2. Education
(1) Illiterate (2) Literate with non-formal education (3) Primary / Middle (4) High School (5) Higher
education / Technical / Professional courses(6) Any others__________________________
3. Occupation
(1)Housewife (2) Unemployed / Not working (3) Student (4) Non-Agricultural labourer (5) Domestic
servant (6) Agricultural labour (7) Cultivator (8) Small artisan in Household and Cottage Industry (9)
Any other__________________________
4. Marital status
(1)Unmarried (2) Married (3) Divorce (4) Widow
5. With whom do you currently live
(1)Alone (2) Parents (2) Husband (3) Divorce with Husband and Living alone (4) Friends (5)
Temporary Husband / Lover (6) Partner (7) Any others__________________________
6. Do you have Children, If yes how many
(1) 0 (2) 1 (3) 2 (4) 3 (5) 4 or more than 4
7. Total number of family members
(1) 1 - 3 (2) 3 - 5 (3) 5 - 7 (4) 7 – 9 (5) 10 and above
8. Number of dependable family members
(1) 0 (2) 1 (3) 2 (4) 3 (5) 4
9. What is your total Income from all the sources in a given month (including Sex work)
(1) Below Rs.2500 (2) below Rs.5000 (3) below Rs.10,000 (4) more than Rs.10,000
(1) Objective: To check the awareness of BCC strategies among Sex Workers
10. Did anyone in the past, approach you to educate the STI / HIV prevention programme. Yes / No
If Yes, who are they
(1) NGO staff / Social Workers (2) Community Peer’s / Guide’s from local NGO’s (3) World AIDS Day
event programme / ASHA Volunteers / ANMs (4) Friends / Neighbour (5) Temporary Husband / Lover (6)
Clients (7) Brothel owners / Pimps (8) Any other________________________
11. Did anyone in the past, approach you to educate on use of condoms? Yes / No
If Yes, who are they
(1) NGO staff / Social Workers (2) Community Peer’s / Guide’s from local NGO’s (3) World AIDS Day
event programme / ASHA Volunteers / ANMs (4) Friends / Neighbour (5) Temporary Husband / Lover (6)
Clients (7) Brothel owners / Pimps (8) Any other________________________
12. Kindly re-collect the Communication tool’s / material’s used by the NGO staff / Community Guide’s
(1) Print material (Posters / Leaflets / Flipcharts / Pamphlets / Booklets (2) Traditional Communication
(Cultural activities (Drama / Skits / Street play / Puppet show)) (3)Oral Communication (4) Electronic form
(5)Game shows / Adult learning method or activities (6) All the above
13. How do they inform about STI / HIV prevention communication?
(1) Print material (Posters / Leaflets / Flipcharts / Pamphlets / Booklets (2) Traditional Communication
(Cultural activities (Drama / Skits / Street play / Puppet show)) (3) Oral Communication (4) Electronic form
(5)Game shows / Adult learning method or activities (6) All the above
14. Why do they educate about HIV / AIDS to you (your community) only
(1) We are sex workers (2) We have sex with many clients (3) Some of our community people died of AIDS
(4) It is spreading very fast (5) It is a dangerous disease (6) Need to protect ourselves (7) Any other_______
15. Why do you think HIV prevention communication is necessary?
(1) Protection of Life (2) It will protect my family (3) To generate more income (4) Scared (5) If I will be
affect, my family in trouble (6) If I will be affect, society will be prohibit me (7) Any other______________
16. Which is the most important source of the STI, HIV / AIDS information?
NGO staff / Social Workers
Print material (Posters /

husbandClients /Temporary
NewspaperTV / Radio /

Peer’sCommunity Guide’s /

Traditional Communication
ANMs / ASHA Volunteers

Friends / Neighbours
Pamphlets / Booklets)

Sources of Information

Which is the
most important
source of the STI,
HIV / AIDS information?

Use and benefit of condoms

Symptoms of STIs
Complete treatment of STDs
Safer sex practices
Risk perception
Importance of Internal
examination / Medical check-up
Transmission of HIV
 (2) Objective: To examine whether the BCC strategies enhanced knowledge and created awareness about
HIV/AIDS and personal risk factors.
17. Do you feel you are at risk of contracting STIs or HIV / AIDS? Yes / No
If Yes, how do you know, you’re in risk to infect the STI / HIV
(1) NGO staff / Social Workers (2) Community Peer’s / Guide’s from local NGO’s (3) World AIDS Day
event programme / ASHA Volunteers / ANMs (4) Friends / Neighbour (5) Temporary Husband / Lover (6)
Clients (7) Brothel owners / Pimps (8) Any other________________________
If yes, what do you feel is your level of risk of contracting HIV / AIDS?
(1) Yes (2) No (3) I don’t know (4) 50 – 50 percent (5) May be or May not be
18. How many sexual encounters you had in last one week
(1) 5 -10 (2) 11 - 15 (3) 16 - 20 (4) 21 - 25 (4) 26 and above
19. Do you know, how to use the condoms Yes / No
If Yes, are you using the condoms Yes / No
If Yes, In last one month, how many times did you think you have a sexual intercourse without using a
Condom?
(1) Sometimes (2) Never (3) Usage with Clients but not the Temporary Husband / Lover
20. What are the benefits of using Condoms with all the sexual partners
(i) To prevent Pregnancy (ii) Prevent Sexual Infections or STDs (iii) Prevent Risk to prone any other
diseases (iv) Prevent HIV / AIDS infection from others (v) For more enjoyment to the clients
(1) i only (2) ii, iii & iv only (3) v only (4) i, ii, iii, iv & v only
21. Reasons for not using a condom with clients?
(i) Client doesn’t accept (ii) Client offer more money for without condom (iii) Client look like more healthy (iv)
One time exception (v) Regular Client (vi) Sudden / Unplanned (vii) Didn’t have condom (viii) Using Anti-
biotic medicine (9) Applying Oil’s / Homeopathy medicine to Vagina
(1) i, ii, iii, iv & v only (2) vi, vii only (3) viii & ix only (4) v & vi only (5) I only (6) ii & iii only (7) All the above
22. Reasons for not using a condom with Temporary Husband / Lover
(1) Sudden / Unplanned (2) Didn’t have condom (3) One time exception (4) Love / Affection (5) Using
Anti-biotic medicine (6) Applying Oil’s / Homeopathy medicine to Vagina (7) Any other_______________

Question Strong Agree Can’t Strong Disagree

Agree say Disagree
23 Uses of condom in every sexual encounter with all the
partners have a good protection against getting STIs /
HIV / AIDS?
24 Using double condom’s provide protection against STI /
HIV infection
25 Condoms distributed free of cost, do not provide complete
safety from STI / HIV
26 Person can be suffering from STI’s had a greater chance
of HIV /AIDS exposure
27 Sexual intercourse by Oral / Anal does not infect the
STI’s / HIV
28 People can be cured of STI/HIV by having sex with a virgin
29 Washing with Dettol or any other septic lotion at Vagina
 after sexual intercourse will avoid STIs / HIV infection
30 People can be completely cured of HIV / AIDS by taking
prescribed medications from a chemist or drug store or
any other person
31 A person get HIV /AIDS from a mosquito bite, if the
mosquito has been already used by HIV /AIDS infected
person

(3) Objective: To ascertain whether BCC strategies have led to adoption and continued use of safer sex
practices.
32. Are you aware that your partner (Temporary Husband / Lover) has sexual intercourse with others? Yes /
No
If Yes, Have you ever discussed with your partner (Temporary Husband / Lover /Client) on chances to spread
the STIs / HIV to both of them?
(1) Yes (2) No (3) Don’t remember (4) Some extent
33. Are there particular segments of society that will reject condom usage?
(1) Young College going students (2) Illiterates (3) Regular customers (4) Aged persons (5) Labour’s (6)
Rickshaw Pullers / Auto Drivers (7) Lorry Drivers (8)Police men (9) Goondas
34. Are you trying to use the condom with the rejected clients? Yes / No
If Yes, how do you convince your sexual partner (client) to use condom?
(i) By explanation of the risk factors (ii) Using of communication material (iii) Recollecting old experiences
(iv) Remembering the family position (v) Practice of Inter Personnel Communication (vi) With forcefully (vii)
Without knowing the Customer
(1) i, ii, iii, iv & v only (2) vi only (3) vii only (4) All the above
35. Have you refused to have sex without condom with your client for any reason in the past six months
(1) Yes (2) No (3) Don’t remember (4) Don’t know
36. At any time did you use condom with your spouse? Yes / No
If Yes, for what purpose have you used a condom?
(1) To avoid pregnancy (2) To protect myself from STI/HIV/AIDS (3) To protect my partner from
STI/HIV/AIDS (4) For pleasure (5) No Response
37. Do you think that a healthy looking person can also transmit STI / HIV infection? Yes / No
38. Have you ever heard of any diseases other than STDs that can be transmitted through sexual contact?
Y/N
39. People can get HIV / AIDS from an infected blood transfusion?
Yes / No
40. People can get HIV/AIDS by getting injection with a needle that has been already used by someone else?
Y/N
41. Can HIV positive pregnant woman transmit the virus to her unborn child? Yes / No
42. Can a HIV positive woman transmit the virus to her newborn child through breastfeeding?
Yes / No
(4) Objective: To assess whether BCC motivates sex workers to visit clinics for treatment of STIs and
opportunistic infections
 43. Are you aware of the symptoms of the STIs?
Yes / No
44. STI symptoms can be seen only around the sex organs? Yes / No
45. Do you have pain / burning while passing urine in the past?
Yes / No
46. Do you have white discharge with foul smell in the past? Yes / No
47. Have you had an ulcer or sore in your genital area in the past?
Yes / No
48. Do you consult the doctor for any of the STI symptoms? Yes / No
49. After how many days do you consult the doctor after noticing STI symptoms?
(1) 1 -5 (2)5 -10 (3) 15 days (4) 1 month (5) 2 months (4) When it was happening continuously (5) 6 months
50. How many times do you think you have consulted the doctor for the same problem?
(1) Twice (2) Thrice (3) Number of times (4) Don’t remember (4) Till completely cured
51. Are you aware of that, the regular medical check-up (Internal examination) is required? Yes / No
If Yes, are you testing the internal examination regularly (1) Yes (2) No (3) Not regularly (4) No Response
52. How do you know the symptoms of the STIs and the importance of the regular medical health check-up
(Internal examination) for being a healthy person?
(1) Educated by the local NGO staff (2) Community Guide’s / Peer’s (3) Reading the pamphlets / Books (4)
Watching the Films / Documentaries of HIV / AIDS (5) Participating the awareness programme’s

(5) Objective: To check if BCC helps care & support of HIV positives
53. Which features of the person will help us to tell his / her HIV status?
(1) Prolonged illness (2) Regular weight loss (3) Continuously Cough (4) 1, 2 & 3 (5)None of these
(6) Through Blood / HIV test only
54. Do you receive counselling and basic information from the Government health providers about HIV / AIDS,
to know the HIV status? Yes / No
55. There should be mandatory HIV test for sex workers?
Yes / No
56. Are you aware of any facility in your area where you can get tested for HIV / AIDS?
Yes / No
57. Are you positive Yes / No If Yes,
Do you or anybody of them feel you are treated differently because of HIV status? Yes / No
Are you facing or have faced discrimination from community? Yes / No
Are you facing / have faced discrimination from family? Yes / No
58. Would you share food / shake hands / hug / share the cloths with an HIV / AIDS patient? Yes / No
59. In which of the following domains / areas do HIV / AIDS infected person face maximum problems and
discrimination?
(1) Spouse(2) Children (3) Parents (4) Friends (5) Employer (6) Any others_____________

(6) Objective: To find out if BCC mobilised community members to strengthen HIV/AIDS prevention
programme
60. Did you ever attend / participate in any campaign / meeting on STIs /HIV / AIDS? Yes / No
If Yes, which campaign / meeting do you attend on STIs /HIV / AIDS?
(1) World AIDS Day (2) Local NGO conducted events (3) Special Events conducted by Health Department /
Government (4) Celebrities meeting (5) Rally’s – for creating awareness (6) Local prevention programme
61. Did anyone in the past, approach you to educate on necessity of community mobilisation of prevention of
STIs / HIV? Yes / No If Yes, how they approach
(1) Print material (Posters / Leaflets / Flipcharts / Pamphlets / Booklets (2) Traditional Communication
(Cultural activities (Drama / Skits / Street play / Puppet show)) (3) Oral Communication (4) Electronic form
(5) Game shows / Adult learning method or activities (6) All the above
62. After interaction with the NGO staff / Peer’s or Community Guide’s, are you interest to participate the
HIV/AIDS prevention program? Yes / No
63. Do you think, is it necessary for community mobilisation to strengthen HIV / AIDS prevention programme?
Y/N
If Yes, are you part of the community mobilisation? Yes / No