Saadhan HIV/AIDS Helpline - Mumbai, India

The Saadhan Helpline is a call-in centre located in Mumbai. Currently operational from 10am to 9pm Monday through Saturday, the helpline is staffed by 3 counselors, who are supervised by a clinical psychologist/counselor. Counselors are recruited and trained by PSI; when counselors began receiving a number of calls on homosexuality, counselors were trained by the Naz Foundation, an organisation working with men who have sex with men. Counselors help callers through difficult times: for example, they may provide support to callers who have recently learned that they are HIV-positive. They also provide health information and counseling on topics such as sexuality, masturbation, contraception, pregnancy, HIV/AIDS, and sexually transmitted infections (STIs). A doctor is also available during certain hours if callers wish to speak with one.

A computer software package was designed to complement helpline services. The software, which operates on 4 computers at the call-in centre, contains a data bank with a list of possible questions and appropriate responses, as well as a contact list of health and social services for referral. The software tracks clients so that counselors can follow up with repeat callers, as well as a local lingo list that enables counselors to access slang and vernacular terminology that clients may use. In addition to serving as an HIV/AIDS information and counseling resource for counselors, the software programme documents information on callers and call content for monitoring purposes. Organisers explain that information extracted from the monthly reports can be used for developing HIV/AIDS prevention interventions.

Two PSI mass media communication campaigns have promoted the Saadhan Helpline. The Balbir Pasha campaign promoted the helpline number through billboards and press inserts in January and February 2003 (click here to read more about this campaign). The Saadhan Clinic campaign, running since April 2003, promotes the helpline number along with the Clinic's voluntary counseling and testing (VCT) services through the use of billboards and wall paintings in high-risk areas, on train panels, and in press inserts. These ads feature the slogan "Right advice equals peace of mind".

PSI is interested in helping others replicate this HIV/AIDS helpline. The Saadhan Helpline Set-up Manual includes guidance on estimating helpline demand as well as suggestions for recruitment and training of counselor and management staff. This manual is intended for use with the computer software, which can be set up at additional sites. (PSI plans to expand the Saadhan Helpline to other high-risk cities in India, including the port cities of Chennai and Viskakhapatnam). In addition, the Saadhan Helpline User Manual serves as a reference and training tool to guide staff in using the software system.

HIV/AIDS, Sexual and Reproductive Health, Technology.

According to UNAIDS and the National AIDS Control Organization (NACO), India has an estimated 3.5 to 4 million HIV infected people and is home to the second largest HIV infected population in the world. Approximately 80% of HIV cases in India have been transmitted through heterosexual sex. Mumbai sits at the epicentre of the HIV/AIDS epidemic - the city is home to the largest brothel-based commercial sex work area in India, with an estimated 6,000-10,000 commercial sex workers (CSWs). Over 50% of CSWs in Mumbai are estimated to be HIV-positive.

PSI selected a helpline as a tool to exchange information about HIV/AIDS because they say it is a low-cost, anonymous, and confidential channel that offers personalised interaction with a professional. This medium is especially helpful, they say, in that the concept of talking freely to a doctor is not common in Mumbai, especially about sex and HIV/AIDS. To compound information barriers, people do not wish to be seen at places associated with HIV/AIDS due to associated stigma. Telephones are widely accessible in Mumbai; in addition to cellular phones and landlines, public phones are available nearly every 100 meters.

From January through May 2003, 5066 clients used the helpline, with an average of 1000 callers per month. The majority of these callers were single males between the ages of 21-30 years old, who often called to request information about modes of HIV/AIDS transmission. The majority said that one of the campaigns first alerted them to the existence of the helpline.

With funding from the U.S. Agency for International Development (USAID), PSI is implementing Operation Lighthouse, a 5-year (2001-2005) HIV/AIDS/STI intervention programme. This national programme is being implemented across 12 port communities along the east and west coasts of India, with a core technical team based in Mumbai. The programme involves various integrated communication and service provision strategies that are designed to decrease the spread of the epidemic among vulnerable groups associated with the port facilities.