FINAL REPORT Updating Mapping and Size Estimation for Core Groups at Risk of HIV/AIDS in West Bengal Commissioned by West Bengal State AIDS Prevention and Control Society Quest Asia Flat GA1, 201 Jodhpur Park Kolkata 700 068 Final Report: Updating Mapping and Size Estimation for Core Groups at Risk of HIV/AIDS in West Bengal Prepared for West Bengal State AIDS Prevention and Control Society March 2007 A Study Conducted by Quest Asia, Flat GA1, 201 Jodhpur Park, Kolkata 700068. CONTENTS EXECUTIVE SUMMARY ................................................................................................................................... 1 I INTRODUCTION.............................................................................................................................................. 9 1.0 BACKGROUND................................................................................................................................................ 9 1.1 NEED FOR MAPPING EXERCISE .................................................................................................................... 10 1.2 SCOPE OF THE MAPPING EXERCISE ............................................................................................................... 10 1.3 OBJECTIVES OF THE PRESENT STUDY ........................................................................................................... 11 II METHODOLOGY ......................................................................................................................................... 13 2.0 DEFINITION OF CORE GROUP........................................................................................................................ 13 2.1 GEOGRAPHICAL COVERAGE ......................................................................................................................... 13 2.3 RESEARCH TOOLS......................................................................................................................................... 14 2.4 RESEARCH TECHNIQUIES.............................................................................................................................. 14 2.5 TRAINING OF FIELD TEAM ............................................................................................................................. 15 2.6 TYPES OF SITES MAPPED AND ESTIMATED..................................................................................................... 15 2.7 APPROACH.................................................................................................................................................... 15 2.8 FIELD OPERATION ......................................................................................................................................... 19 2.9 DATA MANAGEMENT AND ANALYSIS ............................................................................................................ 22 2.10 LIMITATIONS .............................................................................................................................................. 22 2.11 VALIDATION OF RESULTS............................................................................................................................ 22 2.12 UNCOVERED AREAS .................................................................................................................................... 22 III ESTIMATES OF CORE GROUP POPULATION .................................................................................. 24 3.0 INTRODUCTION ............................................................................................................................................ 24 3.1 OVERALL SIZE ESTIMATE ............................................................................................................................. 24 3.2 NUMBER OF SITES COVERED FOR CORE GROUP POPULATION IN WEST BENGAL............................................ 24 3.3 ESTIMATED SIZE FOR CORE GROUPS POPULATION IN WEST BENGAL (DISTRICT WISE) ............................... 26 3.4 FEMALE SEX WORKERS .............................................................................................................................. 27 3.4.1 Introduction ......................................................................................................................................... 27 3.4.2 Site Summary of Female Sex Workers in West Bengal ........................................................................ 27 3.4.3 Brothel Based Sex Workers.................................................................................................................. 32 3.4.4 Non Brothel Based Sex Workers......................................................................................................... 37 3.4.5 Home Based Sex Workers.................................................................................................................... 58 3.5 MEN HAVING SEX WITH MEN...................................................................................................................... 62 3.5.1 Introduction ......................................................................................................................................... 62 3.5.2 Site Summary of Men having Sex with Men in West Bengal................................................................ 62 3.5.3 Men having Sex with Men.................................................................................................................... 67 3.5.4 Male sex Workers ................................................................................................................................ 80 3.5.5 Hijras.................................................................................................................................................... 85 3.6 INJECTING DRUG USERS .............................................................................................................................. 91 3.6.1 Introduction ......................................................................................................................................... 91 3.6.2 Site summary of Injecting Drug Users in West Bengal........................................................................ 91 3.6.3 Injecting Drug Users ........................................................................................................................... 95 ANNEXURE ....................................................................................................................................................... 109 Abbreviations used AIDS Acquired Immuno Deficiency Syndrome BBSW Brothel Based Sex Workers CBO Community Based Organisation CKI Community Key Informant CSW Commercial Sex Worker FSW Female Sex Worker HIV Human Immunodeficiency Virus HBSW Home Based Sex Workers HRB High Risk Behavior HRGs High Risk Groups IDA International Development AIDS IDUs Injecting Drug Users MC Municipal Committee MSM Men having Sex with Men MSW Male Sex Worker NBSW Non Brothel based Sex Workers NACO National AIDS Control Organisation NACP National Aids Control Programme NGO Non Government Organisation NM Non Municipal TIs Targeted Interventions TWG Technical Working Group UNAIDS United Nations AIDS WBPSU West Bengal Project Support Unit WBSAP&CS West Bengal state AIDS Prevention and Control Society Acknowledgement Quest Asia extends its gratitude to West Bengal State AIDS Prevention & Control Society (WBSAP&CS) for providing financial resources for this study We also gratefully acknowledge the contribution of Dr. R. S. Shukla, - Project Director, WBSAP&CS, Mr. Udayan Pandya - Divisional Manger RCSHA, Mr. Mahesh Nathan – Team Leader WBPSU and his colleagues for their insights, constructive criticisms, and valuable recommendations throughout the research process. Quest Asia team fondly acknowledge the contribution of Mr. Guna Shekharan Rajaratnam, National Mapping Consultant who has guided us in different stages of the study. We express our gratitude to the members of the Technical Working Group. We also take this opportunity to thank the members of all TI partners, who have provided valuable support to our field researchers. Many individuals have provided direct and or indirect support to bring this report to successful completion. We thank all of them, even if they are not mentioned individually by name. Updating Mapping & Size Estimation for Core Groups At Risk of HIV/AIDS in West Bengal EXECUTIVE SUMMARY Introduction The threat of HIV/AIDS looms large over India, necessitating adequate and effective response to meet this deadly disease. NACO estimated that the number of people infected with HIV in India increased from 3.86 million in 2000 to 5.2 million in 2005. The HIV/AIDS epidemic in India is characterised by heterogeneity. The transmission route is predominantly heterosexual (85.7%), of except in the North Eastern states where injecting drug use is a major driver of HIV transmission. To combat the pandemic, NACO had already been implemented NACP I and II. The programmme has reached the third crucial phase in the country’s battle against HIV/AIDS - National Aids Control Programme III. The thrust area for NACP-III is a move from project to program mode and changing the role of NACO from implementing agency to program catalyst through State AIDS Control Societies (SACS). The 'targeted interventions' approach was a key strategy of NACP II all over the country in partnership with NGOs/CBOs offering services like accessibility