1. Statement of needs
Tibetan refugees in India, approximately 83,000, should be categorized as a high risk group for HIV infection, due tohigh mobility, poverty, and lack of access to healthcare facilites. About 65% of the Tibetan refugee workforce travel in India seasonally as street venders; most of them travel to urban areas alone and are separated from their family for several months out of the year. Although no formal study has been conducted to determine the risk factors among Tibetan male refugees, it is highly speculated that they are at risk of exposure to HIV due to engaging in unprotected sex with commercial sex workers(1). According to the WHO, HIV prevalence among commercial sex workers is significantly high in India; for example, in Bombay, 60 % of sex workers are HIV positive. India has the third highest number of HIV infections in the world, and 85.6 % of cases are sexually transmitted. The above data on HIV/AIDS in South-East Asia should be considered a warning to the community. The prevelence rate of HIV infection among Tibetan community is not offically announced but one data showed that 2 out of 45 Tibetan youth tested were HIV positive, as a result of a random sample test conducted in 2006. It leads to a conclusion that a dedicated program of education intervention and treatment is needed in the Tibetan refugee community. Despite of the urgent needs to tackle with HIV issues in the community, there are few awareness and prevention programmes visible within the communities. CHOICE takes an initiative to scale up prevention intervention and design and implement comprehensive HIV programs. Our challenges include: promoting behavior change among people through a broad communication of information on HIV, developing women’s negotiation skills through gender workshops; and reducing stigma and discrimination against people living with HIV/AIDS (PLHA). CHOICE plays a facilitator’s role in community mobilization and sensitization. We recognize that every phase of our programs should be people-centered and respond to people’s need. Therefore, involvement of every stakeholder, including Tibetan Government in Exile (TGiE), NGOs, local community and People living with HIV/AIDS (PLHA) in designing and implementing programs is crucial to the success of our project. This strategy would bring a sense of ownership among the project beneficiaries and would help for sustainability of the project. (1) “Migration for work, seasonal labor and professions such as truck-driving can separate men from their spouses or regular partners for long periods, increasing the likelihood of entering into casual, unprotected sex, including relationships with sex workers” (UNAIDS. 2006, HIV/AIDS and Gender: Facts sheets).
2. Organaizational history
Responding to the need for HIV/AIDS intervention, with supports from Lung-ta Project (Japanese NGO), CHOICE was established in 2007 by three Tibetan medical personnels and three social workers in order to take action to: scale up prevention intervention and design and implement comprehensive HIV programs. Our challenges include: promoting behavior change among men and women through a broad communication of information on HIV prevention such as promoting condom use, developing women’s negotiation skills through empowerment workshops; and reducing stigma and discrimination against people living with HIV/AIDS (PLHA). The Board Members of CHOICE: Mr. Dawa Tsering, MP Tibetan Parliament Mr. Karma Yeshi Nazee, Editor Voice of Tibet Dr. Tenzin Namdul, Tibetan Medical & Astrological Institute of H.H. the Dalai Lama Institute of H.H. the Dalai Lama (TMAI) Dr. Yangzom Dolkar, Delek Hospital Dr. Rigzin Sangmo, TMAI Nurse Tsering Paldon, Delek Hospital Ms. Dolma Choephel, Kunphen Centre for Substance Use and Drug Abuse Mr. Sonam Topden, PGT, TCV Gopalpur Mr. Tashi Dhondup, Health Worker, Sherabling Mr. Tenzin Lekphel, Kunphen Centre for Substance Use and Drug Abuse Mr. Phuntsok Chomphel, RTYC top