Fast Track VCT@WORK – Closing the HIV testing gap

Nearly 1 million workers took the HIV test in 2016 in five Indian states. Successes continue but ILO pushes for greater cooperation for an integrated response to HIV and AIDS.

Close to one million workers showed up at the government-run Integrated Counselling and Testing Centres in five Indian states (Delhi, Jharkhand, Madhya Pradesh, Maharashtra and West Bengal) and took the HIV test in 2016. Since July 2013, the ILO in these states has been working closely with its partners— governments, employers, and unions —as well as state AIDS Control Societies under its Voluntary Counselling and Testing for Workers or the VCT@WORK Initiative.

On 16-17 February in New Delhi, the HIV testing data was presented and discussed at a National Workshop organized by the National AIDS Control Organization (NACO), Ministry of Labour and Employment (MOLE) and the ILO. As over 30 percent people living with HIV in India do not know their status, the theme of the workshop was “Fast Track VCT@WORK”.

Dr Arun K Panda, Add Secretary and DG NACO, encourages people to test early and be aware of their health status
Dr Arun K Panda, Additional Secretary and Director-General, NACO during his inaugural address at the workshop said “People do not demonstrate health seeking behaviour and this trend is similar for HIV as well. We must encourage people to get tested so that they know their health status”.

Dr Panda also stressed on the need to end stigma and discrimination in order to encourage people to opt for HIV testing.

The VCT@WORK Initiative builds on the ILO’s Getting to Zero at work campaign, which was first launched in India. In order to promote HIV testing, a communication package under the theme of the Earlier, the Better has been developed and is being actively used in India.

The national workshop, now organized for the third consecutive year, brought together 48 participants (18 women and 30 men) from state AIDS Control Societies, National Board for Workers’ Education, trade unions, corporates and organizations of people living with HIV.

The ILO has assisted NACO in analyzing the HIV testing data for workers for three years. In three years, over 20 million workers have undertaken HIV testing in India. From this analysis, HIV positivity among workers was found to be at 1.4 per cent, which is over five times higher than the 0.26 per cent HIV prevalence among general population in India. The data has been analyzed state-wise, gender-wise and occupation-wise. Truck drivers, with HIV positivity of 2.65 per cent, were found to be the ones having the highest positive cases among all other occupational categories. This was followed by other transport workers (1.92 per cent), hotel workers (1.82 per cent), and agricultural workers (1.69 per cent). The participants used this analysis and state-wise results to develop action plans by prioritizing interventions among occupational groups that showed higher HIV positive cases in their states.

Shauna Olney, Chief, Gender Equality and Diversity and ILOAIDS, Geneva, said, “An extraordinary amount of work has been done in India. Successful initiatives, such as VCT@WORK, need to be continued and scaled up. The VCT@WORK is not only about mobilizing workers to test for HIV. It focuses on ensuring non-discrimination at work and enhancing access to treatment. When employed, workers are more likely to adhere to treatment and suppress their viral loads. This way the VCT@WORK Initiative contributes to all the three 90-90-90 targets of the fast track response to AIDS.

Olney also stressed that the AIDS response has to be gender-responsive, addressing harmful traditional norms, practices as well as inequalities. She highlighted the challenges still being faced in the AIDS response and cautioned that “AIDS is not over yet.”

Dr Naresh Goel, Deputy Director General, NACO said: “Over 30 per cent people in India do not know their HIV status. Most people are in informal employment and are vulnerable. We must expand HIV testing, and reach out to them.”

The ILO corporate partners - Coal India Limited, Bombay Electric Supply and Transport (BEST), JK Tyres, Transport Corporation of Indian Ltd. and Ambuja Cement - shared their experiences with the participants in a session on strengthening public-private partnerships.
ILO corporate partners sharing their experiences
The workshop had a very positive evaluation. 63 per cent participants said they will be able to apply what they learnt during the workshop, 70 per cent said their organizations will benefit from their participation in the workshop, and 78 per cent said the analysis of HIV testing data for workers provided them with the clarity they needed for better positioning of their workplace and galvanizing private sector efforts to scale up VCT@WORK.

The key learnings of the workshop shared by the participants were on — doing better advocacy with businesses, triggering behavioural change communication for workplace programme, mainstreaming of HIV testing in different departments and strengthening private public partnerships. Lastly the participants also said that using the HIV testing data to prioritize interventions in their states will be a critical step.

Panudda Boonpala, Director, ILO Decent Work Team for South Asia and Country Office for India said, “I am very happy to see the outcome of the group work presented by the participants. It is good to see the HIV testing data for workers being put to good use in prioritizing action on certain economic sectors in each state.” She thanked NACO and assured continued support from the ILO.

ILO and NACO will be working together to follow up on the main recommendations of the workshop. These are-
  1. Organizing regional sensitization workshops;
  2. Better defining the occupational category of workers in the national system,
  3. Strengthening the mainstreaming of HIV testing with the aid of different ministries/governmental departments; and
  4. Strengthening the link between HIV testing and treatment.