The document outlines steps to assess HIV risk among migrant construction workers: 1) map sites and worker demographics, 2) conduct a KABP study among 380 workers on knowledge, attitudes, behaviors and practices, 3) analyze stakeholders' roles in reducing risk. The KABP found poor HIV knowledge, high-risk behaviors like alcohol use and sex work, and stigma. Stakeholders like contractors and group leaders were willing to support interventions. There is a need to work with all stakeholders to address HIV risk factors and improve prevention efforts for this vulnerable group.

2.  Conduct mapping exercise to identify potential sites
and provide information on geographical areas where
migrant construction workers are present, their origin
and size
 Carryout a knowledge, attitude, behavior and practice
(KABP) study to assess the level of risk for HIV
infection among the migrants at the potential
intervention sites, and
 Carryout stakeholder analysis at the identified
destination sites to assess their role in reducing HIV risk
among the migrant construction workers.

3. Mapping
 conducted in the identified geographical areas (not the
entire taluka)
 carried out at three types of locations where migrant
construction workers congregated (Nakas) /worked
(Construction sites)/ lived (Bastis).
 Conducted using Primary Key Informant Interviews
 Trained NGO workers conducted mapping
 Information gathered during mapping included –
estimated number of migrants, migration
behavior, risk factors and HIV/AIDS services available

4. KABP Survey
 conducted using a standardized questionnaire
developed by ILO for workers in the
unorganized sector
 Conducted at 15 locations in Panvel taluka (6
Nakas, 6 Construction sites, and 3 Bastis)
identified for intervention
 Among a sample of 380 using random
sampling with PPS approach at each location
 Trained NGO workers conducted the fieldwork

5. Stakeholder analysis
 conducted using in-depth interviews
 Stakeholders consisted of Contractors,
Mukadams (group leaders of construction
workers), and NGO workers (NMS) associated
with construction workers.

6. Mapping




7.  In all, 86 locations were mapped (6 Nakas, 31
Construction sites and 49 Bastis)
 There were 36,571 migrant construction workers in
these locations
 Nakas had high mean no. of workers per location
(783) compared to Bastis (586) and construction
sites (144)
 No. of migrants increased by 10-15% during peak
seasons (April-May, Oct.-Nov)
 Two-third of the migrant construction workers
were men
 Most of the workers were from the weaker sections
of the society

8. 12.0
Maharashtra
11.0
Uttar Pradesh
Karnataka
51.0
12.0 Bihar
Others
14.0

9. 80 76
71
70 67
59
60
52
50
40
33
30 25
22
20
10
0
% Seasonal workers % Living singly
Naka Constructin site Basti Basti (NFN)

10.  Two-third of the locations had sex workers
operating nearby (brothels, etc.)
 Women construction workers reported to work
as part-time sex workers in one-tenth of the
locations (mostly Nakas)
 More than half consumed alcohol
 About 1.5% of the construction workers in Basti
injected drugs

11.  General health care seeking from private
allopath (80%) and govt. facilities (28%)
 Among a dozen NGOs/CBOs operating in the
area, very few provided HIV related services
 In less than half of the locations condoms were
available (very low in Nakas and sites)
 Workers in only about one-tenth of the
locations knew about VCT services

12. KABP Survey









13.  Three-fourth of the respondents were men
 While 45% were 21-30 yrs old, 29% were 31-40 yrs
old
 63% were married
 While 34% were illiterate, 25% had studied from 1
to 5 standard, 21% from 6 to 8 standard
 Duration in construction work varied from 1 to 8
years
 Only about half of the respondent reported living
with their spouse currently

14. 45 42.7
40
35
31.3
30 27.8
26.5
25
20
15
10
5
0
Naka (n=162) Construction Basti (NFN) Total (N=380)
site (n=103) (n=115)

15. 5
4 3.9
3
2.6 2.6
2 1.9
1
0
Naka (n=162) Construction site Basti (NFN) (n=115) Total (N=380)
(n=103)

16. 70
60 58.3
49.6
50
44.7
40
32.7
30
20
10
0
Naka (n=162) Construction site Basti (NFN) Total (N=380)
(n=103) (n=115)

17. Agree to live in the same house with
50.5
a family member who is +ve
HIV+ children should be allowed to
57.4
study in schools
Willing to share a room with
44.7
someone who is living with…
Willing to hold hands with someone
51.6
who is +ve
Willing to share tools with co-
52.1
workers who is +ve
Willing to eat food with co-worker
43.2
who is +ve
Willing to use toilet used by co-
44.2
workers who is +ve
Willing to work alongside co-worker
47.1
who is +ve
0 10 20 30 40 50 60

18. 14
12.6
12 11.3 11.1
9.9
10
8
6
3.5
4
2.5 2.4
2
1.0
0
Naka (n=162) Construction site Basti (NFN) Total (N=380)
(n=103) (n=115)
% of respondents knowing at least 2 STI symptoms in women
% of respondents knowing at least 2 STI symptoms in men

19. Care and support information 2.1
VCT information 0.8
STI treatment information 2.9
Condom availability 22.9
HIV prevention education 11.8
0 5 10 15 20 25

20. Required condom 18.2
Information on Care and support 10.5
Information on VCTC 11.3
Information on STI treatment 10.8
HIV/AIDS education 11.8
0 2 4 6 8 10 12 14 16 18 20

21. 27
25.9
26
25.2
24.7
25
24
23
22.6
22
21
20
Naka (n=162) Construction site Basti (NFN) (n=115) Total (N=380)
(n=103)

22. 90
78.6 76.9
80
74.5
70 65.4
61.5
60
52.4 53.2
50 46.2
40
30
20
10
0
% used condom in last 2 sex acts % intentinally reduced partners
Naka (n=42) Construction site (n=26) Basti (NFN) (n=26) Total (N=94)

23. Stakeholder analysis

24.  Key stakeholders included –
Builders, Contractors, Mukadams, NGO workers
 Builders interacted with workers only on financial
matters (pay for work, compensation). Kept strict
vigil on the premises.
 Contractors had a key role in hiring
workers, negotiating pay, providing civic
amenities at sites
 Mukadams being team leaders, managed and
controlled workers
 Contractors and Mukadams were willing to support
HIV/AIDS intervention by providing space and
letting their workers to participate in program

25.  Presence of substantial number of single male
construction workers who fit the definition of NACO
 Mapping indicated HIV/AIDS vulnerability – sex
workers nearby, part time sex work by women
workers, high alcohol consumption, some amount of
drug use
 Poor knowledge of HIV transmission, prevention
methods, and STI symptoms
 Lack of HIV/AIDS services in workplaces in the
construction sector
 About half of the workers did not have favorable
attitude to HIV infected co-workers
 Clear evidence of high risk sexual behavior, and
relatively low consistent condom use
 Need to work closely with all the stakeholders
associated with construction workers