Understand, engage and change!
NGO in San Kampaeng district has a community care project. Project
has been working with children affected with HIV/ AIDS. They have
taken care of these children who have now become teenagers. These
boys and girls are now becoming sexually active. the NGO now
started talking about life skills, sexual education, protection.
They are recruiting these teenagers to become volunteers to help
with education of younger generations. So they started with care
for these groups and psychosocial support. When they now grew
older, they see that the prevention part also needs to be
addressed. The boys and girls have gone from the object of care to
the subject of care. Care turns into prevention. They have seen
their target groups are changing or evolving.
It's not shampoo, it’s a condom!
In Bombay, the AASDHA project has done intervention in sexworkers.
Doing health education and identifiying peer educators for them.
Started with the care component of STI treatment and saw the
potential to use their ideas and insights for prevention. Teaching
them what condom use and safe sex was about. Some of the sexworkers
don’t know that they are in sexwork. They see that there is stigma
when condom is in the bag.
They came up with a campaign where the condoms looked like shampoo
packets. Together with FHI, the condom was designed in a shampoo
package without anybody geting suspicious. Sexworkers were involved
in the decision making process. Innovative powers and prevention
message came across easier.
Tuktuk drivers in Mattakkuliya give free
rides to VCT centre.
Sri Lanka is a low prevalence country. Mattakkuliya, a coastal
community situated in the heart of the Colombo city, is peculiar in
that common perception is that it is inhabited with aggressive,
socially destructive and uneducated people. People are scared to
even go alone. Lots of crimes do originate from the area. Youth in
the area also have different characteristics to those in other
parts of the country. They are extremely outgoing, there is little
interest in getting educated and learning things, risk-taking -
their role models being aggressive risk-taking type. This community
was marginally affected by the Tsunami.
Therefore a lot of organizations active in this community. In 2007,
we got funded by the UNESCAP for building life skills to prevent
HIV// AIDS among youth. We met around 30 young men and women and
started a discussion about HIV and what needs to be done. They
confirmed that 10 organizations were working with them on HIV.
So: What did change? “Nothing, these programs are far from us. Most
programs try to educate us in a language that we don’t even
understand. We don’t understand all these technical terms. If you
are coming to do the same thing, don’t bother to come”. OK, so we
want to work with you if you think it is needed and what do you
need? Community replied: there is a drug and alcohol problem and we
are conscious of our risks. Why not provide our community a forum
so we can discuss these issues ourselves? We provided the basic
facilities and a facilitator who understands the community and is
young and let them work for a while. After a while, the group grew
so much it had to be split up in 5 separate groups. After 4 months,
they started coming up with various responses they can make to
prevent HIV/ AIDS. They were beginning to feel concerned about the
community who were not involved and who do not get tested. “Now,
there are musical events that our peers love to attend. We’ll
educate our friends who do not join the forums, but who will join
the musical events. We’ll use our own ways, not using chalk and
A lot of the people involved were three-wheel (tuktuk) drivers who
were aware of the peers who engage in risky behaviours. They now
see it’s not just their job to bring these people from a to b, but
also to inform their passengers and provide peer support. Three
wheeler drivers became agents of change. They now offer a free ride
to the National HIV/AIDS control programme’s laboratory to whoever
is interested in getting their HIV status checked. Confidentiality
is ensured. Not only that, they will promote getting an HIV test
done among their peers and of course clients who they know had been
engaging in risk behaviours. Funding ended after 1year, but the
results are still continuing. They do not consider the things they
do as “HIV prevention work”. They just lead their day to day lives.
Educating and empowering their peers have become something in their
"What's the point of saving my baby if I will
Mama Fatuma in Tororo district in Eastern Uganda came to the
village clinic asking: “What is the point of saving my baby’s life
if you can’t save me?” The reason she was complaining was that in
that clinic the common practice for PMTCT was to provide mother and
baby medicine only during the birth process and before., common
practice. Mama Fatuman was angry. Even if I give birth to a healthy
child, it won’t have a mother for long and there will be no care
for the child. What is the point? The community decided to have a
meeting with the clinic and discussed the way they practiced this
They came up with the idea that if they could put the mother on
treatment as well, they would be able to save the mother who could
then take care of the child. The partners gathered a meeting to
bring many partners to the table including the ministry of health
that agreed to provide treatment to the mothers, so they could then
take care of their babies. Although the PMTCT program started with
a focus on prevention, it changed into a program that also cared
for the mothers. After the baby was born, the HIV positive mother
was invited to come to the clinic, get advice and support from the
staff. She was educated to how to breastfeed the baby, how to keep
the baby healthy and was taught about future pregnancies.
Due to this intervention, in 5 years 300 healthy babies have been
born by HIV positive mothers and both mothers and babies are still
alive. At the same time the husbands were effectively stimulated to
get tested as well.
"By the way, I also have a partner”
One afternoon, one staff member of Violet house MSM organization in
Chiang Mai, Thailand received a phone call from an MSM and was
infected with HIV. He was very worried what would happen and was
very concerned. The staff advised to take care of his health and
provide the counselling on the phone and suggested to test for
viral load. And also to have a health check at the hospital. After
that, the person was referred to home visits by peers.
And that first home visit, focused on the health issues. On
subsequent visits, the person started to become more open with the
visiting volunteer. He finally came to terms with his status and
told his partner. The volunteer started to talk about the partner
of the infected person. He shared that: “yes, I have a partner, but
i haven’t shared my status yet”. The volunteer of Violet House
started to talk about prevention. The prevention did not only focus
on condom use but also negotiating with the partner. The person has
started a new relationship with a partner, followed the advice and
negotiated to practice safe sex with his partner every time. Care
is not only medical care, but goes much further. The question that
this story brings forth: Do PLHIV eventually have to disclose their
status to partners?
A wake-up call!
In the summer of 2005, I was single. I had finished a relationship
with a girlfriend, we were not practicing safe sex but both had had
HIV tests. I had a short relationship with someone else which was
over. I didn’t consider I was at risk and therefore didn’t worry
about my relationships. I was attending a meditation centre in
France. A call from an old girlfriend while at meditation retreat.
She told me she had and STI, Chlamydia, and perhaps she had
transmitted it to me. After the meditation week I returned and
asked my friends where to go – went for tests for STIs and HIV. All
negative but I had treatment for Chlamydia. The treatment was
simple and painless. However it started my reflection on
vulnerability and risky behaviour. I became more aware of risks I
was taking. Also I noticed that because my ex-girlfriend cared
about me, she called me to prevent further (unconscious)
"Cricket for Jagruti (Hindi for
In three communities in Uttar Pradesh state. First visit to 5
communities. Amongst those communities, 3 communities gave a good
response. Those communities are muslim communities. Initially they
didn’t accept the visitors, because they had other religions. After
that, we decided to organize competeitions and different kind of
games. One event was to organize a cricket tournament: Jagruti
cricket tournament. We invited nearby villages and young people. 5
teams came to participate in the first tournament. District
magistrate was also invited and other local leaders. Through the
tournament, we provided awareness on HIV/ AIDS. IEC materials and
verbal. After the tournament, youth capacity trainings were
provided. A youth committee encouraged 3 people who were truck
drivers and vulnerable who went for testing and were positive. They
are now under treatment via the government hospital. Since 3 years,
the month of December, the tournament is repeated and young people
do the fundraising themselves.
"Community dialogue allows son of PLHIV to
go to primary school”
In Azawl, Mizoram, India, CHAN is a centre that offers counselling
and medical facilities for IVDU’s referrals, home visits and a
facilitation team that does community counseling. It is run by the
Salvation Army. The facilitation team follows up the clients in
their communities to talk to people in the neighbourhood on their
concerns. Since IDU is a big problem, the facilitation team talks
to the community to listen and talk to people about their concerns.
Then entry points are the clients. They go to their communities of
clients who come to the centre. A young women of 20 who had
abscesses and wounds resulting from IDU came to the centre for
medical treatment. She tells the counseller, that there is a rumour
in her community that I am positive and she has this bad feeling
that people act differently towards her. Since the rumour is there
she wants to get tested.
In the hospital she got tested and she finds she’s positive.
Rumours still continue in the community. The facilitation teams
(who was already working in that community) feel that they should
go beyond home visits and start a conversation in the entire
community as a group. The Community arranged a venue and time. They
called representative of each of the most important associations.
Issue of IDU’s and other issues were discussed. This women had a
son and she to admit him to kindergarten in her locality. Other
parents complained and insisted they would leave the school this
child was admitted.
Community leaders asked if CHAN could come and talk about HIV/ AIDS
during a second meeting. The facilitating team has been to the
community to give seminars workshops and support as and when
invited by the community. The son was admitted to the school. The
community has now set but its own counselling centre in their
community, has a counsellor and own a building and mobilizes its
own resources, it has set up a board of directors elected by the
community from different CBO’s, Churches, organisations in the
community who looks after the running and management of the centre.
The funds for the functioning of the centre is met by contributions
collected from each and every house in the community. The
facilitation team stills pays visits and supports the
"Home-based visits in Chiang Mai integrate
care and prevention”
Christian AIDS Ministry (CAM), FBO under the church of Christ.
Staff conducted home visits to PLHIV in different communities in
Chiang Mai. The Home visits combined care and prevention in itself.
If they visit PLHIV in their home they provide advice, emotional
care, medical care, spiritual support and psychosocial support.
Facilitators also talk to the care takers and wider family also to
prevent infection and how to best care of them AND how to take care
of themselves. They also talk to children in the family to provide
emotional psychosocial support. They provide little training to the
caretakers so that they can transfer this to other caretakers in
the community. Care and prevention can be done in single home
visits. Different needs are met throughout the community.