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Impact of HIV/AIDS Communication

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Impact of HIV/AIDS Communication

Hi and thanks for being part of The CI/Drum Beat network with an active engagement and interest in HIV/AIDS issues.

A recent issue of The Drum Beat (see http://comminit.com/global/drum_beat_595.html ) highlighted these evaluation results from the Soul City process in South(ern) Africa.

...Proportion of those who used a condom at last sex increased as exposure intensity to Soul City media increased...

...Those that were exposed to 4 Soul City media were almost 3 times more likely to be tested for HIV compared to those without exposure...

...There was a 17% increase in non-stigmatising attitudes attributable to exposure to Soul City 7 TV...

...Increase in non-stigmatising attitudes in children on 6 items was attributable to Soul Buddyz TV.

(The presentation that these came from is attached as a file)

In your opinion is this compelling data for the impact of communication strategies and action related to HIV/AIDS issues?

Please share your thoughts with the network by replying by email or opening the Read More link below and replying online. I would be very interested in your views.

Thanks - Warren

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(Apologies - resending with

(Apologies - resending with the links accessible)

To: The HIV/AIDS Network within The Drum Beat Network From: Warren Feek

Hi and best wishes. I was just reviewing the peer reviewed journal articles shared in this space HIV/AIDS, Young People, Research at http://www.comminit.com/hivaids-youngpeople/category/sites/global/hivaids-young-people-research - see Recent Journal Articles block in right column - and noted this article from the Journal of Epidemiology and Community Health

How effective is community mobilisation in HIV prevention among highly diverse sex workers in urban settings? The Aastha intervention experience in Mumbai and Thane districts, India http://www.comminit.com/clickthru/3637c369a1f3df1fbc7a4c289e06c401

I am aware that many of you use community mobilisation style strategies. It is of often difficult to produce peer reviewed evidence that these are effective. Does this paper help as both compelling evidence of what works and and as insight into effective strategies?

The part of the abstract for this paper that summarises the results includes:

"Of the analytical sample of 2106 FSWs, 532 (25.3%) reported high degree of collective efficacy for achieving certain goals and 1534 (72.8%) reported collective efficacy for addressing specific problems. FSWs reporting a higher collective efficacy as compared with those reporting lower collective efficacy were as follows: more likely to negotiate condom use with occasional clients (60.3% vs 19.7%; adjusted OR (AOR) =6.3, 95% CI 4.8 to 8.4) as well as regular partners (62.8% vs 20.2%; AOR =6.4, 95% CI 4.9 to 8.4); confident in facing troublesome stakeholders (73.5% vs 38.8%; AOR =4.3, 95% CI 3.3 to 5.6), confident in supporting fellow FSWs in a crisis (76.1% vs 49.6%; AOR =2.9, 95% CI 2.2 to 3.7), received help from other FSWs when a client or partner was violent (73.9% vs 46.3%; AOR =3.5, 95% CI 2.7 to 4.5) and had stood up to the police or madams/brokers to help fellow FSWs in the past 1 year (5.8% vs 3.3%; AOR =2.7, 95% CI 1.5 to 4.9).

I very much look forward to your critical thoughts/reflections on this data. And please do share in this space any papers that have attracted your attention.

Thanks - Warren

Warren Feek Executive Director The Communication Initiative

http://www.comminit.com

Twitter: https://twitter.com/warrencomminit

Facebook: The Communication Initiative Network http://www.facebook.com/pages/The-Communication-Initiative-Network/344005148956579

LinkedIn: Warren Feek

Skype: Warren Feek Office - 1–250-658-6372 Mobile 1-250-588-8795 Fax 1-250-658-1728

To: HIV/AIDS network in The

To: HIV/AIDS network in The Drum Beat Network Re: Impact of HIV/AIDS Communication http://networks.comminit.com/hivaidscommunication/node/4719

Many thanks Warren,

My comment: A clear definition and standard measure of efficacy, and relationships between problems abd goals.

Kind Regards

Angus Graham

Thanks Warren for this

Thanks Warren for this interesting discussion: Community mobilization among sex workers may be effective or ineffective in HIV prevention depending on the culture of the surrounding environment, attitude of the people around towards sex workers, the life style, the method of mobilization among others. For the case of Africa, Uganda in particular i have ever participated in this kind of exercise in a national HIV testing organization called "AIDS Information center" in one Northern district, the town of Arua. We conducted the "Moonlight HIV test" exercise as it was termed, for sex workers. It was always done in late evening 7-10pm. We used to visit converging areas for sex workers, gather and talk to them on the importance of HIV test, mobilized them to turn up in big numbers in such identified test areas. Since the areas were isolated and late hours, many sex workers turned up for HIV lessons and tests. Those who were found negative were given packet of condoms and urged to insist on using them, many of whom adopted it and those who were found positive were referred to the main center for positive living packages. Most of those who thought were already positive and were shocked to learn that were still negative ended up leaving the behavior, to doing other constructive work, those who were educated were enrolled for peer education courses and became peer educators for the rest, ended up getting serious partners for marriage.

Note that, if we had used an open day time mobilization and testing, almost none of the sex workers would turn up for such lessons and for tests. Therefore, the approach matters a lot if one is to tap sex workers for any campaign. Its important to study the nature of the environment and how the sex workers adapt to surviving in such environment Eg, whether they are free to interact with the public, whether the public fully accept them or are just labelled.First share with them in their private places the significance of the exercise and their responsibility, let them tell what they feel and how best they can be helped to access such services.

Thanks Bernard

To: HIV/AIDS network in The

To: HIV/AIDS network in The Drum Beat Network

Re: Impact of HIV/AIDS Communication http://networks.comminit.com/hivaidscommunication/node/4719

Hi - access follows to 4 more Journal articles that may be of interest/added value on the theme of the impact of community based strategies on HIV/AIDS. If you do manage to review these please do share your strategic thoughts on their implication for both the credibility of community based strategies and/or the implications for future practice. Click "Read More" below and scroll down for the comment form or just reply by email to this note. Thanks - Warren

Community mobilisation for HIV prevention in India: What difference does it make? http://www.comminit.com/clickthru/bb0359eb87627ed88eb5ed9541c57805?node=

Monitoring community mobilisation and organisational capacity among high-risk groups in a large-scale HIV prevention programme in India: selected findings using a Community Ownership and Preparedness Index http://www.comminit.com/clickthru/f1d1af03040adf394d8e35bbe696c15a?node=

Structural stigma, sex work and HIV: contradictions and lessons learnt from a community-led structural intervention in southern India http://www.comminit.com/clickthru/643b13b77a1fc255fbbd712d3da0f90a?node=

Navigating the swampy lowland: a framework for evaluating the effect of community mobilisation in female sex workers in Avahan, the India AIDS Initiative http://www.comminit.com/clickthru/54492a9f58b4c1f821e04316d87097d8?node=

Thanks Warren for sharing.

Thanks Warren for sharing. In Swaziland, we have just started to focus more and more attention to changing/modifying social norms that impede HIV prevention efforts. Can anyone share experiences with us? are there specific indicators that can be monitored both at output and outcome level that deal specifically with this issue? Thanks I look forward to your responses

To: HIV/AIDS Network within

To: HIV/AIDS Network within The Drum Beat network

From: Jean Delion

Re: John's Zimbabwe request

Hi, I;m John I am a retired World bank Senior Social development officer,

I retired and I am not sure the following lines will be of any ise, may be you already know all of it, just putting some quick reactions here.

I worked a lot on HIV AIDS operations, mainly in the field. I tried to call attention on the need for social engineering" to support the fight against HIV/AIDS. I meant acting on determinants of behaviors. In very simple words as we all know, behaviors are influenced by norms, which are influenced by values. I "preached" for acting on norms and values. Not as outsiders but as trainers of local leaders in communities. In some cases, like in Central African Republic, I was able to bring an experienced social anthropologist who helped teams of local anthropologists, social workers and others to assist the communities to do some social mapping, identifying places of high risks, talking with the communities to help people identify by themselves the norms and the values influencing the risky behaviors. On this basis the communities could take steps to change norms and to start some changes on values. For example social mapping of risk areas led to closing of bars near schools, enforcing patrols by traditional community wards (this was North Cameroon). We also did some work in the WB on social dimensions of the fight against HIV/AIDS. Another angle to change norm comes from leaders who feel they need to make changes. One example was a traditional leader I think it was in Swaziland, who decide to enforce rules to protect his people. If I remember well he asked young people to enforce traditional rules that girls need to be virgins in order to receive blessings from the traditional authorities for their marriage. It might look anecdotal and archaic to some people. But it is an example of changes on norms, coming from leaders who felt they needed to take some decisive actions. In other communities like in Benin, any communities decided to enforce rules that people needed to pass HIV/AIDS tests before getting married so that they know each other stats. Such decisions should be made by the local level, at the local level, so that they are supported by the population, not by higher level authorities and certainly not by outsiders. If they are really put in place by the community members, they can be very powerful. Compared with other measures, small changes in norms can cost noting in term of money but can have a huge impact on the socal groups (from family norms to community norms and in some cases higher level.

One case of higher level is Thailand, with few hundred thousands prostitutes: the government decided to enforce norms that all prostitutes engaging in sexual relations (mainly in brothels, massage parlors, etc.) should use condoms. Again penalties were put in place to enforce the norms (police asking questions, denunciations, etc.) It worked most prostitutes used condoms, very strictly.

Another angle was the importance of putting " punishment" to enforce norms. Famous examples are the So in short: there are many examples of fighting HIV/AIDS, acting on norms. But not enough on acting on values supporting norms. Without the work on values, the new norms are likely to be temporary and have short-lived impact. On contrary, changes on values can lead to deep changes in societies, influencing norms.

Best wishes in your efforts in this direction in Zimbabwe

Jean Delion

To: HIV/AIDS Network within

To: HIV/AIDS Network within The Drum Beat network

From: Deborah McSmith

A few years ago in some regions in Ethiopia, spiritual elders influenced communities to agree that young couples wanting to marry must first be tested for HIV. The husband and wife to be shared their results with one another, no one else other than the counselor, and from the beginning they knew whether they were both negative, a sero discordant couple, or both positive, and were counseled and treated accordingly. This seems quite practical.

Deborah McSmith, MPH Global Health Consultant HIV/AIDS, Sexual and Reproductive Health, Maternal and Child Health, Gender Chapel Hill, NC 919 308 0863

Addressing HIV/AIDS Social

Addressing HIV/AIDS Social Norms

To: The HIV/AIDS network within the Drum Bea network

(Below is a response from Sofía Hammoe to this question from FDennis: "In Swaziland, we have just started to focus more and more attention to changing/modifying social norms that impede HIV prevention efforts. Can anyone share experiences with us?" A rough English translation follows)

Boa noite!

No Brasil existem várias experiências que vinculam Comunicação-HIV/AIDS como forma de prevenção e mudança de comportamento. Além disso, há casos de formação de agentes de saúde para a comunicação e de formação de comunicadores/as sobre HIV/AIDS como uma forma de construção conjunta de ações de prevenção e informação.

Pode solicitar mais informações na Associação Mundial de Rádios Comunitárias sub-região Brasil: AMARC Brasil amarc_brasil@amarc.org ou secretariaamarcbrasil@gmail.com

Abraços! Sofía

Sofía Hammoe

sofiaviaja@gmail.com Argentina

Good evening!

In Brazil there are several experiences that related to communication on HIV/AIDS for prevention and behavior change.

In addition, there are cases of training of health workers to communicate and training of communicators / as HIV / AIDS as a form of construction for both prevention and information.

You can request more information on the World Association of Community Community - sub-region Brazil at Brazil amarc_brasil@amarc.org or AMARC secretariaamarcbrasil@gmail.com

Hugs! Sofia

  • Sofia * Hammoe

sofiaviaja@gmail.com Argentina

To: The HIV/AIDS network

To: The HIV/AIDS network within the Drum Bea network

(Below is a response from M. E. Khan to this question from FDennis: "In Swaziland, we have just started to focus more and more attention to changing/modifying social norms that impede HIV prevention efforts. Can anyone share experiences with us?")

I have not worked in BCC related with HIV / AIDS but have good experience in understanding of the barriers that does not allow adoption of even simple behavior like early initiation of breast feeding , delay in first bathing as part of thermal care or postpartum contraception. Most barriers are embedded in context , social norms and lack of knowledge and service delivery . Unless we understand them and address to resolve them.

You may like to read our recent publications " shaping demand and practices to improve family health outcomes -- designing a behavior communication strategies " VOL I and VOL II published by Sage publication, delhi 2012

With best. M E

M. E. Khan Population Council EMail mekhan@popcouncil.org

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