HIV/AIDS Prevention
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Posted August 7th, 2008 by New Tactics
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August's featured online dialogue focused on HIV/AIDS Prevention. The New Tactics project decided to keep the momentum going from the International HIV/AIDS Conference held in Mexico City this month, by hosting this important dialogue on HIV/AIDS Prevention tactics. It's not too late to join our dialogue practitioners working in this field and share your experiences, challenges, successes and questions as well as gain ideas and tools to apply to your efforts.  

Our featured resoure practitioners include:

  • Sarah Kalloch of the Physicians for Human Rights (PHR) (USA)
  • Dr. Syed Asif Altaf of the International Transport Workers Federation
  • Nathalie Applewhite of the Pulitzer Center on Crisis Reporting (Jamaica and Haiti)
  • Pablo Frisch of Intercambios Asociación Civil (Argentina)
  • Lorraine Teel and others of the Minnesota AIDS Project (USA)
  • Lucrecia Jose Wamba of the Southern Africa AIDS Trust (SAT) (Mozambique)

Click here for biographical information on this month's featured resource practitioners.

Summary of dialogue

Introduction: HIV Prevention and Human Rights

In a context of huge social inequality, income disparity and poverty, drug users are extremely vulnerable in terms of human rights, experiencing social marginalization, discrimination, stigmatization, and deprivation of rights. Intercambios, works to reduce the adverse consequences of drug use, mainly the risk of HIV infections, and to ensure users have access to information and protection against abuse by police officers and health care providers.

More broadly, the Physicians for Human Rights believes that human rights are absolutely central to HIV prevention and every facet of the epidemic. In particular, women rights are crucial, notably the right to education, employment, inheritance, health care and reproductive health services. Prevention is about the right to information. However, physicians and activists who work on HIV prevention remain at risk of persecution – a case in point is that of two Iranian doctors who worked on harm reduction and who were detained in Iran in 2008.

Community Capacity-Building, Outreach and Education

Communities have the potential to tackle HIV and AIDS. Through mutual support and solidarity amongst community members they can come up with strategies to respond to the challenges brought by HIV/AIDS, just as they in the past with other challenges. At the same time, it is important to reach at-risk communities where they are and to reach and test those individuals who would otherwise not have access to testing.

Community capacity building is a key tool of harm reduction programs. Each community has its potential to develop effective networks and these kinds of programs can have strong political consequences in terms of local empowerment and creating bigger networks of social inclusion which go beyond the strictly sanitary field. That is where their potential resides. As it is crucial to adapt to the local context and needs of a certain community, each program is inevitably different.

Raising Awareness

Video can be a most effective tactic in raising awareness of an issue. The Pulitzer Center in the Caribbean created two videos focusing on the stigma and discrimination associated with the HIV epidemic and having a positive outlook on life with HIV. Putting a human face on these issues, is by far the most critical "value added" that video offers, helping others relate to those who are HIV positive, challenge stereotypes and create a window into larger more complex issues. Using video for their HIV projects was part of Pulitzer’s overall approach to raising awareness of under-reported issues by engaging the audience through every platform possible. In another project, Heroes and Hope, Pulitzer targeted different groups for “heroes” and for “hope”. While it is challenging to measure impact with media and education they did have some success stories - grants, people stepping forward to help/speak about HIV, increased reporting by journalists on the issue and discussions in schools.  Many things need to be kept in mind, however, when deciding to create a video of this nature, as discussed in the online dialogue on Video Advocacy.

Pictures too may be a helpful tool in raising awareness of HIV/AIDS, stimulating and facilitating discussions on issues surrounding the epidemic. One organization, Humilza, collaborated with a local artist in Tanzania to produce paintings in a traditional style using animals instead of pictures. It is hoped that this tactic will reduce stigma in the country.  Another tactic that has been used involves real people being photographed and then asking the question: “Am I [HIV+]? Are you?... You can’t tell by just looking”.

Finally, sport, especially soccer, has been used to raise awareness and prevent HIV/AIDS. Soccer players are worldwide role models and can have a significant influence on youth.

Treatment, Care and Support

In Zambia, a book was produced by HIV+ parents with the aim of of supporting parents to disclose their status to the children and hopeful increase levels of community treatment literacy and to improve adherence to ARV drugs.

In Minnesota, the Minnesota AIDS Project AIDSLine is this state’s information and referral service for both HIV prevention and services. It accomplishes this through a variety of programs and interventions, one of which is the “Quick Connect Program” which offers short-term, face-to-face assistance for people living with HIV.

Advocacy

In the 1990s there were no clear laws in Minnesota on the sale and possession of syringes, leaving pharmacists to use their discretion on who to sell to. This often lead to discrimination against younger people and those of color. Syringe exchange programs sprung up and the MN Department of Health attempted to clarify the law and allow for the legal sale. Despite much opposition, a law was passed allowing the sale of up to 10 syringes, with criminal charges for those individuals caught in the possession of a used syringe with residue of a hard drug.

The Physicians for Human Rights launched the Health Action AIDS Campaign (HAA) in 2002 to bring together infectious disease experts, medical and public health students, researchers and AIDS activists to advocate for science and human rights based response to the epidemic. Since then, PHR has used three advocacy tactics to get HIV prevention to the forefront of community and policy maker minds:

  1. an annual summit in Washington DC on a particular topic - including women and AIDS (2007) and IDU and harm reduction (2006)
  2. town hall meetings 2-3 times a year with colleague organizations like the Minnesota AIDS Project, students, health professionals, people livings with HIV/AIDS, community organization, media and the general public
  3. annual AIDS Week of Action to raise awareness and take action on critical AIDS prevention, treatment and care issues.

Using both a top-down and bottom-up approach broadly educates not only the policy-makers, but also their constituents on the ground in order to hold them accountable and responsible for their decisions regarding HIV/AIDS policy

Intercambios thinks criminalization is one of the biggest obstacles that drug users face. Since 2003 they have organized and promoted the National Conference on Drug Policies in Argentina. Advocacy has brought them good results - in 2008, the Argentine national government publicly announced deep compromise with the modification of the current legislation in the direction Intercambios had been pointing for more than 13 years.

Measuring Impact

The Minnesota AIDS Project has worked to prevent new HIV infections among men who have sex with men since the epidemic came to Minnesota in 1983.  The PrideAlive program is designed to create a community of gay and bisexual men who maintain and advocate for health-promoting choices for themselves, peers and community affected by HIV, by confronting social issues including homophobia, HIV/STD prevention and health disparities. Between 2003 and 2008, PrideAlive reached almost 90,000 people through programming and community outreach, held almost 1000 educational trainings, social events, and safer sex workshops for MSM and distributed more than 100,000 condoms, lube and dental dams. In addition, 950 people have used PrideAlive’s HIV counseling, testing and referral services.

The global transmission of the HIV/AIDS for the past two decades has coincided with the current period of economic globalisation, making HIV a workplace issue and a trade union issue. As it reaches epidemic proportions in heavily affected regions, it devastates the economy and market, as is being witnessed in sub Saharan Africa. While the transport sector plays an important role in the economic and social development of a country, it also plays a role in HIV/AIDS transmission. Since the late 1980s, International Transport Workers Fedetation (TF) has been actively involved in HIV prevention programmes for different sectors of transport workers, by bringing HIV/AIDS into the mainstream of transport unions; project activities that support and coordinate transport unions’ interventions in awareness raising, negotiate collective bargaining agreements and workplace policies on HIV/AIDS, lobbying national governments and international institutions, and providing treatment and care for already infected workers; and ensuring that the lessons learnt are captured, shared and used by affiliates to defend and improve the rights and conditions of transport workers.

It is now well recognized that to gain the upper hand against the AIDS epidemic, community and membership organisations such as trade unions need to be involved in an active way. HIV/AIDS interventions that have proved to be successful are successful only because comprehensive local responses were developed and a broad mobilisation of civil society organisations took place. To control the HIV/AIDS epidemic among international drivers and helpers, it is very important that unions and employers work very closely in consultation with other relevant stakeholders.

Resources

Introduction

Community Capacity-Building, Outreach and Education

Raising Awareness

Treatment, Care and Support

Advocacy

  • MN Department of Health Syringe/Needle Access Initiative   
  • Physicians for Human Rights Proven Advocacy Tactics
  • Intercambios articles (Spanish) 
  • The International Transport Workers Federation HIV/AIDS Prevention Programmes
    • Related New Tactics Resources
    Related Tactical Notebooks: 
    Engaging Key Stakeholders: Ensuring the right to HIV/AIDS education and health care services
    PulitzerCenter's picture

    target audiences and impact: the power of the person

    Submitted by PulitzerCenter on Wed, 08/20/2008 - 14:37.

    Our target audiences differed for the Heroes and Hope projects. For Heroes, which focused on Haiti/DR we were targetting policy-makers and also the public at-large in the US, so while we still focused on the human stories, you'll see more of an emphasis on statistics and policy questions (especially regarding PEPFAR) in this project. For Hope, it was about reaching the public in both the US and Jamaica and the emphasis was much more on personal experiences, including those of the author Kwame Dawes who ended up writing these beautiful poems as a result of his experience reporting the story.

    Impact is always really challenging to measure with media, it's the same with education (and in fact, when it comes to the kind of work we do, we see this meda as educational). Just because a certain number of people see a broadcast, or read an article, its difficult to measure actual impact without doing pre and post assessments, which is realy difficult to do on a large scale. We do have some success stories though.

    For Heroes, there was a portion of the series which focused on the conditions inside the National Penitentiary in Haiti and how these were directly contributing to the spread of HIV: http://pulitzercenter.org/openitem.cfm?id=674

    After the story ran in the Palm Beach Post and the videos started circulating on air and online, USAID pledged 200,000 in immediate assistance to the prison. We can't prove this was a direct result of our reporting, but according to Dr. Richard May, the doctor who opened our eyes to the situation there, it was very much related. Our intent had been to raise awareness of the issue. The reporting did not advocate to take action in any particular way, but because the video showed what statistics and numbers could not, it moved people to action, whether directly at the policy level or not. It goes without saying that the more people are informed of the issues, the more likely they are to take informed action. The video demonstrated the absolute horror that existed in a way words could not;  it became impossible to ignore.

    For Hope, as I said our target audience was more the public, in both the US and Jamaica. Our goal was to challenge the stereotypes that surrounded people living with HIV, so as to help prevent further spread of it, since stigma not only leads to human rights abuses, it often perpetuates the disease and makes prevention even more challenging. Here, we were blessed with a poet/reporter and a group of characters who had already stepped forward to try and change the "face" of HIV in Jamaica. Our impact as of yet, is qualitative, we only know we've moved people to write about our work, send donations to the people featured in the video and start using the videos in their outreach work to demonstrate how some are facing the challenges of living HIV positive. We'll start our outreach work in Jamaica this fall, and I hope we'll see some concrete results. There were so many inspirational stories, from the clinic worker in her late 40s who would head to night clubs to talk to people about their sexual parctices, to the heartbreaking testimonials of those living with the disease and their journey to find hope. 

    One way we have been able to measure impact was through the outreach in the schools   that we do. We used these projects to raise awareness of the epidemic in the Caribbean, and also to help the students find ways to talk about the issues, without it being too personal. Their reflections on what they learned were really telling. Here's one:

    " I had no idea that this problem was
    so widespread. I learned, first of all, that this even was a problem. I
    also learned much more about how the disease is spread, and about the
    overwhelming poverty that contributes to the spread of HIV/AIDs in
    these countries, countries that are usually thought of as toursist
    destinations. The things that stuck with me the most were the stories
    of the sex workers in the Dominican Republic, the debate over who the
    aid should go to, the overcrowded penitentiary in Haiti, and the huge
    epidemic in Florida. "

    http://pulitzercenter.typepad.com/global_gateway_heroes/2008/04/st-josep...

    I realize that these tactics may not directly apply to those of you working as practicioners, but these awareness-raising campaigns can impact the way the public views the issues at both the personal and policy level. Video is a great way to challenge the "othering" that takes place... it is hard to measure, no doubt, but we believe worth the effort, especially when combined with additional  resources.

    Reaching out to reporters to make sure they understand the issues, and making information available on your sites about what you do, will make it more likely that the media pick up the stories, and this will help inform policy choices. 

    I'll post more on reaching the "at risk" populations in the next few days. 

    I've tried to give an overview of what we've done with these two projects and how we approached them overall, more as an introduction. I'm happy to answer any questions you all have about dealing with the media, telling your own stories, telling the stories of your consituents, or anything else I can address, even technical matters.