HIV/AIDS Prevention

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HIV/AIDS Prevention

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.

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

  • INTRODUCTION: HIV PREVENTION AND HUMAN RIGHTS

    What is the connection between HIV Prevention and Human Rights?

    HIV and Human Rights

    Intercambios is a Civil Asociation for the study and attention to drug related problems. In this area, harm reduction programs are focused on reducing adverse consequences of drug use, mainly the risk of HIV infections due to contamined injection equipment and unsecure sexual practices. Nevertheless, non-injecting drug use -particularly inhaled or smoked cocaine- has been described as a risk factor for both HIV and HCV infections, with consistent findings of higher prevalence of HIV infection among non-injecting cocaine users than in the general population.

    In a context of huge social inequality, income disparity and poverty, drug users all over de region become more vulnerable in terms of human rights. They experience many forms of social marginalization, discrimination, stigmatization, arbitarry deprivation of rights and have restricted access to adecuate medical assistance. These challenges have been targeted by integrated harm reduction initiatives.   Therefore, harm reduction programs work in order to ensure human rights for people who use drugs in terms of access to information and measures to reduce the risk of infection, adecuate medical attention for people living with HIV, protection against arbitrary incarceration and forced institucionalization, as well as against abuse by police officers and health care providers.  

    The situation points out the need of expanding harm reduction ideas and practice in order to broaden its initial focus on IDU. Latin American harm reduction organizations have achieved a wide experience with community-based interventions and networking with different stakeholders like human rights, social medicine and peasant movements. This regional experience can make a steady contribution to build a broader harm reduction concept.

    HIV and Human Rights Resources and Advocacy Actions

    Physicians for Human Rights believes human rights are absolutely central to HIV prevention, care, and treatment—indeed, to every facet of the epidemic. Bio-medial, behavioral and human rights approaches much come together to stop the spread of AIDS. PHR and our constituents conduct outreach, education and advocacy to make sure the world adopts integrated, scientific, rights based prevention polices and programs—I’m happy to answer questions about our work and why human rights is so central to fighting the epidemic.  

    In the mean time, there are so many great resources out there about human rights and AIDS prevention: I wanted to provide links to a few of the best and encourage other participants to add to this so we have a strong list of resources by week’s end. 

    1.       OSI and colleague organization have a fabulous—you can find it at. PHR has endorsed this, and your organization can too—just check out their website for more details http://www.soros.org/initiatives/health/focus/law/articles_publications/publications/human_20071017 .

    2.       Anyone interested in AIDS should check out al of the general human rights documents by the UN—see http://www2.ohchr.org/english/law/index.htm.

    3.       The Un also has published International Guidelines on HIV/AIDS and Human Rights—see these at http://data.unaids.org/Publications/IRC-pub07/jc1252-internguidelines_en.pdf

    4.       HIVAIDS and Human Rights in a Nutshell is a great white paper by the FXB Center at Harvard School of Public Health. http://www.hsph.harvard.edu/fxbcenter/HIVAIDS_and_HRinNutshell-Webversion1.pdf

    5.       Prevention is about women's rights: the right to education (studies have shown girls with higher education levels in sub Saharan Africa are less likely to get HIV), employment, to inheritance, to integrated health care, to family planning and reproductive health services, to freedom from violence and early marriage—and more. See PHR’s Healthy Women=Health Rights platform at http://physiciansforhumanrights.org/hiv-aids/issues/health-rights-healthy-women.html for our vision on making the health care system recognize women’s rights—many other groups d amazing work on HIV and education, domestic violence, land ownership, employment and more. Prevention programs that work in Africa have some behavior change and education component—but many also have an income generating component, showing how economic rights are so integral to health rights.

    6.       Prevention is about the right to information and scientific advancement for IDUs. See PHR’s briefings and fact sheets on the intersection of human rights and harm reduction (http://physiciansforhumanrights.org/hiv-aids/issues/hiv-prevention-for-drug-users.html), which were eloquently outlined by Intercambios.

    7.       On another human rights note, physicians and activists who work on HIV prevention remain at risk of persecution. One case in point is that of Drs. Arash and Kamiar Alaei, two Iranan brother who work on harm reduction who were detained in Iran in June and whose whereabouts remain unknown. PHR’s Colleagues at Risk Program does advocacy to support these kinds of cases—and you can add your voice by visiting www.IranFreetheDocs.org and signing the petition there for their release. 

    I’d love to hear more about participants’ perspectives on human rights and HIV/AIDS prevention, about new resources, about articles or IEC materials, about how you integrate human rights and HIV in trainings, etc.

    Interviews on HIV/AIDS and human rights

    Hi Sarah,

    Here's a resource that could be useful. WITNESS was just part of a participatory video project at the AIDS08 conference linked to the OSI 'Now More than Ever' initiative that you mention. One great resource that came out of that was a series of over 30 interviews filmed by activists attending the conference who were asked to look for key voices they believed needed to be heard on why human rights needed to be at the heart of the global struggle against HIV/AIDS. We think these short interviews are a powerful, succinct way of bringing the perspectives of activists including PLWHA and sharing them, and also encouraging all activists to realize the power of the stories they work with, and their own ability to share them. They cover rights of women, rights of sex workers, men who have sex with men, and prisoners, rights of PLWHA, issues affecting orphans, transgender and lgbt rights, amongst other rights-based concerns.

    A video compilation of the highlights is now on the home page of the Hub (WITNESS' online human rights channel for uploading, sharing and acting around human rights media) at hub.witness.org; and at http://hub.witness.org/en/share/groups/group/8046 we have 30+ interviews shot at the conference, as well as a range of other media on HIV/AIDS and human rights. We'll also be adding shortly a video showing the rally attended by 1000+ people at the conference, which in itself is inspiration to the human rights movement to make the linkage between rights protection and HIV/AIDS.

    We're still aggregating rights-based media on the page, linked wherever possible to concrete ways to act, so if any participant in this dialogue is producing or knows of media, we do encourage you to upload or embed it on the Hub.

    Thanks,
    Sam

    Sam Gregory, Program Director, WITNESS (www.witness.org/hub.witness.org)

    Re: Interviews on HIV/AIDS and human rights

    Great video, Sam!  Sounds like a really interesting and important project.  I'm glad that WITNESS is bringing this collection of perspectives to all of us.  There are so many dimensions to the relationship between human rights and HIV/AIDS, and this video project gives a much-needed voice to these.

    Thank you for sharing this, Sam! 

    Kristin Antin, New Tactics Online Community Builder

    COMMUNITY CAPACITY-BUILDING, OUTREACH AND EDUCATION

    In what ways do you engage the community through outreach, education and capacity-building?  How do you modify your tactics to suit your target audience? What have been your challenges and successes?

    Capacity Strengthening of CBOs?NGOs

     

     

    we believe that communities have potential to tackle HIV and AIDS. this potential can be seen in the areas of mutual support and solidarity amongst community members. along the history communities had come up with strategies to respond to many challenges. wht happens with HIV and AIDS is the fact that this epidemic is affecting all the community structures severely. but the potential is still there. is based on this belief that SAT works with communities to assure an effective response. how do we do this?

    any given community at the moment is responding to the challenges posed by AIDS using local resources and strenghts. in general, what is missing to turn that response into an effective one are resources, knowledge, community mobilisation, exchange and networking. that's where SAT comes in- providing the additional tools that will boost what the communities are already doing. how?

    - sub- granting

    - SWW model- for exchange of lessons and training for CBOs/NGOs operating in the communities

    - Action research for learning proposes and documentation of best practices

    - Communications and Publicacoes

    - Monitoring and Evaluation

    - Advocacy and lobby to influence policies

    - Strategic partnerships

    Currently we are supporting 25 partner organisations in Mozambique. our partners have a comprehensive response to HIV and AIDS- prevention, care, support, impact mitigation, treatment and advocacy.

    we work with communities trough CBOs/NGOs. we target emerging CBOs/NGOs that have the potential to work as the bonding factor for the communities. the major challenges are as follows:

    - other resource providers dont provide funding for administration costs which increases the burden on SAT

    - partner organisations struggle to acess government funds, such as from the National AIDS Authority (due to stringent policies)

    - this kind of partnerhsip requires constant monitoring and provision of technical support

    in general, the challenges we face are basically within our scope of operations.

     

    Click here to download a document that contains several articles about SAT's work published by the Canadian Public Health Journal.

     

    Lucrecia Wamba

    Country Programme Manager

    Southern African AIDS Trust (SAT) Mozambique

    Reaching the community where they are at: HIV testing

    It's important to reach at-risk communities where they are at. Our outreach programs are staffed by members of the target population, and our outreach teams often are comprised of volunteers from the target community. A great example of success we've seen in that regard is HIV testing.

    For instance, our gay/bisexual outreach program, PrideAlive, sets up testing in LGBT bars -- a traditional gathering place for much of the community. Individuals who might not otherwise access HIV testing can access it through us. There is much to be said for reaching HIV testing clients outside a clinic setting.

    Staff from the target population conduct the test process, while volunteers from the target population engage the community and give them the information they need to decide whether or not an HIV test is right for them.

    And the advent of rapid testing technologies has made that outreach much more efficient. With older technologies, clients would have to wait at least a week to get test results. Often clients don't return to the same venue and our results rate hovered around 60 percent.

    With a 10-minute same-day result, clients know their status right away. It also puts the burden on the test counselor to be able to gauge the client's readiness to receive a potentially life-changing result with 10 minutes contemplation versus a week or more.

    Knowledge of status is a major factor in reducing the spread of HIV, and by bringing HIV testing to the community, we eliminate barriers to accessing that knowledge.

    HIV testing in the community

    Thanks for your great example of how building capacity and reaching communities where they are at may improve your programs' success rate, both in terms of the number of people being tested as well as the rate of which they obtain test results!


    Have you experienced any challenges with HIV testing outside of a clinic setting? Do you or does anyone else have similar experiences from other countries? How do they compare?

    Rana Hjeltnes, New Tactics Intern

    Community Capacity Building and Harm Reduction

    We think community capacity building is a key tool in of harm reduction programs. We need to work with drug users where they are and must not expect them to come looking for help in sanitary institutions which deal with them as if they were criminals.

    Each community has its potential to develop effective networks, so considering intervention as a process, the neighbors designate the key persons to assume leadership and also decide and establish priority actions. We develop these interventions in the districts of Buenos Aires which present higher poverty rate and serious deficiencies in health and social services. They are centered on the population of drug users.   

    In the areas of Matanza and Moreno programs include training of community referents and promoters, street work strategies, workshops, articulation between several social organizations and public institutions and weekly technical supervisions.     

    The program named “locos de avellaneda” has actions directed to know the situation of drug users, preventive actions, and street assistance.   

    Personally, even though community building is not my specialty, I think these kinds of programs have strong political consequences in terms of local empowerment and creating bigger networks of social inclusion which go beyond the strictly sanitary field, and that´s where their potential resides.

    Re: Community Capacity building and harm reduction

    Thank you, Pablo.  It sounds like your project's community capacity building / outreach project successfully compliments your advocacy campaigns! Do you believe that this tactic is adaptable to other contexts / situations / regions of the world? 

    Has the 'locos de avellandeda' program been able to see impact on the ground? 

    Kristin Antin, New Tactics Online Community Builder

    RAISING AWARENESS

    What methods do you use to raise awareness are HIV/AIDS?  What medium do you utilize (film, TV, print, demonstrations, internet, etc)?  What have been your challenges and successes?

    Using video to raise awareness

     Greetings all,

    I wanted to point out  2 videos that have been created by one of our practitioners of the Pulitzer Center:

    INFOCUS FILM #1 Talking HIV in Jamaica

    Stigma and discrimination are fueling the HIV epidemic in the Caribbean. In Jamaica, those living with HIV often face social isolation and harrassment. Stigma also stops at-risk people from seeking information on prevention and testing, altering their sexual behavior, and accessing counseling, support groups, and treatment.  In this video, Kwame Dawes talks about HIV-related stigma with people living with the disease and those at risk of contracting HIV. 

    INFOCUS FILM #2 Positive Outlook

    Once a poster child for living HIV+ in Jamaica Annesha Taylor knows firsthand that life after a positive diagnosis is not an easy one.  The campaigns to show that there is life after a positive diagnosis are right -- HIV is not a death sentence. But strong stigma and the difficulties of juggling family life, the batteries of medications, and bouts of depression have left Annesha fighting to survive. 

     

    pulitzer

     Video can be a very effective tactic in raising awareness of your issue.  Sharing personal stories of those affected can be a moving and personal experience for the viewer.  There are many things to keep in mind, however, when deciding to create a video of this nature.  For example, one must take into account the target audience - who are you trying to reach with this video? (Please take a look at June's online dialogue on Video Advocacy for more information)

    Nathalie - can you please share more about the Pulitzer Center's decision to make these films to raise awareness?  Who is the target audience? Was it successful? (or more importantly, how do you know if these films are successful?)

    Has anyone else used video to raise awareness of HIV/AIDS issues in their communities? Please share your experiences! 

     Kristin Antin, New Tactics Online Community Builder

    media for raising awareness: multiple approaches/the human face

    Kristin, thanks so much for bringing this up and sharing these resources, you saved me a step!

    You mention this importance of putting a human face on these issues,
    and I believe that is by far the most critical "value added" that video offers. It
    helps others relate to those who are HIV positive and universalize
    their experience. So much of what we hear about HIV is about statistics instead of the human experience, and yet how is the public to care without feeling their own connection to these issues? It's also a great way to challenge stereotypes. This was a big part of what we were trying to do with the Hope project (see my next entry on target and impact for more on that). I find that video is a great way to introduce an issue, by
    putting a human face on it and creatng a window into larger more complex issues. I see it as an invitation to learn more, not the final story. It's
    not great for getting into complexity, statistics and historical
    evolution, at least not in a short internet-friendly video, but that is
    why it important to approach the issue from multiple platforms and cross-link like crazy between the resources you offer.

    The decision to use video for the HIV in Caribbean projects  was an application of the Pulitzer Center's overall approach to raising awareness of under-reported issues. We've found that the best ways to engage the audience is to go about it through every platform possible: print, video, blogs, images and combine them into one comprehensive resource but you also need to disseminate materials independendtly as well. Point is, you can't wait for people to come to you. So while we post the videos on the project pages with the related reporting, they are also available as part of the interactive narratives which stand alone, and on YouTube, and on blogs and pretty much anywhere we can think of! For example, for Hope, our HIV in Jamaica project you mention above, we aired these videos on our partner braodcast show Foreign Exchange, posted the videos on YouTube:

    Positive outlook: http://www.youtube.com/watch?v=WVoCmaKJVNM

    and Talking HIV: http://www.youtube.com/watch?v=La7__0mR-lo

    And they were also available as part of an interactive narrative at: www.livehopelove.com

    which incorporates poetry, video, and music and links back to the related articles. And they are also available directly off of our site, with additional related resources:

    http://www.pulitzercenter.org/showproject.cfm?id=61 

    We did something similar with the Heroes of HIV project, whcih explored the situation in Haiti and the Dominican Republic, where the videos we produced were tied to the print articles, online interactive narratives, and more. I don't want to overwhlem folks with links, but you can find links to the videos, articles and interactive site here: http://pulitzercenter.org/showproject.cfm?id=51

    I'm going to answer the target audience and impact question in a separate entry.

     

     

    target audiences and impact: the power of the person

    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. 

    Raising awareness through outreach in schools

    Thank you for your thoughtful comment, Nathalie. It sounds like your organization put a lot of thought into these videos, including defining the target audience and accepting the challenge of measuring your impact. 

    I am curious to know more about your outreach in schools. What age were the students? What was the context in which you were able to show these videos?  

    Kristin Antin, New Tactics Online Community Builder

    Using pictures to raise awareness

    Pictures may be a helpful tool in raising awareness about HIV/AIDS. Humuliza of Tanzania and Pact in Botswana are two organizations that have introduced pictures in their HIV/AIDS prevention efforts. The pictures are used to stimulate and facilitate discussion on important issues surrounding HIV/AIDS.

    Pact uses pictures to be used in group outreach sessions to stimulate discussion around behaviours which put people at risk of HIV infection. Pact uses real photographs of real people in situations which provide choices for specific behaviours. Accompanying each photograph is a list of questions for the outreach worker to ask group participants in order to stimulate discussion. These are followed by a list of "talking points" or information the outreach worker can share with participants. The picture codes also come with a set of instructions on how to best use them as an educational resource. To download these pictures, go to http://www.comminit.com/en/node/269867/38.

    Humuliza, in collaboration with artist John Kilaka, has created a collection of pictures inspired by the "Tingatinga" style, a Tanzanian style of painting using images of African wild animals. By portraying animals instead of people to facilitate discussion about issues surrounding HIV/AIDS, the producers hope to reduce stigma and the reinforcement of negative stereotypes that may accompany pictures of humans. The pictures come with corresponding guidelines to encourage discussion. To download these pictures and for more information about this project, go to http://www.humuliza.org/index.php?option=com_content&task=view&id=14&Itemid=69.

    Does anyone have successes or challenges they would like to share about using pictures to raise awareness about HIV/AIDS? In your opinion or experience, will using pictures of real people reinforce negative stereotypes or increase stigma?

     

    Using real people photos...

    One of our programs, Positive Link, partnered with a local photographer to create a campaign called "Am I? Are You?".  This photographer had approached us when a model he worked with reported becoming HIV+.  The photographer thought to himself, "you can't tell by looking?". While many of us that care about HIV have known that for years, it was striking that the belief that you can tell still exists.  

    From that first contact came a photo campaign where 50+ individuals volunteered to have their photo taken -- 25 were HIV+, 25 were HIV-.  There were a few group shots of, for example, young men or couple (male:female; two men)

    This was all assembled itno a powerpoint slideshow.  First the photo pops up followed by just a few words, e.g. "I'm a father. I'm a grandfather. I'm 57 years old."  There is then a pause and the words "Am I?" appear followed by a pause again and the words "I am HIV+" OR "I am HIV-" appear. 

    The viewer is challenged with each photo in those seemingly long pauses to guess the status of the person based on the stereotypes of age, gender, race, sexual orientation (if the first words "I'm gay" or "I'm heterosexual" are stated), etc. 

    The words chosen to describe the person were chosen directly by that person.  We edited a bit just so that there was some consistency in the way in which people described themselves.  We showed the presentation to a broad audience, including many living with HIV, on World AIDS Day and received great feedback.  We have also used hard copy photos with the words over the photo in various educational settings.  Those that view the exhibit are challenged to "guess" who's positive and who isn't -- it is a great way to challenge stereotypes. 

    Using soccer for HIV/AIDS awareness and prevention

    There is a great initiative taking place in Africa that uses soccer as a means to raise awareness and prevent HIV/AIDS. Grassroot Soccer utilizes soccer and powerful role models to teach awareness about the disease, critical life skills,
    and prevention strategies to young people. Their HIV prevention curriculum includes:

    - a 120-page Coaches Guide
    to train professional soccer players in Africa to speak to school
    children about HIV prevention

    - Extra Time, a 36-page magazine and workbook used as a guide for peer educators. The workbook features pictures and quotes of professional athletes as well as activities related to HIV/AIDS prevention that young people
    will do at home or in class with their peers

    - a 12-page Kick AIDS Guidebook, designed to train US college-aged Kick AIDS Ambassadors, who use what
    they learn to talk to US high school and junior high school Kick AIDS
    participants about the global HIV epidemic

    I recommend checking out their website at http://www.grassrootsoccer.org!

    Does anyone have any thoughts on using sports as a means to raise awareness about HIV/AIDS, or similar experiences they would like to share?

    Rana Hjeltnes, New Tactics Intern

    TREATMENT, CARE AND SUPPORT

    How have you used treatment, care and support for those living with HIV/AIDS for prevention? What have been your challenges and successes?

    Prevention through support for parents living with HIV/AIDS

    A book produced by HIV positive parents in Zambia provides an example of how support for people living with HIV/AIDS may be used for prevention. "My Mum has HIV," authored by Melissa Hein, is an edutainment book intended for parents living with HIV and their children. It aims to support parents to disclose their status to their children, thereby hoping to increase levels of community treatment literacy and to improve adherence to HIV drugs (ARVs).

    The book tells the story of a family affected by HIV, showing how the infected family members disclose their status to their family, seek treatment and live positively with HIV. "My Mum has HIV" was produced by HIV positive parents in Zambia who are members of the Treatment Advocacy & Literacy Campaign (TALC). (A PDF version of this book is available at http://www.comminit.com/en/node/268716/304).

    Do you have any examples of using treatment, care or support for HIV prevention?

    Rana Hjeltnes, New Tactics Intern

    Connecting to Care

    The Minnesota AIDS Project AIDSLine is this state’s information and referral service for both HIV prevention and services. The AIDSLine accomplishes this through a variety of programs and interventions. One of these is the “Quick Connect Program”.

    The Quick Connect program offers short-term, face-to-face assistance for people living with HIV. This program serves an average of 200 individuals annually.  Clients meet with an AIDSLine staff member to learn more about HIV and local resources (insurance, HIV medical care, financial assistance, food resources, etc.).  Before the appointment, clients complete a phone screening. Staff uses the data from the screening to help tailor the information and referrals given to the client during the appointment. The majority of the clients seen in Quick Connect are referred to programs for long-term support such as HIV Case Management.

    In the process of the appointment, staff will assess the client’s understanding of HIV and transmission risk and provide the client with more information as appropriate. If the client is sexually active we engage him or her in a non-judgmental discussion about their sexual practices and what they can do to reduce their risk of transmitting HIV to their partners or becoming re-infected with a different strain of the virus. Staff offers clients free condoms and lube to encourage safer sex practices. Our agency stocks a wide variety of condoms, including the female condom, and we work with the client to determine which product would be most appropriate for them.  

    One challenge we have in this program is that the clients we meet with often have multiple needs, many not related to HIV, and often are in some state of crisis. Clients who are unable to meet their basic needs, e.g. housing and food,  or have just learned about their status are often unable or unwilling to discuss sexual practices in detail. When this is the case we still provide the client with material to read about transmission after the appointment if they are willing to take this. We also make sure the client understands that they can contact the AIDSLine through the phone or on-line chat service in the future if they need to learn more about safer sex practices. We have found that simply opening the door to these discussions encourages the client to continue them at a later time when they are ready and able to focus on sexual health issues. When appropriate, we will refer the client to local health education and risk reduction programs for more in-depth education regarding HIV transmission.

    Similarly, if we meet with a client who is an injection drug user, we discuss harm reduction options to lessen their risk of transmitting HIV to drug partners. If they are actively using, we inform them of needle exchange programs and other area supports to ensure that they have access to clean needles.

    Having frank and open sexual discussions with clients, especially those newly diagnosed, can be difficult. AIDSLine staff receives extensive training on these skills. This training includes cultural pieces to assist our staff in connecting with the diverse clientele we meet with. We have found more challenges in engaging some of the refugee populations we work with in safer sex discussions and continue to brainstorm internally and with partner agencies on best practices in this area. However, as noted above, we have found that simply informing the client that they can have these discussions with staff encourages later follow-up, often with their case manager or medical provider.

    Here is a link to the section of our website that has information about the MAP AIDSLine:

    http://www.mnaidsproject.org/prevention/aidsline.htm

     

    SOCIAL RESEARCH

    How have you utilized social research of HIV/AIDS for prevention? What have been your challenges and successes?

    ADVOCACY

    In what ways have you used advocacy strategies (law and policy review, litigation, mass action, lobbying decision-makers, and communication campaigns) for HIV/AIDS prevention? What have been your challenges and successes?

    Advocacy to change laws regarding syringes

    In the United States the sale and possession of syringes was treated differently state to state and often even with states, city to city. In Minnesota, in the 1990's the laws regarding the sale and possession of syringes was a bit unclear. State laws "allowed" for the pharmacist to use discretion in regards to the sale of syringes. In other words, if the pharmacist thought, or knew, that you were diabetic or had another condition requiring injections, they would generally sell syringes to you, no prescription required. For example, if you purchased your insulin at that pharmacy, you could easily purchase syringes. If, on the other hand, the pharmacist "suspected" that perhaps you were purchasing syringes for illicit purposes, e.g. to inject non-prescribed drugs, s/he would more often than not refuse to sell syringes. In practicality this often translated to a refusal to sell syringes to young people and most especially those who were people of color.

    As syringe exchange programs began to spring up across the country working to make syringes available on a one-to-one exchange basis (one used syringe exchanged for a new sterile syringe), in Minnesota we attempted to clarify the law and allow for the legal sale. At that time, one other state, Connecticut, had been successful in a similar effort.

    We first worked to gain the support of a number of stakeholders that we anticpated would oppose these efforts. These included pharmacists (fearful that their retail stores / pharmacies would become havens for illicit drug users seeking to purchase syringes), leaders from communities of color (who were increasingly opposing syringe exchange or legal access to syringes on the basis that drug abuse was devastating their communites) and substance abuse professionals (who viewed those of us working to provide better access to syringes as "enablers" or indivduals who were aiding drug abusers to continue their abuse. We also had to contend of course with talk radio and other media outlets who saw this effort as an idiotic strategy that would increase the number of drug abusers, criminal acts, etc. And we naturally had an entire legislature and governor to convince.

    Ultimately what made the difference in a key way in Minnesota was grass roots organizing of all our supporters to support this initiative. Tthe Minnesota AIDS Project had already grown a statewide network of individuals who were willing to contact their local elected officials regarding HIV concerns. Letters of support for clarifying the law and allowing for the legal purchase and possession of up to 10 sterile syringes was what we were seeking. They key was sterile syringes. If someone was caught with a used syringe that contained, for example, cocaine residue, then that individual might be charged with drug possesion. We only fought for the right to purchase AND for their to be clarity on safe disposal of used syringes options.

    Most important was the story told by one constituent of a legislator uncertain how to vote. This constituent was living with HIV and had been infected through a contaminated needle used to inject drugs. He had been working on an oil rig. He was heterosexual, married and had children. His story was persuasive and we ultimately won the vote in a committee by that one legislator's vote (a 10-9 vote in our favor). The measure moved to the full legislature where we had already been working with members and also the governor.

    I will never forget what a difference that one vote made based on the one story from one person living with HIV. As a result, Minnesota now allows for the legal sale of up to 10 syringes. We also have two needle exchange programs (one mobile, one fixed site) and have never been challenged.

    For more information on the Minnesota Laws, information is available at the Minnesota Department of Health's website here http://www.health.state.mn.us/divs/idepc/dtopics/stds/mnpharmacy.html

    Re: Advocacy to change laws regarding syringes

    What a great success-story, Lorraine! Thank you for sharing this experience. It reminds me that this kind of advocacy work might feel daunting and near-impossible with so many forces working against you...but if you focus on tackling one task at a time, using one tactic at a time, eventually you will be able to make the change you are looking for!

    What a difference one person, with their story can make! Great work!

    Kristin Antin, New Tactics Online Community Builder

    finding the right character

    Lorraine,

     This is very interesting. One of the first videos I helped produce was about a needle exchange program in Philadelphia! I think your experience echoes my recent post about video in the importance of recognizing the value of the individual's stories. It's the human impact that impacts us most. It seems so obvious, but is too often ignored!

    PHR's Proven Advocacy Tactics

    Physicians for Human Rights has a 22 year history of advocacy and engagement on key health and human rights issues. In 2002, we launched the Health Action AIDS Campaign (HAA), which brings together infectious disease experts, medical and public health students, researchers and AIDS activists to advocate for science and human rights based reposonse to the epidemic. For more information on this campaign, see http://physiciansforhumanrights.org/hiv-aids.  

    I wanted to share three advocacy tactics we have used to get HIV prevention to the forefront of community and policy maker minds over the past 6 years:

    1.) Summits: Every year, HAA holds a major summit in Washington DC on a particular topic—including women and AIDS (2007) and IDU and harm reduction (2006). These summits bring together 30-40 key advisors, mainly health professionals from across the country who specialize in these fields. We spend the first day discussing each other’s research and clinical work, talk about ongoing and upcoming policy initiatives, and prepare to hit the Hill on Day 2. That second day, teams of health professional advocates have several meetings on Capitol Hill with their Senators and Congressmen to raise awareness and educatepolicy makers on the pressing human rights barriers facing the globe on HIV prevention and treatment.  For more info on these events, see http://physiciansforhumanrights.org/hiv-aids/2008-womens-summit.html and http://physiciansforhumanrights.org/hiv-aids/summit-on-prevention-idu.html.

    2.) Town Hall Meetings: PHR works with colleague organizations like the Minnesota AIDS Project to host Town Meetings 2-3 times a year. We invite 2-300 PHR members, students, health professionals, people livings with HIV/AIDS, community organization, media and the general public to come to 2 hour events which include speeches, a talk from the Senator or Congressman, and a question and answer period. These meetings are a great way to engage communities, get policy makers to stand up and listen, hear from experts, and debate and discuss prevention strategies, programs and funding streams. Check out more info on our Minnesota meeting at http://physiciansforhumanrights.org/hiv-aids/um-town-mtg-4-28-08.html (Lorraine, there is a nice photo of you at the bottom)

    3.) AIDS Week of Action: Each year, more than 100 medical, public health and undergraduate universities across the US hold a national AIDS Week of Action to raise awareness and take action on critical AIDS prevention, treatment and care issues. Student chapters plan a week of events—which range from lectures to rallies to art displays to meetings with policy makers to fundraisers to postcard drives to volunteer days—MANY varied events to energize their peers, professors, policy makers and community around AIDS. This model has been so successful it has spread to student groups in East Africa. The Week of Action is held every year in February/March—if you want to learn more or join in 2009, send me an email. You can also check out the following web pages for more details: http://physiciansforhumanrights.org/students/fight-global-aids.html provides the 2007 Week of Action Guide, which is a step by step manual on how to organize a week and http://physiciansforhumanrights.org/students/student-chapter-toolbox.html includes general student organizing materials PHR’s student chapters use throughout the year. 

    These are just three strategies we use—we also have house parties, press conferences, in-district meetings, student conferences, widespread media outreach, web blogs and micro sites, and more. Let me know if you have questions on how these events work and/or if your organization has others that make an impact on AIDS prevention. 

    Re: PHR's proven advocacy tactics

    Thanks, Sarah. These tactics seem very well thought-out and effective! Similar to Intercambios, PHR has chosen to approach its advocacy work both from the top-down and the bottom-up. The top-down tactic requires your health professional advocates to be on the hill talking face to face with the policy-makers to educate them on the issues.  The bottom-up engages the constituents in a 'town hall meeting' to discuss the issues and strategize on solutions. I think this combination of tactics is important to broadly educate not only the policy-makers, but also their constituents on the ground in order to hold them accountable and resonsible for their decisions regarding HIV/AIDS policy. 

    I also like the AIDS Week of Action idea! Your 2007 'Week of Action' had two very practical, hands-on activities - signing a petition and speaking with med students in Uganda about their experiences. Allowing people to actually take action is crucial to keep them engaged in the issues! 

    I wonder about the outcomes of these activities. Was the petition presented to a Committee on the Hill? Was the conversation among med students here in the US and in Uganda productive? I would love to hear more about these activities!

    Thanks! 

    Kristin Antin, New Tactics Online Community Builder

    Drug Policies and legislation

    Intercambios is deeply compromised with the review of national and international drug policies and legislation. We think criminalization is one of the biggest obstacles drug users face in order to achieve social inclusion and, of course, proper access to the health system in terms of prevention and attention.  

    Our research team has published several articles related to this issue, all of them are available at www.intercambios.org.ar and the organizations promotes, as well, different campaigns in order to question and modify the drug policies and legislation in our country. 

    Since the year 2003 we organize and promote the National Conference on Drug Policies, which has been declared of national interest by the Honorable Chamber of the Senate of the Nation, also by the Honorable Chamber of Representatives of the Nation and the legislature of the City of Buenos Aires. Tomorrow we launch the VI edition of this event, which will cover Socio-cultural context of drug phenomenon, Contributions to an evidence-based and human rights-rooted approach for public policy, International experiences, National legislation on drug-related issues: a necessary revision, Public health policies: the access to healthcare issue, Possibilities and limits of working in communities and the Revision of the 1998 United Nation General Assembly Special Session on Drugs (UNGASS) goals. The program is also available at www.intercambios.org.ar 

    Advocacy has brought good results. This year, the national government has publicly announced deep compromise with the modification of the current legislation in the direction we have been pointing for more than 13 years. The first announcement was made during our last National Conference on Drug Policies in 2007, and since then the government has created an advisory council in order to implement the proper adjustments with very respectable, informed and reliable experts.  

    Drug legislation is now installed in the media´s agenda, and a really strong debate has began. We look forward to see the new legislation debated in the congress before 2009 and hope the presence of high ranking government officials in the conference tomorrow will bring more good news.

    MEASURING IMPACT

    How do you measure your impact?  Please share your challenges and successes!

    Community empowerment program

    Minnesota AIDS Project has worked to prevent new HIV infections among men who have sex with men (MSM) 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.  The target audience for PrideAlive are MSM who are at high risk for HIV and STDs. MAP emphasizes reaching men who are 25 and over, a population that represents approximately two-thirds of the incidence of HIV in Minnesota.

    The service primarily reaches white men, who represent approximately 75% of the incidence of HIV among gay and bisexual men in Minnesota. In the last 5 years, PrideAlive has reached 89,400 people through programming and community outreach. PrideAlive has held 990 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. PrideAlive targets the highest-risk MSM through community outreach and on the Internet. A recent focus on reaching methamphetamine using MSM has also met with some success both in community venues such as bars, clubs and community groups as well as on the internet, a venue where many meth-using MSM gather.  

    PrideAlive is a multi-level intervention that aims to prevent HIV and STD infections by supporting participants’ capacities to adopt and maintain health-promoting practices, as well as their abilities to become peer leaders who shape knowledge and attitudes within their communities of influence.  PrideAlive draws from empowerment theory to create community ownership and participation.  A long-term effort is critical. Social norms cannot be changed quickly. Change occurs as a result of sustained, consistent intervention over time. 

    Sexual health education and health promotion is visible in every aspect of PrideAlive’s programming: Outreach is conducted during community mobilization activities at venues frequented by MSM including bars, clubs, and community groups several nights a week. Safer sex kits are distributed, informational materials are provided, and, most importantly, personal connections are made with MSM by other MSM by engaging them in conversations about HIV prevention.  Volunteer nights are held in PrideAlive’s community space called QueerSpace each week and provide MSM the opportunity to learn more about HIV prevention and PrideAlive’s activities, as well as contribute to the health of their community. Whether it’s assembling safer sex kits, generating ideas for marketing or designing a community mobilization event, HIV prevention and health promotion are infused into every volunteer night.  Counseling, Testing and Referral are provided by PrideAlive at venues such as bars and coffee shops frequented by MSM several times a month.  

    PrideAlive has two ongoing advisory groups that seek input from the community. They guide the program’s everyday activities as well as inform the program emerging risks and co-factors.  SafeR Zone is a popular, one-day safer sex workshop that provides MSM with intensive HIV and STD information, skill-building exercises around disclosure and communication in sexual relationships, and personal empowerment techniques. It’s held six times a year.   Community Mobilization Events are held by PrideAlive throughout the year. Infused with health promotion messaging, these large events help draw the MSM community into the PrideAlive program and help spread the word about the program. While social in nature, these events draw a wide cross-section of MSM communities and provide community-wide awareness of HIV and STDs.  Peer Educator Internet-based Outreach provides online communities with information and referral in internet venues where MSM meet for sex. Conducted daily during the week, PrideAlive staff and volunteers connect MSM, many of whom do not identify as gay or bisexual with referrals to needed resources. Internet-based outreach enables PrideAlive to break-down geographic and cultural barriers in the delivery of risk reduction and health promotion information.   

    This is the link to our PrideAlive website -- please note that the website contains sexually explicit information targeting adult gay and bisexual men.  http://www.pridealive.org/

    HIV/AIDS is a workplace and a trade union issue

    Syed Asif Altaf

    The global transmission of the HIV/AIDS for past two decades has coincided with the current period of economic globalisation- a process spearheaded by liberalisation of trade and financial transactions. In the era of globalisation and liberalisation, HIV has become a workplace issue and a trade union issue. UNAIDS estimates that 37 million working people are living with the virus and the global labour force has lost 28 million people to AIDS since the beginning of the pandemic. As it reaches epidemic proportions in heavily affected regions, it devastates the economy and market, as we are witnessing in sub Saharan Africa. It must be stressed that the full impact and visibility is not yet fully evident in most areas, although HIV is prevalent. Thus the visible effects are going to become far worse.  UNAIDS predicts that without access to treatment, this number could grow to 48 million by 2010 and 74 million by 2015. The ILO has estimated that an average of 15 years of working life will be lost for each employee affected by AIDS.

    The transport sector plays an important role in the economic and social development of a country but also plays an important role in HIV/AIDS transmission. HIV/AIDS has a triple impact on the transport sector. It affects transport workers, their families and communities, the enterprise concerned and the economy as a whole. Some groups of workers are particularly more vulnerable to acquiring and transmitting HIV infection because of the nature and conditions of the work. Transport workers, in some situations are such a group, whether they work on land, sea or air routes. With the globalisation of production, increasing numbers of transport companies are transforming into inter modal freight and logistics companies with several forms of transport, which may increase the likelihood that their workers may be required to be away from home for even longer period of time. The consequences are not only national but also sub-regional and beyond. Global production and the supply chain also mean the deadlines are tighter with increased work pressure on the workers. The growth of “just in time” inventory control means much tighter delivery times with penalty clauses for late delivery adding to the stress which workers experience.

      

    International drivers and helpers are sometimes blamed and stigmatised for the raising rates of HIV infection particularly along key transport corridors, but this counter productive as this vulnerability is not only controlled by an individual’s behaviour; it is rather influenced and governed by many cultural, socio-economic and institutional factors. Long delays at borders, lack of entertainment and health facilities, and stress are factors, which exposed truckers to risky behaviour such as having multiple sex partners or having sex without using a condom.

    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.

    Transport unions fight HIV/AIDS

    Syed Asif Altaf

    Some groups of workers are particularly more vulnerable to acquiring and transmitting HIV infection because of the nature and condition of their work. Transport workers, who are mobile, are such a group-whether they work on land, sea or air routes.

    Since late 80s, the International Transport Workers Fedetation (TF) through its affiliates have been actively involved in HIV prevention programmes for different sectors of transport workers. The ITF has developed its HIV strategy, which consists of three interrelated elements that support and reinforce each other: first bring HIV/AIDS into the mainstream of transport unions and the ITF industrial sections’ daily work based on a holistic trade union perspective. Secondly though project activities, supporting and coordinating transport unions’ interventions in awareness raising, negotiating collective bargaining agreements and workplace policies on HIV/AIDS, lobbying national governments and international institutions, and providing treatment and care for already infected workers. Third ensuring that the lessons learned from all of our work are being captured, shared and used by our affiliates to defend and improve the rights and conditions of transport workers.

    Our past experience clearly show us that HIV/AIDS, more than any other disease, needs a bold, well-planned international response. It is an enormous medical as well as social, economic and humanitarian crisis that must be tackled as a global emergency.

    This means that transport unions need to fight the epidemic effectively on a global scale through multi-faceted global programme. We will cover new regions such as CEE countries, Caribbean and the Middle East. Beyond that the ITF will also focus on industrialised countries if we don’t want our fight against HIV to fail in the long run.

    Global HIV/AIDS project The ITF implements different regional and sub regional programmes but it has recently launched its new visionary Global HIV/AIDS project. The Global project is aiming to globalise solidarity amongst transport workers in which transport unions from different countries cooperate to mobilise their resources and coordinate responses. Target Groups:Our past experience clearly show us that HIV/AIDS, more than any other disease, has shown the necessity of a bold, well-planned international response. It is an enormous medical as well as social, economic and humanitarian crisis that must be tackled as a global emergency.

    This means that as transport unions to fight the epidemic effectively on a global scale, we need to transform our current programme into a more effective and multi-faceted global programme. We should cover new regions such as CEE countries, Caribbean and the Middle East. Beyond that we should intensify our grassroots activism in industrial countries if we don’t want our fight against HIV to fail in the long run.

    Trade union leadership, peer educators, negotiators and union activists are generally the target group of this project. As HIV/AIDS has an important gender dimension the ITF women contact persons in the transport unions and the existing women network will be part of the project. This is also important to reach into the union membership. For the same reason educators network will also be targeted. Project Objectives:Transport trade unions will be able to develop and assimilate a holistic trade union perspective to combat HIV/AIDS. The project aims at assisting affiliates to direct their activities towards reducing vulnerability created by many factors including poverty, fast changing character of transport (logistics), different sorts of discrimination and gender inequality. The ITF and its affiliated unions will have the capacity to play a more active role in HIV/AIDS projects targeting their members by activating their existing capacities as well as building new capacity. The project aims at empowering ITF affiliated unions to get actively involved in projects and initiatives targeting transport workers. Transport trade unions will be able to engage employers in the development of workplace policies and will be able to negotiate comprehensive HIV/AIDS clauses into collective agreements. The project aims at developing negotiating strategies, social dialogue, negotiate agreements, implement and monitor them.

    In addition to the Global HIV/AIDS project, the ITF is also implementing number of regional and sub-regional projects especially in Sub-Saharan Africa and South Asia where HIV prevalence rate is very high.

    The other ongoing projects on HIV/AIDS are:

    • HIV/AIDS and transport workers in Africa: This is a continuation from previous ITF projects in Sub-Saharan Africa encouraging affiliates to recognise HIV/AIDS as a workplace and trade union issue. The project puts particular emphasis on the development of workplace policies and collective bargaining.
    • HIV/AIDS and transport workers-South Asia: The project is primarily concerned with focusing on HIV/AIDS as trade union and workplace issue targeting affiliates in India, Bangladesh and Nepal.
    • Joint Regional HIV/AIDS project in the Abidjan-Lagos transport corridor: This is a World Bank financed HIV/AIDS prevention project and ITF affiliates in Cote d’Ivoire and Togo are taking part in the project.
    • REDSO Transport Corridor Initiative: This a Family Health International funded HIV prevention project and our affiliates in Kenya and DR Congo is taking part in the project.
    • Seafarer’s Health Information Program (SHIP): This is a health promotion campaign implemented by the International Committee on Seafarers’ Welfare (ICSW). This project covers seven health issues and HIV/AIDS is one of the important issues among them.

    ITF resources on HIV/AIDS:
    · Highway of Hope: Documentary on HIV/AIDS

    The ITF has produced a documentary on the HIV/AIDS vulnerability of transport workers. The objective of this documentary is to highlight the seriousness of the HIV/AIDS crisis affecting transport workers on the Northern Corridor- a strategic arterial line connecting East Africa with the rest of the world and covering Uganda, Kenya, Tanzania and South Africa. Notorious for accidents, traffic deaths along its difficult and dangerous route and hotspot for HIV infections, this highway is also called as the Devil’s highway.

    The documentary explores the relationship between HIV/AIDS and the factors making transport workers vulnerable to the deadly infection. It also shows how transport workers unions including ITF affiliates are leading the fight back against the deadly disease and turning the devil’s highway into a “Highway of Hope”. The documentary is available in English, French, Spanish and Arabic.

    · Web The ITF website has a dedicated page on HIV/AIDS with all the HIV/AIDS related materials and information produced by the ITF.

    • HIV/AIDS Manual:

    The ITF has developed an education manual called HIV/AIDS: Transport workers take action. This manual is aimed at leaders in transport unions, especially senior shop stewards, educators and negotiators. It can be used to facilitate workshops, seminars and training.

    · Research study on AIDS and transport: The ITF produced a report based on the experiences of Ugandan road and rail transport workers and their unions in fighting HIV/AIDS.

    • Agenda, the ITF annual publication on HIV/AIDS:

    The ITF has published the first edition of “Agenda,” an annual publication on “HIV/AIDS and Transport workers”. The objective of this publication is to help affiliates and other relevant stakeholders to develop a trade union perspective of the epidemic within the context of a holistic intervention. It is published in 4 languages (English, Spanish, French and Russian). It will also be translated into Arabic for the ITF Arab World website.

    · Global HIV project E-bulletin:
    The ITF is producing a fortnightly E-bulletin on HIV/AIDS. The objective of this E-bulletin is to circulate AIDS-related news, publications, literature and research to affiliated unions and others working in this field on a regular basis. · HIV/AIDS campaign materials:

    Starting from World AIDS Day 2006, the ITF has initiated a long-term campaign on HIV/AIDS. The objective of this campaign is to move HIV/AIDS into unions’ core programmes and activities and to encourage unions to Establish HIV as a workplace issue. Detailed guideline and other campaign materials like posters, stickers, and leaflets have been produced. The ITF strongly believes that, with the organisational strength of almost 700 affiliated unions in 148 countries, we can make a difference and keep transport workers and their families healthy and safe from HIV/AIDS.

    • Playing cards with HIV/AIDS educational messages:

    Designed by a railway union activist in India, the ITF Delhi office has produced playing cards with HIV awareness slogans. Transport workers sometimes play cards when off duty or resting. These cards are a tool to raise awareness and remind workers in their workplace, communities and at home to protect themselves and their families from HIV/AIDS. For all the above-mentioned resources, please visit the ITF website: www.itfglobal.organd for further information please contact the ITF Global HIV/AIDS Coordinator, Dr. Syed Asif Altaf, Altaf_Asif@itf.org.uk, + 44 207 940 9298

     

    Drug laws in the U.S.

    thanks Pablo for your post -- the drug laws in the United States also need serious attention.  our incredibly large incarceration rate unfairly keeps primarily men of color behind bars with the sad result that for many women of color seeking a partner means that with the humber of available men being lower than women results in a high rate of concurrent relationships -- all increasing HIV rates in communities of color.  just one more reason for us to look at how archaic these laws are! 

    partnership with SAT

    Dear colleague

    many thanks for your comments. SAT is currently working in 5 countries in subsaharian africa and we have extension plans to angola, swaziland and south africa. about kenya, let me discuss this with myb regional office and I will get back to you.  

     

    Lucrecia Wamba

    Country Programme Manager

    Southern African AIDS Trust (SAT) Mozambique

    Re: [New Tactics Dialogues: HIV/AIDS Prevention] partnership wit

    <p>Hi Lucrecia</p>
    <p>Thanks for the response</p>
    <p>Looking forward to hearing from you</p>
    <p>Leonida<br />
    --- On Mon, 9/1/08, New Tactics wrote:</p>
    <p>&gt; From: New Tactics<br />
    &gt; Subject: [New Tactics Dialogues: HIV/AIDS Prevention] partnership with SAT<br />
    &gt; To: "Leonida"<br />
    &gt; Date: Monday, September 1, 2008, 5:59 AM<br />
    &gt;</p>

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