ACTIVITIES
Youth, Families, and Communities Supporting Abstinence/Be faithful for Youth (ABY) Interventions in Haiti
Dates: 4/1/2005 – 7/15/2007
Quality Improvement and Promotion of HIV-Related Health Services
Dates: 8/1/2003 – 7/15/2007
Community Care and Support and Social Inclusion
Dates: 7/1/2003 – 7/15/2007
HIGHLIGHTS
BACKGROUND
HIV/AIDS has had a more severe impact in Haiti than in any other country in Latin America or the Caribbean. As of 1999, AIDS was the leading cause of death in Haiti, accounting for as much as 20.5% of all deaths in certain age groups (UNAIDS/WHO 2002). The Haitian population is very young, with more than 55% under 20 years old (US Bureau of the Census, 2004). Intermittent political turmoil and the suspension of aid by international donors have impaired the government’s ability to respond to the epidemic and forced non-governmental organizations to take the lead in the fight against HIV/AIDS. Despite these difficulties, a wide variety of organizations and government agencies continue to implement HIV/AIDS programs in the country. Although the efforts of the organizations working with HIV/AIDS in Haiti do seem to have produced positive results, risk perception and preventive behaviors remain low, particularly among youth.
Based on population-level research conducted by HCP, youth are a particularly vulnerable segment of the population when it comes to reproductive health and HIV/AIDS, because it is at that period that many begin sexual activity. Unfortunately, safer sex is rarely discussed or practiced. A recent study conducted in the metropolitan area of Port-au-Prince indicates that nearly half (48%) of girls and boys, 13-19 years old not in union, were sexually experienced. However, only 50% of those used a condom at last sex. In addition, more that one in four had had multiple sexual partners in the 12 months preceding the survey. The median age at first sex was 15 for girls and 11 for boys. (HCP & Intell Consult, 2005). The Health Communication Partnership is well positioned to increase the adoption of HIV prevention strategies and the use of HIV/AIDS services among youth.
The overall goals of the Haiti HCP program have included fostering the development of a sustainable, supportive environment for HIV prevention and stigma reduction; promoting community-wide change through community dialogue and collective action; and promoting healthy sexual behaviors at the individual-level through BCC and social support. HCP Haiti achieved these goals through three strategic approaches, which are:
- Providing technical leadership and capacity building through support of the Ministry of Health’s national HIV/AIDS program and through the Groupe Technique, an inter-agency technical working group for HIV/AIDS behavior change communication.
- Supporting “Added-Value Interventions” that reinforce the work of multiple institutions around the four USAID program pillars: prevention, services and treatment, advocacy, and community mobilization.
- Multi-media communication interventions on stigma reduction and risk management to reflect and stimulate community efforts and interpersonal communication.
A modified mandate and severe political turmoil across the country have challenged HCP/Haiti. Building on new PEPFAR/Haiti orientations, HCP’s role has shifted to focus more on prevention, particularly ABY interventions while supporting the National AIDS program in the coordination and technical support to youth programs. In the implementation of this new mandate, a major challenge was to support the development of a strategic HIV/AIDS prevention BCC framework with all partners to ensure synergy between ABY and non ABY interventions. Linking prevention to services has also been key in reducing HIV/AIDS among youth and the general population. Crosscutting activities such as research and capacity building support and enhance the above activities.
MAJOR ACCOMPLISHMENTS TO DATE
In Year 1, HCP provided assistance to the Groupe Technique (GT), a central HIV/AIDS coordination mechanism and a strong foundation for technical leadership to effectively support the national HIV/AIDS BCC program in Haiti. Through the GT, HCP conducted an inventory of ongoing HIV/AIDS BCC interventions in Haiti (literature review) and identified gaps and added-value interventions that would further reinforce the national effort. HCP outputs include a desk-top literature review of HIV/AIDS-related knowledge, attitudes, and practices in Haiti; plans for formative and baseline research on behavior-related attitudes and practices; development of model guidelines for peer educators; development of PMTCT leaflets for the general public and pregnant women; exchange of lessons learned among community care and support organizations; development of PMTCT counseling cards for service providers; development of curricula on stigma reduction and training for service providers; development of community care and support guidelines; and training of Boy Scouts and development of a national-level Boy Scout action plan for HIV prevention and community care and support.
In Year 2, to further support HIV/AIDS prevention efforts, HCP supported planning and coordination of the launch of a national campaign to promote VCT and PMTCT services. Guidelines for community care and support interventions were finalized and distributed to partner organizations. HCP also contributed to the training of trainers and the replication at the departmental level of community care and support. To further reduce stigma and discrimination, HCP partnered with POZ, an organization supporting PLWHA, and other PLWHA support groups in four departments to develop interventions to reduce stigma and discrimination. HCP also conducted a stigma and discrimination reduction training for service providers and conducted subsequent training sessions with providers in several departments. Youth related interventions included finalizing the national youth peer educator guidelines and organizing a capacity building workshop in youth message and materials development with a view to launching a national youth HIV/AIDS campaign.
In Year 3, HCP had the opportunity to build on prior PEPFAR behavior change communication/community mobilization (BCC/CM) abstinence and fidelity (AB) interventions and other youth initiatives. HCP developed a BCC/CM youth strategy in partnership with the MOH National AIDS program and private sector partners. The Youth Strategy focused on the following 5 areas:
- Teach skills to young children (10-14 yrs old.) for appropriate behavior development;
- Promote social norms of health and safe behaviors;
- Strengthen parents’ ability to communicate adequately with their children about sexuality, sex and HIV prevention;
- Promote AB to adolescents and youth in and out of school (ABY);
- Strengthen training and monitoring and evaluation of BCC interventions.
In year 4, HCP supported 12 local organizations in planning and implementing interventions identified in the ABY strategy by using a combination of channels. Through interpersonal communication (IPC), and community outreach programs, young people have been reached with messages promoting abstinence and the reduction of sexual partners. Community outreach has taken many forms: educational sessions, group discussion, conferences, debates, rallies, theme camps, info-entertainment days, etc. HCP also provided training and capacity building to local partners to ensure effectiveness of interventions and sustainability of infrastructures that deliver prevention services to youth. In collaboration with the Youth Division of MOH, HCP launched a youth campaign, focused on risk perception and risk management, AB prevention, and parent-child dialogue. Many media materials such as audio and video spots and jingles were developed and aired at the national level along with the 20-episode radio program, Paran Pitit Ann Pale (“Parents and Children, Let’s Talk”), which also aired on a network of 24 community radio stations. To create a supportive environment for behavior change, HCP also designed, with the involvement of young people, an interactive radio program aimed at reinforcing positive social norms in the communities.
Narrative research was conducted to determine factors influencing behavior change among youth 10-24 years old in order to refine our AB and risk prevention messages. HCP, under the leadership of the youth division of the Ministry of Health conducted an inventory of all organizations/facilities that offer HIV/AIDS services to youth. HCP promoted the “Partnership Defined Quality (PDQ)” approach, encouraging youth and health providers to work in partnership to improve the quality and accessibility of services. To support interventions in the community, HCP produced many print materials (promotional and educational materials): posters, leaflets, booklets, youth passports, anatomical boards, promotional t-shirts, bags, an HIV/AIDS message guide, a curriculum on sexuality, etc.
In year 5, through the HCP mechanism, CCP as prime partner of Creative Partnership, a consortium including the International HIV and AIDS Alliance, FOSREF, World Relief, and the national Boy Scout association conducted a project aiming at reducing HIV prevention by promoting AB among youth. CP built on the previous work and experience of HCP to achieve the project goal. CP reproduced all AB materials developed in year 4 and also continued with the mass media interventions and the community outreach program. As part of its scope of work, CP developed interventions with vulnerable children, specifically street children and young domestics, mainly around building life-skills of children aged 10-17 for HIV prevention. Peer education strategy has been the main approach used for reaching them. CP developed materials to educate them on sexuality and other relevant means of HIV prevention. CP has also advocated for a supportive environment for orphans and vulnerable children (OVC) in catchment areas covered by its partners.
MAJOR CHALLENGES
A modified mandate and severe political turmoil across the country have challenged HCP/Haiti. Building on new PEPFAR/Haiti orientations, HCP’s role has shifted to focus more on prevention, particularly ABY interventions while supporting the National AIDS program in the coordination and technical support to youth programs. In the implementation of this new mandate, a major challenge was to support the development of a strategic HIV/AIDS prevention BCC framework with all partners to ensure synergy between ABY and non ABY interventions. Linking prevention to services will also be key in reducing HIV/AIDS among youth and the general population. Crosscutting activities such as research and capacity building will support and enhance the above activities.
CONTACTS
Esther Braud, ebraud@jhuccp.org
Yvrose Chéry, yochery@yahoo.com |
