|
|
 |
A measurable prevention intervention
Nicola Stanley. HIVAN Sectoral Networking Team
|
There is an Ashanti proverb that reads: If you understand the beginning well, the end will not trouble you.
This principle can be translated, in the project management field, into an emphasis on detailed planning in the formative design phase. To support this practice, Nelson Mandela Bay in the Eastern Cape is home to an exciting example of collaboration in the HIV/AIDS prevention field. The "High Transmission Area" (HTA) Project is a partnership between the Nelson Mandela Municipal Metropole (NMMM), the AIDS Training, Information and Counseling Centre (ATICC), the Eastern Cape Department of Health, USAID (EQUITY and Measure projects), and the University of Port Elizabeth (UPE).
Initiated in 1999, the HTA project in the western region of this province aims to reduce the risk and spread of HIV infection through casual and commercial sexual activity in a focused, measurable approach to community-led education. The intervention also aims to engage both the infected and affected in constructive debate and information-sharing on the extent of unprotected sex.
"HTA's" are defined as areas where HIV infection is most likely to occur. These include densely populated urban areas with: social mixing near commercial activity, high rates of unemployment and mobile, migrant populations. Sites in identified HTA's have high rates of "new partner" sexual interaction without condom use. Patrons at these sites include: sex-workers, their clients, people who have multiple partners, people who engage in frequent sex with new partners and the members of the communities in which these groups are significantly concentrated.
Based on a model successfully implemented in Zimbabwe, the HTA project employs a specific methodology. Firstly, a PLACE baseline assessment is conducted in the planning of the project (PLACE stands for Priorities for Local AIDS Control Efforts). This assessment entails: (a) identification of High Transmission Areas (HTA's); (b) mapping of all public sites in HTA's where people meet new sexual partners; (c) assessment of the feasibility of intervention at these sites; (d) description of the sexual behaviour and condom use at these sites, and (e) planning of a targeted site-based prevention campaign.
The planning phase is followed by recruitment and training of peer educators. Peer educators comprise persons from the target population. They can represent vulnerable groups, being high-risk groups, and are people who have close ties with the targeted communities.
Peer and community education occurs through open-ended role-play, song, story-telling and general information sharing on sexually transmitted infections (STIs) at targeted sites. Condom distribution at sites is also an integral task performed by the peer educators, who meet weekly to train, discuss achievements, develop material and discuss strategy. Progress is mapped on site maps.
An impact assessment conducted by Measure/Evaluation (University of North Carolina) in 2003(i.e. three years after the initial baseline assessment) reveals that:
- condom use is increasing among both men and women (35% increase in men, 46% increase in use by women) in general and with new partners,
- AIDS prevention coverage at sites has increased significantly, and
- Condom availability has increased.
A challenge facing the project implementers, in terms of the impact assessment, is that although condom use has increased due to the intervention, half the people at the targeted sites still engage in weekly sexual episodes with new partners. Self-reports from men interviewed reveal no significant reduction in STIs.
In addressing the need for sustained intervention in the area, the HTA project management in the Bay engaged the services of the Small Projects Foundation to conduct a series of participatory planning and action workshops in the community. The aim is to develop links between resources in the community in a sustainable fashion through a "stepped" programme of story-telling, webbing, developing a matrix, self-evaluation, preliminary planning, two-pile sorting and detailed planning.
Participants draw from their knowledge and experience to strengthen and maintain links between clinics, volunteers and resource organisations.
The Nelson Mandela Bay HTA Project is funded through the Provincial AIDS Directorate, Eastern Cape Department of Health. The NMMM provides staffing in the form of the HTA Co-ordinator. ATICC, under whose auspices the HTA project falls, provides the floor space, and technical and administrative support to the project. EQUITY has provided funding for training, and Measure/Evaluation has provided funding for research. The Small Projects Foundation has assisted with the baseline survey, and in participatory planning and action workshops.
For further information or contributions to the project, please contact the Project Co-ordinator, Sister Mafane, or the Assistant Co-ordinator, Lulama Mtsi, on (041) 506 1415.
Useful link: http://www.sacities.net/downloads/HIVcasestudy.doc
|
| Was this article helpful to you? |
 ?100%???? ?0%
|
|
Back
|
|
|
|
