Showing posts with label prevention. Show all posts
Showing posts with label prevention. Show all posts

Tuesday, October 14, 2014

Stigma, HIV and Sexual Health in India: A Peer Educator's Perspective

The Government of India estimates that about 2.40 million Indians are living with HIV, with children (<15) accounting for 3.5% of all infections. In addition, 39% of the total number of people living with HIV are women. As such, stigma and discrimination towards those living with HIV is widespread. 

Nevertheless, there are numerous organizations that are working tirelessly to combat the general lack of information about HIV, as well as the rampant stigma that is associated with it. One such organization is The YP Foundation, who through their Know Your Body, Know Your Rights (KYBKYR) division is seeking to dispel myths and misunderstandings about HIV and sexual health among young people in India. 


What follows is an interview on stigma, HIV and sexual health in India with Sukhmani Kaur, Peer Educator at the Know Your Body, Know Your Rights division of The YP Foundation. In her time as a Peer Educator, Sukhmani has held workshops on comprehensive sexual health & reproductive rights, and HIV/AIDS with over a 100 girls and young women across India.  

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SAN: How does the Know Your Body, Know Your Rights program of The YP Foundation seek to address issues of stigma and discrimination among young people in India?

Sukhmani: The Know Your Body, Know Your Rights branch of The YP Foundation is a youth-led program which provides young people with an opportunity to enhance their knowledge and skills in the fields of health, gender, education, sexuality and human rights. It enables them to create, strengthen and promote new policies and programs by building leadership, with a special focus on peer education.

The peer educators are trained thoroughly on sexuality education and motivated to broaden their perspectives by addressing the various issues of stigma and discrimination at the national and international level. They are encouraged to think about the various possible solutions to the problems that dominate the sphere of sexuality, gender and health. The role of the peer educator extends to spreading awareness and imparting knowledge among other young people about stigma, and to also shed light on the common issues of discrimination with a set of coping strategies, through various workshops and advocacy programs.


SAN: What role do you think the persistence of stigma plays in the continuing prevalence of HIV and AIDS in India?

Sukhmani: The stigma attached to HIV and AIDS exists in a variety of ways, including shunning, discrimination and avoidance of those living with HIV. Stigma-related violence can prevent many people from seeking HIV testing, which could ultimately perpetuate the spread of HIV. Many people fear the absence of confidentiality and are consequently unable to disclose their HIV status.

Fear of rejection and violence also prevents people from seeing a doctor and seeking a secured treatment. Also, the widespread perceived association of AIDS with homosexuality, prostitution and drug abuse, which are already stigmatized in Indian society, has generated intense fear and resentment among the population at large. At a policy level, the stigma associated with HIV can deter the government from taking fast, effective action against HIV and AIDS. Thus, stigma is an important barrier to public action, making AIDS the silent killer. 


SAN: Do you think there is a strong correlation between the absence of testing services, lack of general information and the existence of taboos and stigma?

Sukhmani: Yes, undoubtedly there is a strong correlation between the absence of testing services, lack of general information and the existence of stigma and taboos. In health care settings, people living with HIV can experience stigma and discrimination such as being refused medicines or access to health facilities, receiving HIV testing without consent, and a lack of confidentiality. Many people do not get to choose to who, when and how to disclose their HIV status.

In the workplace, people living with HIV may suffer stigma from their co-workers, in the form of social isolation, or discriminatory practices such as termination of employment. Fear of an employer's reaction can also cause anxiety to a person living with HIV.

Despite the best efforts of civil society organizations, in India a large proportion of the population is still unaware of the distinction between HIV and AIDS, where the two terms are used as synonyms. This can arguably be one of the major causes for the generation of various myths surrounding HIV and AIDS. Also, a considerable number of people do not have adequate access to clean and secure health facilities, condoms and ART therapies. Because of the lack of general information, many are not aware of the modes of transmission and prevention, and therefore associate irrelevant actions, such as holding hands, kissing and hugging to HIV transmission.


SAN: How do you view the efforts of the government of India with regard to addressing issues of stigma and Discrimination?

Sukhmani: HIV and AIDS are major causes of concern for the Government of India. The government's major AIDS control initiative is the National AIDS Control Program and the premiere AIDS agency is the National AIDS Control Organization (NACO). The organization attempts to provide a dignified support to all the people living with HIV, as well as access to quality health care.

With sustained effort, the government has been successful in reducing HIV transmission through blood transfusion by ensuring the availability and safety of blood in blood banks. Mother to child transmission of HIV has also been reduced considerably by providing access to various testing services and experienced counseling. With the effective use of media, the government has also attempted to impart knowledge about the various modes of transmission and prevention. Condoms have also been made cheaper and easily available in some areas, which has also helped in the reduction of other sexually transmitted diseases.

However, to reduce the stigma and discrimination that surrounds HIV and AIDS, the government needs to redirect its focus on comprehensive sexuality education. All adolescents and adults should have access to sex education. People should also be provided detailed information about the various modes of transmission of HIV, and ways to prevent it, so as to dispel myths that surround HIV and AIDS. The stigma around the use of condoms should be eliminated for its effective usage. Also, it is imperative to completely eliminate stigma related violence in workplaces and health care centers. By improving the implementation of the policies undertaken by the various centers at the state level, the government could also make the access to testing services and medicinal drugs affordable and convenient.

SAN: In your work, have you seen a reduction in the stigma associated with HIV, especially among young people?

Sukhmani: The Know Your Body Know Your Rights Program of The YP Foundation creates and advances platforms for young people to advocate with decision makers for Comprehensive Sexuality Education. With a special focus on the rights-based approach, the program has been successful in reducing stigma associated with HIV and AIDS in the locations that it has worked in. In addition to providing detailed and accurate information about HIV, KYBKYR also attempts to eliminate the myths and misconceptions surrounding it. Other key objectives include sensitizing people about all forms of violence and discrimination, increasing access to quality health care, educating the youth and inculcating value education and clarification.

KYBKYR has also been successful in strengthening youth led initiatives and movements and advancing young people's human rights by building leadership. Various taboos and issues of discrimination are carefully addressed with accurate coping methods and strategies. Realizing the importance of educating people about HIV and AIDS, more and more young people have been targeted for spreading awareness about its causes, prevention and treatment. Also, it is important to realize that AIDS is not 'someone else's problem'. It is an issue that everyone should fight for, so as to completely eliminate all the myths and misconceptions and treat those living with HIV with dignity and respect. 

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To learn more about the Know Your Body, Know Your Rights Campaign check out their facebook page and their website

To learn more about The YP Foundation visit their facebook page and their website

Wednesday, January 15, 2014

"Shuga" is Saving Lives in Nigeria - Mario Christodolou


Read the original post in its entirety here, at The Impatient Optimist: http://www.impatientoptimists.org/Posts/2014/01/Media-Can-Change-Lives-and-it-Can-Save-Lives



January 06, 2014
Sophie has just had unprotected sex with her “Sugar Daddy” (a person who exchanges large amounts of money or gifts for sexual favours). While he goes to freshen up in the bathroom, she innocently snoops around the bedside drawer to reveal a box of pills—little does she know that they are antiretrovirals. She has unknowingly put herself at risk of HIV infection.
The scenario described above is from the new series of the MTV show Shuga, which has now landed in Nigeria. Condensed into this 60-second scene are issues related to transactional sex, negotiation of safer sex, HIV treatment, and HIV disclosure. But this depiction is just the tip of a gargantuan, mass-media behavior-change iceberg.
A scene from Shuga showing Sophie and Solomon in bed. Photo © MTV Staying Alive Foundation
Produced by the MTV Staying Alive Foundation in partnership with the Bill & Melinda Gates Foundation, US President’s Emergency Plan for AIDS Relief (PEPFAR), and the Nigerian National Agency for the Control of AIDS (NACA), the award-winning Shuga TV show has already had two hit seasons in Kenya. But Georgia Arnold, the Executive Director of the MTV Staying Alive Foundation and Executive Producer of Shuga, has a vision for the Shuga campaign in Nigeria that far exceeds anything attempted previously in Kenya.

“Shuga is a ground-breaking TV show that portrays the lives and loves of a group of young people. Seamlessly interwoven into the storylines are vital messages related to HIV and a wide range of other sexual health messages,” explains Arnold. “Alongside the TV series is a substantial mass-media campaign, which reaches our audience at all the points where they interact, improving their access to vital sexual and reproductive health messaging and directing them to the health services they need.”
As well as the TV show, the points of interaction that Arnold alludes to include a radio series, a mobile service (SMS), a comic book (focused on the domestic violence story line in the TV drama, aimed specifically at girls with low literacy levels), digital and social media, and a Skype service through which users can “call a character” from the show and share their thoughts.
Nii and Malaika in Shuga. Photo © MTV Staying Alive Foundation.
“The particular nature of stories and dramas not only deliver informational content but create emotional connections to characters and role models, which promote a better context for learning and behavior change than do factual presentations,” observes Victor Orozco, an economist at the World Bank and coordinator of their Africa HIV/AIDS Impact Evaluation Program. “TV could play an important role in introducing ideas to large segments of a society, especially segments where literacy is low and social norms discourage discussion of stigmatized issues such as HIV/AIDS and teen pregnancy.”
 Shuga series 3 aired for the first time on World AIDS Day, 2013, on more than 70 channels, with a potential audience of a half billion people.By keeping messages from the TV show at the forefront of people’s minds, the introduction of multimedia elements may have the potential to reinforce and promote positive behavior change. For example, sending weekly text messages can significantly increase adherence to antiretroviral treatment for people living with HIV. The Shuga campaign in Nigeria will aim to reinforce the messages of the Shuga TV show with a 360-degree campaign, including several social media and mobile components, such as text messaging and interactive voice recordings. Orozco is working with MTV to evaluate the behavior-change effects of the show and the additional impact of mobile messages through a randomized study.  
A character on the show is tested for HIV. Photo © MTV Staying Alive Foundation.

Shuga has made the journey from Kenya to Nigeria for several reasons. While some might argue that on the basis of prevalence, the need for a campaign like Shuga is greater in Kenya than in Nigeria—HIV prevalence in Kenya (
6 percent) is double that of Nigeria (3 percent). However, Nigeria has the second highest number of people living with the disease, and while maternal mortality has significantly fallen since 1990 in the country, one in 13 women still die during childbirth. Additionally, of Nigeria’s burgeoning population of over 150 million, nearly a third are young people aged 10 to 24 years—a population that falls neatly into the MTV demographic and who will relate more closely with stories portrayed in Shuga.
These public health concerns are compounded by a severe lack of knowledge about HIV among young men and young women. “Comprehensive knowledge about HIV is defined as knowing that condom use and having just one HIV negative and faithful partner can reduce the chances of contracting HIV; knowing that a healthy-looking person can have HIV; rejecting the two most common misconceptions about HIV transmission—that HIV can be transmitted by mosquito bites and that HIV can be transmitted by supernatural means," explains Dr Emmanuel Alhassan, Director, Resource Mobilization at NACA. “However, only 22 percent of young women and 33 percent of young men [in Nigeria] have comprehensive knowledge about HIV.”
Shuga has the potential to displace the silence that has engulfed serious issues like HIV in Nigeria and beyond, and to fill the knowledge vacuum that such silence has created. Shuga series 3 aired for the first time on World AIDS Day, 2013, on more than 70 channels, with a potential audience of half billion people. With this kind of reach, the ability for this so-called entertainment education to inform, change attitudes, and even change behavior is undeniable.
However, Orozco notes that policy makers and funders might be seriously under-investing in such mass-media approaches due to lack of rigorous evidence. But with the support of the Gates Foundation and MTV Staying Alive, he and other researchers are remedying this by evaluating Shuga and creating a knowledge base of what methods works and what is worth scaling up in Nigeria and elsewhere.
“Our vision for Shuga is to see a transformation in attitudes about the way the world talks about sex, not as a dirty topic, or something that should be hidden, but something that is openly discussed: parent to child, peer to peer,” envisions Arnold. “Only by doing this will we see a real change in people’s attitudes about HIV and their knowledge about it. Only through open and honest dialogue can we can hope to save lives.”
Find links to the episodes that have aired so far here
Read the original post in its entirety here, at The Impatient Optimist: http://www.impatientoptimists.org/Posts/2014/01/Media-Can-Change-Lives-and-it-Can-Save-Lives

Thursday, September 26, 2013

World Contraception Day 2013: 12 Awesome Posters that Promote Condom Use and HIV Prevention

One hundred years ago (and, in fact, well before that), if you wished to be intimate with some significant other, you’d only have had a handful of contraceptive options. And of those options, no method could, without a doubt, protect against HIV or STIs. But you now live in an era where access to modern contraceptive methods (particularly barrier methods like male and female condoms) are made effectively and are more accessible, a pretty amazing accomplishment when you consider how far we've come in this department.

Hence, each year, we commemorate this awesome feat with World Contraception Day, in hopes to raise awareness of the contraceptive methods available, as well as to celebrate decades of responsible and thoughtful decision-making. As an organization, committed to reducing the prevalence of HIV through eliminating the stigma surrounding it, we celebrate World Contraception Day as a day to celebrate taking control of your health and preventing the spread of HIV through male and female condom use!

On that note-- we’ve compiled twelve noteworthy health posters from the last few decades that promote condom use and preventing the spread of HIV! Be sure to look out for your favorite.


1. Lifesaver. Condoms Can Protect You.



While this poster is rather simple, its message of condom use as a life-saving tool is incredibly accurate. Sometimes you don’t need all of the bells and whistles to pull off an effective condom awareness ad; a few words of encouragement will do.


2. Protect Your Valuables



You wouldn’t let your dog out without a leash, right? That’s the underlying message behind this condom awareness ad: keep your equipment safe! (And, for goodness sake, please don’t actually put your house pets in condoms.)


3. Whatever you call it use it, or call it a night!


To some people it’s a Sling; to others it’s a Thing! What’s it to you?


4. Condoms Can Protect Any Person, No Matter What Color They Are


HIV doesn’t discriminate, and neither do condoms! In fact, you could probably find the condom of your dreams right now, in your closest convenience store.


5. Do the Safe Thing



This cheerful ad gets us every time. Choosing to use contraception is not only important for you, but for your loved ones as well! You wouldn’t want to expose your significant other to HIV, and you would hope that your significant other was just as thoughtful, right?


6. Stop AIDS



While this HIV awareness poster promotes a very straightforward message, it’s undoubtedly effective. Making the link between contraceptive use and HIV reduction is about as clear as it gets.


7. Be Good in Bed


There really is nothing more benevolent than using a condom every time. It's a great way to do your part, much like volunteering to feed the homeless or not cheating on your taxes.


8. Sailors, 1988



This HIV awareness ad presents a pretty clear message, and it targets a specific group that might be at heightened risk for HIV and other STDs. What more could you want from a condom ad? 


9. The Best Cover-Up Since Watergate





Although Nixon probably wouldn't agree with this HIV awareness advertisement, we sure do! Deciding not to cover up with a condom is almost as scandalous as the Watergate cover-up (okay, it's probably a bit more scandalous).


10. Good Boys Always Wear Their Rubbers



Think about it. You wouldn't dare step outside without your raincoat and your little rain boots; you could easily catch something. Engaging in unsafe sexual activity is basically the same thing.


11. Who is HIV Positive?



Awareness ads like these tend to be attention grabbers, and rightfully so! Habitual use of a condom really is to best way to protect yourself against HIV and other STDs!


12. Moroccan Awareness Poster


You don’t need to understand the text in this ad in order to understand the importance of regular condom use, because that’s one message that clearly transcends location and culture. This is one of thousand of awesome promotion advertisements created for display in countries around the world.



So there you have it. Which one was your favorite? And what did you learn? If nothing else, we hope you grasped that HIV and other STDs don’t discriminate between groups of people, making us all at risk of contracting them. Luckily, a condom can significantly reduce such incidents! Stay safe and use a condom!


Happy World Contraception Day!