Towards behaviour change…
THE National AIDS Programme Secretariat (NAPS) yesterday undertook an analysis of the results of the second Behavioural Surveillance Survey (BSS). NAPS Programme Manager, Dr. Shanti Singh said, at the start, that it is crucial for efforts to continue targeting maximum benefits for the dollars spent.

She spoke at the one day workshop in Regency Suites Hotel, on Hadfield Street, Georgetown, where the objective was also to engage stakeholders in discussions on the future direction of the programme.

The Ministry of Health, in 2003, commissioned the BSS to better understand the dynamics of HIV transmission in Guyana and the focus was on specific groups, among them youths both in and out of school, members of the uniformed services, men who have sex with men (MSMs) and female sex workers (FSWs).

The study conducted on the latter two are called Biological and Behavioural Surveillance Surveys (BBSS), as they have an additional biological component, including testing for HIV and syphillis.

Both the BSS and BBSS used the standardised method developed by Family Health International (FHI).

Speaking about what was accomplished through the BSS and BBSS, Singh said the studies enlighten efforts with regards to what works and what does not work.

“Evidence of who are at risk, where those persons are and when and how to best intervene are ever so important at this juncture of our epidemic, when much has been achieved in educating the general public,” she said.

Singh said, in continuing with the aim of completely understanding the HIV transmission and prevention, attention must also be placed on other factors, such as alcohol that influence the two.

Collaborative
Alluding to the partnership with NAPS that assisted with the surveys, she acknowledged that the undertaking was a collaborative one.

In keeping with the initial focus, the Guyana BBSS 2008 to 2009 yielded findings on the Military, Police, in-school youths, out-of-school youths, MSMs and CSWs, the l,ast being individuals 15 years old and over who exchange sex for money.

The results revealed that there is a high awareness of HIV amongst the CSWs but the comprehensive knowledge on it is low, while consistent condom use with paying partners is high and there is some alcohol and illicit drug use.

It was also disclosed that CSWs are streets, bars and brothels based, ship girls work at the ports, gold seekers work in mining communities, as well as phone solicited or mobile/border workers.

MSMs were found to be persons 18 years old and older who had manual, oral, or anal sex with another male and, in that group, alcohol/substance use continues to be high with one-third of the respondents having admitted using marijuana.

Each had an average three male commercial partners during last six months and condom usage was fairly high, like knowledge of sexually transmitted illnesses (STIs), including HIV and two-thirds knew all three methods of prevention.

However, there was still some misconceptions, such as mosquito transmission, as well as some stigma and discrimination.

According to the report, most MSMs said they took the HIV test and have seen HIV/AIDS advertisements on television, although approximately just about two or three were reached by a peer education activity.

Out-of-school youths were described as persons between the ages of 15 and 24 years of age, not attending school and neither married nor cohabiting.

The revelation about them is that 68 per cent used alcohol but 49.5 per cent consume it less than once a week and, of the respondents, 18 per cent never used marijuana. Another 66 per cent had sex and 21 per cent had it before they were 15 years old. Twenty-one per cent said they had been forced into it and, of the total,  91 per cent heard of an STI and two per cent had boils or sores on their genitalia.

Abstinence
Ninety-nine per cent heard of HIV and 90 per cent thought abstinence could prevent the infection. Yet only 75 per cent knew all three methods of HIV prevention and 94 per cent that a healthy person could transmit it.

In school youths were grouped as individuals between the age of 15 and 19 years attending public and private schools and unmarried.

More than a quarter or 27 per cent of them had sex and, of those, 66 per cent had been sexually active in the last 12 months. More than half, 53 per cent of them used a condom the first time they had sex. Forty-nine per cent always make use of it during sex with regular partners and 39 per cent with transactional partners.

Almost all of them, 93 per cent heard of STIs and 98 per cent of HIV. However, only 52 per cent know all three methods of HIV prevention.

In the Police Force, where individuals 18 years old and older live and/or work at a station or outpost, whilst the use of alcohol is high, nearly half of them drink it less than once a week and one-fifth less than once a month.

With yearly medical check-ups, incidents of STIs are low and the majority of the respondents said they were having sex with regular partners, as compared with non-regular and commercial partners. A vast majority used condoms during their last encounters with a non-regular partner. Additionally, a majority of them are knowledgeable on the methods of HIV prevention, reject the major misconceptions and expressed acceptable attitudes to persons living with HIV and AIDS.  The respondents also know their HIV status, the compilation said.

The Military was defined as members of the Guyana Defence Force (GDF) aged 18 years and older who live and or work at Army bases.

Their overall knowledge of HIV/AIDS is high, as is counselling and testing and the use of condoms with partners at last sexual encounter. But risk perception was found to be generally low amongst them, with a small proportion being unable to assess their risk and acceptable attitudes to persons living with HIV was low.

Concern
In hindsight, Singh said one particular area of concern was pockets of ignorance still existing in society.

She said, even with the vast amount of information available, there is not 100 per cent success.

Singh said the understanding is low among minority groups and it affects behaviour change and increases risks.

She said, though, that, in an effort to inform change, NAPS and its partners are committed to increasing awareness.

“Behavioural change is a very difficult to achieve,” she noted but said: “Our responsibility is to continue all efforts to educate persons.”

Singh said behaviour change is bolstered by the supportive environment that NAPS and partnering entities have been working to create.

“It has to be ongoing.We cannot stop,” she maintained, announcing that the third BSS and BBSS will be undertaken soon.

Singh said she has already identified close to 100 people to be involved in the planning and execution.

She said the target groups will be similar so that some comparative analyses can be done and reviews undertaken on them with the interest of including other groups.

The entire project is funded by the United States Agency for International Development (USAID)/President’s Emergency Plan for AIDS Relief (PEPFAR).

USAID Health Officer, Mr. Matthew Nims told the workshop participants that the mission in this country is committed to supporting the Ministry of Health in accessing data for decision making.