Behaviour change still a challenge in the HIV fight

….media has an important role in this regard
TEN YEARS later, on the HIV frontline, the same messages are heard repeatedly and while there has been some progress, the truth is that there is much more to be done.
Whether it is structural or social factors, the fact remains that years later – and after the introduction of a plethora of HIV/AIDS programmes – behaviour change is still a challenge.
However, a highpoint is that locally, increasing attention is now being placed on the role of the media to affect change.

The Guyana HIV/AIDS Reduction and Prevention Programme (GHARP) Phase II last Thursday held a consultation with members of the media corps in an effort to address their role in tabling and challenging what are becoming harmful cultural norms.
GHARP Chief of Staff, Ms. Silvia Gurrola, is contending that “radical change” is what is needed and the effective channelling of the relevant information can achieve that.“The media can have an incredible impact on people’s attitudes and behaviour and the decisions they make in life,” she said.
Gurrola noted that once done correctly, the dissemination of messages can in fact “create consciences.”
This is most important since ‘someone’ decided that people with HIV/AIDS cannot be loved or cannot have meaningful relationships, or should not be entitled to live a regular life.
Why and is it fair? Of course not; but because of HIV’s association with behaviours that may be considered socially unacceptable by many, it continues to be widely stigmatised.
Official reports cite examples of people living with the virus being subjected to, not only discrimination, but human rights abuses; many have been thrown out of jobs and homes, rejected by family and friends, and some have even been killed.
Stigma and discrimination is one of the greatest barriers to dealing with the HIV epidemic. They not only discourage timely action, but discourage individuals from finding out about their HIV status and discourages disclosure by those infected, who also delay getting treated.
Gender inequality, human rights violations and stigma and discrimination are actions that are not easily measured and increase people’s vulnerability to HIV infection; hence the increasing importance of the media’s role.

According to a recent United Nations Programme of HIV/AIDS (UNAIDS) report, with people living with HIV or otherwise affected by it, the following rights should be protected:
* Non-discrimination and equality before the law: right not to be mistreated on the basis of health status, their HIV status;
* Right to health: right not to be denied health care/treatment on the basis of HIV status;
* Right to liberty and security of person: right not to be arrested and imprisoned on the basis of HIV status;
* Right to marry and found a family, regardless of HIV status;
* Right to education: right not to be thrown out of school on the basis of HIV status;
* Right to work: right not to be fired on the basis of HIV status;
* Right to social security, assistance and welfare: right not to be denied these benefits on the basis of HIV status;
* Right to freedom of movement, regardless of HIV status; and
* Right to seek and enjoy asylum, regardless of HIV status.
Coming out of the consultations, and a general consensus among the HIV/AIDS stakeholder community, is that every one is at risk of contracting HIV and should not discriminate against those who have, regardless of the circumstance.
According to Gurrola, GHARP’s efforts in support of the initiatives of the National AIDS Programme Secretariat (NAPS), are expected to go a long way.
She said they are expected to assist journalists in finding creative ways to provide people with an “easy way” to address what they consider taboo issues, more importantly to understand the impact of their own attitudes and behaviour.

Consultation

At the consultation, information and education programmes were highlighted as essential components of HIV prevention.
GHARP Prevention Director and facilitator of the media consultation, Dr. Karen Gordon-Boyle, stressed that everyone is vulnerable and people need to “wake up to the reality” of HIV.
The social and economic factors that increase people’s vulnerability to HIV infection include stigma and discrimination, as well as poverty and lack of HIV awareness and access to education, health and other services
With the presence of these factors, persons tend to engage in behaviours such as unprotected sex or exchange of contaminated needles, all of which only up the risk a notch.
Dr. Gordon-Boyle said these and other factors fuel the HIV epidemic. In this context, she pointed to the youth, one of the many target populations of HIV/AIDS programmes.
The Prevention Director noted that youths are making their sexual debut earlier.
One of the suggestions raised during the consultation was the need to re-examine the role models that youths are exposed to and introduce new and better examples.
One concept discussed was that of making it “cool to wait” or, in other words, making “virginity” a popular behaviour, rather that treating it as a burden and have youths involved, and in some case pressured by peers, into sexual engagements.
Gordon-Boyle said presently the average age where teens make their sexual debut is around 13, a startling statistic.
Another suggestion raised was getting parents more involved and more comfortable with speaking to their children about issues like sex, which in the past and still is, in many cases, a taboo issue.
Participants of the consultation noted that a way to get around this was to make HIV messages something that the youth can connect with, make the language appeal to them.
One participant noted that as a youth, if there was a problem, you listened to popular artiste Vybz Kartel and you knew what to do, you knew how to handle a situation. Nowadays, the influences are people like Mavado, among others, most of whom are looked down upon by the more rational and mature sections of society.
However, fact is these artistes are major influences and there is a need to reach the youths in a similar way.
Again the significance of the media’s role was highlighted.
Coming out from the workshop, GHARP is now focusing on a Media Skills Building Workshop, expected to be held in October, which will address specific areas and enable media practitioners to affect change.
GHARP’s contention is that it recognizes the role the media can play; and by assisting in building capacity, the relevant issues can be highlighted, as media practitioners assist in molding and reshaping the attitudes and behaviours of the Guyanese people.

Guyana’s Context

Guyana is described as having a generalised epidemic and the first reported HIV case for Guyana was in 1987.
Today, the estimated prevalence among the adult population is around 1.5 per cent, but according to Gordon-Boyle there are “pockets” where the prevalence is higher.
Between 1987 and the end of 2006, there was a cumulative total of 7,831 AIDS cases but this increased to 56.2 cases per 100,000 by 2003. Cases have been reported in all ten geographical regions of the country. The majority of the cases are among persons in the 20-44 age group.
Between 1988 and 2000, the Government of Guyana was the main source of financial support for HIV/AIDS programmes. Since then, external funding has surpassed domestic sources of funding by approximately 50 per cent.
The key elements of the GOG’s current response to the epidemic include:
* Strengthening of the surveillance system to produce information that will inform the design of interventions for HIV/AIDS re
duction and planning care for those affected;
* Increase access to appropriate STI diagnosis and management as a key prevention strategy;
* A plan to increase access to voluntary counselling and testing (VCT);
* A Plan to increase PMTCT Plus sites;
* AIDS awareness and education training at worksites;
* Rigorous blood screening for HIV and other infectious markers;
* To reduce the risk and vulnerability to infection with HIV through targeted public education efforts focused on health care providers, youth, employers, employees, entertainers, commercial sex workers and men who have sex with men;
* Provision of free HIV services including antiretroviral therapy for HIV-positive patients;
* Early infant diagnosis;
* Plan for the expansion of the Laboratory diagnosis and monitoring of HIV, and for the diagnosis of opportunistic infections;
* Support for persons living with HIV (nutritional, psychosocial, economic and others); and
* Support for orphans and vulnerable children.
According to NAPS, in Guyana, HIV prevention is multi-sectoral and multi-dimensional, aligned with One National Programme of a scope and mix that is effective, at an intensity that is sustained, and of a scale to reach and impact everyone.
HIV prevention is also based on and driven by the promotion, protection and respect of human rights, diversity, and gender equality, and addresses the most vulnerable and the drivers of the epidemic, with priority and special consideration.
Notable too, is that Guyana’s ‘combination prevention’ of HIV is devoid of dogma, and based on science; is targeted, focused, evidence-informed, and developed, delivered and maintained at a high level of excellence.
HIV prevention, according to the Secretariat, is locally-adapted and prioritised, according to the epidemiological scenario and socio-cultural contexts, in partnership with all stakeholders, particularly those for whom HIV prevention programmes are developed and implemented.
Most importantly, the delivery of HIV prevention activities is informed by continuous research and development of innovative prevention technologies.

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