HIV/AIDS Prevention & Reproductive Health Project

elated to SRH. One group, for example, said
that now, if they are blamed for not having a
son they would turn this down saying that it
is the men who determine the sex of the
child. Many cases are described where
women are now more open to discuss HIV
with their husbands and other community
members. Some women even described
how they would convince their husbands to
have a blood test or use protection. Some
cases where women previously have
suffered in silence, they now approach the
trained group members and seek advice.
Women group members provide them with
the answer and when they are not sure
themselves the advice-seeking women are
referred to the health facilities.
However, barriers are naturally prevailing. In
general women still find it easier to talk to
close friends on issues related to SRH as
compared to their children or husbands.
Taking protective measures is further
inhibited as there are no VCT centres in the
proximity. In the western districts the closest
VCT centre is in Pokhara, in the eastern
districts it is in Kathmandu. "How can we tell
spouses who come back after years to go
back to Kathmandu, have their blood tested
and then return home with a clean chit
before having sex?"
Compared to the youth, women are in a
better position to address issues related to
SRH to other adults in the community. Youth
usually discuss with closer friends and, in
some cases, also with other peers of their
age and sisters or brothers. They prefer not
to be responsible for sensitizing their
parents. The project took account of these
realities by including the women as
mediators to reach the adult population. The
women groups clearly contributed to
opening up the environment and also
increasing acceptance and support to HIV
prevention at schools and community
initiatives of PEs.
However, women groups do not have the
same institutional links compared to the
J/YRCCs and a main concern regards their
level of sustainability. In more urban settings
HIV prevention targeting the general adult
population mostly focuses on mass media
ideally combined with counselling at health
facilities and work places. These approaches
bear less potential in a rural setting and other
more sustainable alternatives compared to
the community initiatives may not be feasible
or effective. Health posts and family planning
volunteers provide information on HIV, but
they contribute less to reducing barriers and
stigma on issues related to HIV. Where
women groups exist in the frame of other
programmes they may be used to integrate
the issue of HIV, provided that they bear a
certain level of sustainability.
Lessons learnt
Involvement of parents and senior/elder
members of the community provides PEs the
critical support that they need to spread
awareness about HIV and AIDS and SRH.
Proper understanding regarding HIV and
AIDS, their symptoms and the modes of
transmission also contributes to reducing
stigma and discrimination attached to HIV
and AIDS.
Moreover, the project initiatives bear the
potential to increase inter-generational
communication and raise awareness and
openness among parents and other adult
peers on issues of HIV. However, parents
may find it difficult and be reluctant to talk
about relationships and sexuality with their
children out of embarrassment, lack of
accurate information, or fear that they will
appear to condone adolescent sexual activity.
Similarly, youth prefer friends of the same
age and gender to discuss issues on SRH,
followed by sisters or brothers. Inter
generational talk about SRH in all societies is
a challenge for both the youth and parents.
CAPITALIZATION STUDY
HIV/AIDS Prevention and Reproductive Health Project
NRCS/SDC 2000-2007
17