HIV/AIDS Prevention & Reproductive Health Project

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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
Adults furthermore tend not to be very receptive to teaching by the young, regarding any subject but even more so with regard to SRH. These are social commonalities that exist in any country or culture and may be reduced over time but are unlikely to disappear altogether simply by reducing culturally bound barriers. Lessons learnt from the project: • Compared to youth, women are in a better position to address issues related to SRH to other adults in the community. • After the short training many women still do not feel confident to disseminate detailed technical knowledge. A technical knowledge to teach others is unlikely to be achieved after a few days training • Women are most likely to talk to close friends and family members of the same age and gender regarding SRH. Increased communication between adults and youth on issues related to SRH is less likely to happen at all and more so within such a short time frame. • Indirect approaches such as the street drama are easier to implement, talking directly and individually to community members is more difficult. It needs "tools" and IEC materials to open up discussions. • Integrating HIV into other issues related to Reproductive Health is essential to gain and keep the interest of the women. HIV as a stand alone issue is not sufficient to keep the interest and fill regular meetings in a longer term. • The motivational effect of the training tends to fade away and it needs additional incentives to keep the interest up and fill the agenda of meetings. • If PEs meet PLWHA, this has a direct and effective impact on their attitudes and it effectively contributes to eliminate any stigmatizing prejudices that may have persisted (unconsciously) before. 18 CAPITALIZATION STUDY HIV/AIDS Prevention and Reproductive Health Project NRCS/SDC 2000-2007
Page 1 and 2: HIV/AIDS Prevention & Reproductive
Page 3 and 4: Contents List of Abbreviations III
Page 5 and 6: Study Methodology This capitalizati
Page 7 and 8: the National HIV and AIDS Strategy.
Page 9 and 10: Life skills development of Youth Pr
Page 11 and 12: community. Sessions now include dis
Page 13 and 14: Lessons learnt Adolescents have man
Page 15 and 16: national system for distributing IE
Page 17 and 18: forbade his sister to be involved i
Page 19 and 20: PEs disseminate messages related to
Page 21: increased. "We were accused of bein
Page 25 and 26: is not encouraged or allowed at all
Page 27 and 28: female PEs further contributes to r
Page 29 and 30: for Global Fund for AIDS, TB and Ma
Page 31 and 32: Summary of Recommendations • Peer
Page 33 and 34: Annex I Newspaper extracts Advising
Page 35 and 36: Under the initiation of District Re
Page 37 and 38: support.) Do you think there is a y
Page 39 and 40: information materials used? Who dec
Page 41 and 42: III Project documents and consulted

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