HIV/AIDS Prevention & Reproductive Health Project

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CHANGE IN KALPANA I live in Tilahar village. My husband and I have a very good relationship but our economic condition is quite poor. He went to South Korea to earn money. He sent money home and I started to change my lifestyle, eating at the hotel, going to movies, etc. One day I met a boy called Rupak at a hotel. He's a policeman and he asked me to sleep with him. I heard later that he has had relations with other women in the past. One day, I got one HIV and AIDS booklet from Red Cross and I knew about HIV and AIDS and STIs. At the same time, I met one lady trainer of Red Cross, Meena, and I shared my story with her. Then I am afraid of having sex with unknown person, and I left that kind of relation. After meeting with that lady trainer I knew about how to manage conflict, how to say no, how to avoid sexual stress and build my decision making capacity. Now my life is very simple. I think this kind of problem will come with unknown people who have no knowledge about HIV and AIDS and STIs. That's why, I thought information regarding these issues should be given to the community women. Nowadays I am passing information about HIV and AIDS, and STIs to our community people. Opinions of girls whether they prefer female teachers for the reproductive health classes are mixed. In general though the majority of girls would prefer and benefit from a higher number of female teachers to address their concerns. A female teacher stated, for example, that she has become a counsellor for female students. For more private issues they usually approach her out of class. In general and increasingly, men regard the involvement of women as positive. Statements are that women receive an education they need and which also benefits men when women share their knowledge and are less embarrassed to talk about SRH issues. Nevertheless, barriers do persist. All women groups state that their husbands are often curious and also suspicious about the topics and discussions in the women groups. Men tease women asking if they are not shy talking about these issues. In one community men stated that if women spend their time on these activities it means they did not find any (seasonal) work. In another case, while women were trained, the male would make comments about the trainer who dares to talk about these issues to so many women. Cases where men are clearly against the activities of women groups do persist. "My husband, who was working as a tailor in Kathmandu, returned to the village recently. He drinks and stays home all day. He doesn't want me to go to the women's group because he has no good opinion of such groups. He often quarrels with me and even beats me up," said Manju Nepali, member, Devisthan, Women Group, Bhaluwajor Village Development Committee. Women see a need for men to be addressed by the HIV training. Women argue that men are at higher risk compared to themselves. On the other side, men felt excluded, expressing their interest to know more about HIV or even asking for "male groups." As it is the case with the youth, women also prefer the option to have a mixed training with men, given that this would contribute to a higher mutual understanding of the other gender's concerns. Understandably - though perceived as negative by men - women would not want the men to take part in the meetings. "Once we went to the meeting held by women but they did not talk about anything seeing us there but when we left the place they resumed their discussion." In some project districts unwanted and early pregnancy often followed by early marriage reduced over the last years. The increase in CAPITALIZATION STUDY HIV/AIDS Prevention and Reproductive Health Project NRCS/SDC 2000-2007 21
female PEs further contributes to reaching out to girls and women and addressing female issues related to SRH. Cultural beliefs and attitudes are gradually changing and misconceptions disappearing: "Women no longer stay away from the family during menstruation, which used to be an important old tradition," "women dry their underwears and sanitary towels in the sun before using them which did not use to be the case." Before, minor infections were feared as serious STDs or HIV and girls or women suffered in silence, without seeking medical treatment. Now they are more open to talk about any physical 'abnormality' and are less shy to visit health facilities for treatment or counselling. Although these achievements cannot be solely attributed to the NRCS Peer Education approach, this change process was invariably reinforced by NRCS efforts at the school youths and the communities. As those students who are already active in class are selected as PEs, this entails the risk that students from deprived social classes, who are less likely to be academically toppers at school, are precluded. However, within the groups of PE's joint initiatives, new responsibilities and a sense of friendship contributes to removing class barriers. At times youth from lower class backgrounds once they are supported become lively and active members. Lessons learnt Youth need to understand how gender influences their attitudes and behaviours. Training and supervision should cover not only biological differences but also the influence societal gender roles and norms have on HIV and reproductive health and on their performance as peer educators. Gender norms that affect females may include submissiveness, deference to male authority, dependence, virginity until marriage, and faithfulness during marriage. Norms for men, in contrast, are built around power and control, independence, not showing emotions, risk taking and sexual activity. Working in mixed groups in the field allows PEs to practise new roles while the PEs themselves can serve as role models for other youth. Importantly, reproductive health education contributes to reducing misconceptions and cultural beliefs and promoting preventive and safe behaviours. Lessons learnt from the project: • Organizing joint activities and talking more openly about issues related to Sexual and Reproductive Health contributes to increasing interaction between boys and girls. • Education and raising awareness effectively reduces culturally entrenched misconceptions and gender attitudes and norms. • Selection of PE should be participatory and based on students' preference rather than teachers' preference and an effort should be made for equitable representation from all groups. • Direct information exchange on issues related to SRH mainly takes place between peers of the same gender, a balance between female and male PEs therefore is important. • Female teachers can play an important role as counsellors for girls. • Involvement of men is important to gain their support and raise awareness on HIV prevention. • Women themselves have limited capacity to inform and involve the men, they feel that barriers will persist as long as men are not directly targeted. • Male and female want the other gender to know about their concerns. They therefore welcome a joint training. However, at the same time a discussion space with only the same gender is important to achieve in-depth discussion and exchange about more private issues. 22 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 and 22: increased. "We were accused of bein
Page 23 and 24: Adults furthermore tend not to be v
Page 25: is not encouraged or allowed at all
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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