Zimbabwe launches the National Behavioural Change Strategy for prevention of HIV

The National AIDS Council of Zimbabwe (NAC) launched the National Behavioural Change Strategy for prevention of sexual transmission of HIV in Beitbridge on 2 March 2007. The strategy is believed to be the first one of its kind in southern Africa, thereby making Zimbabwe lead again in the HIV and AIDS response in the region – the country was the first to introduce the National AIDS Levy Trusts Funds.

Developed by the National AIDS Council (NAC), with support from the United Nations Population Fund (UNFPA) and other stakeholders, the five-year strategy is aimed at reducing the number of new HIV infections in Zimbabwe.

The strategy:

• builds on epidemiological and social science review processes, focusing on key drivers of the HIV epidemic such as multiple concurrent partnerships;

• addresses underlying factors for vulnerability, in particular gender roles and relations; and

• promotes reduced gender imbalances and increased male responsibility.

It is based on sound empirical research conducted by NAC and other stakeholders. Previous interventions on behaviour change were not based on any empirical evidence.

UN agencies will play a pivotal role in ensuring the success of the goals and objectives of the strategy. UNFPA will support expanded female condom promotion, while UNICEF will assist in training of teachers in HIV life-skills education and gender issues.

Components of the strategy include:

• promoting abstinence and delayed first sexual encounters among unmarried young people;

• implementing programmes and interventions that go beyond awareness-raising and the Abstinence, Be Faithful and Condomise (ABC) approach and addresses underlying factors of vulnerability;

• creating an enabling environment to achieve normative and behavioural change;

• empowering women to allow them to refrain from risky relationships and protect themselves; and

• encouraging people openly living with HIV and AIDS to become strong advocates for prevention.

Government officials including the Minister of Health and Child Welfare, Dr. Parirenyatwa, UN agencies namely UNESCO, ILO, WHO, UNAIDS, UNICEF and UNFPA attended the launch.

Primary and secondary school children, community peer education groups and traditional dancers provided various impressive messages on HIV and AIDS and the need for behaviour change. Through drama, poetry, songs and dances, school children highlighted issues affecting their communities such as stigma and discrimination, orphans and vulnerable children and risk behaviours.

Currently, the HIV prevalence stands at 18.1% and this is attributed to behaviour change including reduction in the number of sexual partners and increased condom use. The launch of the strategy is a scale up mechanism to further reduce the prevalence rate. This new behavioural change focus will be supported by increased access to and availability of prevention commodities and services, including Information, Education & Communication (IEC) materials and condoms.

For more information, visit: www.nac.org.zw. Top

Stakeholders scale up response to HIV and AIDS in Zambia

The Government of the Republic of Zambia and the Global community have stepped up efforts in response to the HIV and AIDS pandemic in the country. Zambia is a signatory to several important commitments to respond to the challenges posed by HIV and AIDS.

Its development agenda is seriously threatened by the pandemic. 15.6% of the adult and productive population is infected with HIV. The number of persons dying as a result of HIV is estimated at 89 000 per year, leaving behind a continuously growing number of orphans currently estimated at 801 000. Life expectancy at birth has fallen below the age of 40. It has weakened individual families, the public and private sectors and Zambia’s long-term development.

To counter its effects, Zambia has been implementing recommendations from the various instruments developed to scale up the national response.

In line with the recommendations of the “Three Ones Strategy”, Zambia has:

• developed a National HIV and AIDS Strategic Framework (NASF 2006–2010) and mainstreamed HIV and AIDS into the Fifth National Development Plan 2006-2010;

• established, through legislation, the National HIV/AIDS/STI/TB Council (NAC) comprising government ministries and civil society to coordinate the multi-sectoral national response;

• developed a costed Monitoring and Evaluation Framework, through the National AIDS Council (NAC), to ensure that it receives financial support in a predictable manner; and

• in collaboration with cooperating partners (the United Nations and donors), developed a Joint Assistance Strategy for Zambia (JASZ), which provides guidance on how to achieve the goals of the AIDS strategic framework and the development plan through better harmonisation and alignment.

Although Zambia and the cooperating partners have made significant progress in response to the pandemic, the country is still facing challenges. These include:

• the need to scale up access to antiretroviral (ARV) treatment (only 25% of HIV positive pregnant women receive a complete course of ARV prophylaxis to reduce the risk of mother-to-child transmission);

• increasing the number of people with knowledge of their status since only 13% of the population has tested for HIV and know their status;

• having only a few people receiving treatment service (75 000 men and women and 7 200 children are on ARV treatment); and

• limited resources for people living with HIV and AIDS, orphans and vulnerable children.

In an effort to overcome the above-mentioned challenges and meet the Millennium Development Goals, stakeholders recommend:

• sustaining a full-scale response through making AIDS a top priority for public action at national level;

• financing and mobilising the AIDS response to ensure a comprehensive and multi-sectoral response;

• dealing with those sensitive issues – the structural drivers of the pandemic – such as the practice of concurrent sexual partners, transactional and cross-generational sex, gender inequality, poverty, stigma and discrimination around sexuality; and

• maintaining AIDS at the core of the development agenda.

For more information, email: sozic@unaids.org. Top

Zimbabwe develops HIV and AIDS District Atlas

The National AIDS Council (NAC) of Zimbabwe, in partnership with the United Nations Population Fund (UNFPA), has developed an HIV and AIDS District Atlas.

It is an initiative of the multi-sectoral Monitoring and Evaluation Task Force under NAC whose aim is to promote utilisation of data collected by the national monitoring and evaluation system and identify gaps in HIV and AIDS programme development and implementation in Zimbabwe. It is also expected to assist the Zimbabwean government, donors and implementers in analysing programmes in the context of the broader district and national response.

Other functions include:

• contributing to making programmes more complementary; and

• assist in planning the expansion and development of programmes.

The Atlas builds on information from various existing sources, including the Zimbabwe AIDS Network directory, the Ministry of Health and Child Welfare, the Central Statistical Office and the United Nations Office for the Coordination of Humanitarian Affairs. It covers the provinces of Manicaland, Midlands, Mashonaland and Matebeleland provinces.

Through the use of colourful maps, the Atlas highlights HIV and AIDS service organisations in different districts, which consist of governmental and non-governmental organisations, the private sector and faith-based organisations.

It also provides statistical information on:

• priority areas of the different AIDS organisations;

• infrastructure and human resources relevant to the HIV and AIDS response;

• population distribution; and

• programme and impact indicators.

This edition of the Atlas only includes information and maps for the rural areas. However, NAC will publish a second edition in the second half of 2007, which will not only highlight urban areas but capture new information on HIV and AIDS in the country.

It is hoped that the Atlas will stimulate an active programming dialogue and contribute to a more effective response to the challenges of HIV and AIDS. Dialogue on strategic programming information is an important process, especially if it identifies areas for improvement in information management as a basis for improved programming.

The target audience comprise national, provincial and district policy makers, programme managers and donors. District level planners will receive the provincial version of the Atlas to allow for comparison of district responses between neighbouring regions within a province.

For more information, email: cmajonga@nac.org.zw. Top

Unleashing the Energy for Change: Life Skills for Vulnerable Adolescents in Mozambique

As part of the multi-country initiative on life skills in eastern and southern Africa, Mozambique, in partnership with UNESCO, UNICEF, and UNFPA, has developed a proposal to scale up life skills provision from 2007-2009. The proposal builds on experiences drawn from the current country programme on implementing life skills interventions in Mozambique and the Multi-Country Initiative (MCI) 2002-2005.

Its objectives include:

• ensuring that vulnerable adolescents develop life skills and are able to use such skills and knowledge to improve their lives in a more sustained manner;

• providing adolescents and young people with access to youth-friendly health services; and

• assisting them practice the life skills learnt and availing the youth-friendly health services provided.

Through the Primary Prevention Programme, the above-mentioned objectives will be achieved. The Programme aims to:

• empower children and young people to protect themselves from infection;

• ensure that programmes are developed with and for children and young people and tailored to the socio-economic and cultural dictates of each community; and

• provide information and knowledge necessary to adopt and maintain positive behaviours that promote social change, among other issues.

The Primary Prevention Programme is part of the National HIV and AIDS prevention programme for children, adolescents and young people and all UN agencies involved in prevention will contribute to its development as part of the United Nations Development Assistance Framework for 2007-2009.

The proposal outlines the strategy to be employed and a key component is the institutionalisation and capacity development of the National Life Skills Framework.

Other components comprise:

• Partnership and participation among all stakeholders, including UN organisations.

• Strengthening the knowledge base on lessons learnt and documentation of best practices.

• Supporting adolescents and young people with relevant service delivery to build their capacities and protect themselves from HIV and AIDS.

• Advocacy and communication to re-position adolescents and young people in the development agenda.

Some of the expected outcomes include:

• strengthened capacities of peer educators and stakeholders involved in the provision of life skills training to be able to scale up their programmes;

• increased number of HIV and AIDS school Youth Clubs; and

• children and young people practising life skills in an enabling environment created through HIV and AIDS community awareness activities.

Children and adolescents in Mozambique face conditions of extreme-poverty and orphan-hood due to the lengthy civil war and high rates of HIV infection. Poverty drives young people, especially girls, to engage in transactional sex and many are subjected to sexual assault among other challenges.

For more information, email: mrelano@unicef.org. Top

Male circumcision for HIV prevention in young men

“Male circumcision could provide substantial protection against acquisition of HIV infection.”

This is one of the key findings of studies conducted in Kisumu (Kenya) and in Rakai (Uganda) to investigate the effect of male circumcision on HIV acquisition in men from 2004-2006. Results confirmed male circumcision reduced the risk of HIV infection by 53% and 48% respectively. Conducted by researchers from the University of Illinois (Chicago, USA), the University of Manitoba (Canada) and the University of Nairobi (Kenya) among others, the studies’ aims were to determine whether male circumcision had a protective effect against HIV infection and assess safety and changes in sexual behaviour related to this intervention.

Other findings:

• Models studies suggest that male circumcision may prevent 5.7 million new cases of HIV infection and 3 million deaths over 20 years in sub-Saharan Africa.

• Male circumcision is highly cost-effective, saving about $2.4 million over 20 years per 1000 circumcisions.

• Medical circumcision can be provided safely to adult men in developing country settings.

• The study recorded a reduction in risk behaviours in both circumcised and uncircumcised men indicating effective initial behavioural counselling and voluntary HIV testing offered to participants.

Despite benefits of male circumcision, studies in sub-Saharan Africa reveal mixed attitudes towards male circumcision as a tool for the prevention of HIV infection. A study conducted in Malawi showed that people’s attitude towards male circumcision varied by region, gender, religion and age. Acceptability was based primarily on the premise that circumcised men were cleaner, carried less disease and increased sexual pleasure. Very few participants equated male circumcision with the reduction of HIV infection and most expressed interest in circumcision once adequate knowledge on the risks and benefits of male circumcision were made known to them.

The Government of Swaziland has endorsed male circumcision. Research shows that a majority of males have accepted male circumcision and are prepared to be circumcised if it reduced vulnerability to HIV infection. Nurses have begun bringing their husbands and sons to be circumcised while the Ministry of Health is keen to roll-out a mass circumcision programme. Swaziland is training doctors in male circumcision procedures and requesting them to help in “circumcision days” (when circumcision is conducted free of charge).

In the addition to acceptability, other studies focused on the various opportunities and challenges of male circumcision. One such study, commissioned by the Ford Foundation, identifies several challenges and opportunities. Male circumcision:

• offers an opportunity to re-engage with religious and ethnic groups in HIV prevention;

• provides lifetime medical benefits (60% protective effect against HIV and AIDS)

• may promote false sense of security which may lead to high levels of risky behaviour and limited condom use;

• promote stigma associated with male circumcision or lack of it.

The review recommends, among other things, the development of national strategic plans for countries with the highest prevalence, a single sentinel surveillance and reporting mechanism, clear guidelines on basic standards of care to ensure utilisation of opportunities.

For more information, email: rcbailey@uic.edu or visit:

http://chipts.ucla.edu/TEMPMAT/PDF/SectionA/Male_Circumcision_020107.pdf.
www.thelancet.com. Top

UNAIDS releases policy on greater involvement of people living with HIV and AIDS

Greater involvement of people living with HIV and AIDS (GIPA) is a principle that promotes the realisation of rights and responsibilities of people living with HIV, including their right to self-determination and participation in decision-making processes that affect their lives. It aims to enhance the quality and effectiveness of the AIDS response by engaging people living with the virus to share personal experiences on factors that make communities and individuals vulnerable to its infection and strategies of managing HIV-related illnesses.

Working with people living with HIV (PLWHA) improves the relevance, acceptability and effectiveness of programmes. Proactive engagement by communities in ensuring their own well-being is a key ingredient for successful intervention programmes. The GIPA policy ensures that PLWHA are equal partners in HIV and AIDS response. It also, seeks to break down simplistic (and false) assumption that “service providers” are people living without HIV and “service receivers” are those living with HIV.

Engaging PLWHA is critical in scaling up national AIDS responses to achieve the goal of universal access to prevention, treatment, care and support services. GIPA has many advantages, including:

• improvements in self-esteem and morale at individual levels;

• changing perceptions, as well as providing valuable experiences and knowledge; and

• breaking down fear and prejudice by showing that PLWHA are productive members of, and contributors to, society.

In terms of the national response, PLWHA support many activities including the roll-out of treatment campaigns (through educating others on treatment options, side effects and adherence), participating in the development and monitoring of HIV-related policies at all levels and taking leadership of HIV support groups or networks.

PLWHA are central to the achievement of GIPA. However, they face challenges such as:

• weak management and funding constraints;

• limited documentation of histories of self-empowerment; and

• societal barriers like stigma and discrimination.

To overcome these and enable their greater involvement, UNAIDS urges governments, international organisations and the civil society to:

• set, implement and monitor minimum targets for the participation of PLWHA, including women and marginalised populations, decision-making bodies; and

• involve PLWHA in developing funding priorities and the selection, design, implementation, monitoring and evaluation of HIV programmes.

UNAIDS further:

• urges governments to include GIPA in the National AIDS Plan;

• calls upon governments to enable PLWHA to claim their rights and meet their responsibilities by creating a supportive legal and policy environment;

• recommends promotion of better understanding of HIV-related vulnerabilities and the needs of people living with HIV in the community and the workplace;

• proposes that organisations of PLWHA should establish common ground with other organisations and networks and be part of the decision-making process.

For more information, visit:

http://data.unaids.org/pub/BriefingNote/2007/JC1299_Policy_Brief_GIPA.pdf.

Top

 Regional AIDS Training Network for eastern and southern Africa

The Regional AIDS Training Network (RATN) is an international non-governmental organisation working in nine countries in eastern and southern Africa. It is a network of 25 member institutions established to advocate for and facilitate capacity development initiatives for individuals and organisations working at the frontline of the HIV and AIDS pandemic.

Based in Nairobi, Kenya, RATN’s founding members include the University of Nairobi in Kenya and the University of Winnipeg in Canada. It also works with the World Health Organisation, the Southern Africa HIV and AIDS Dissemination Service (SAFAIDS) in Harare, Zimbabwe and the Uganda National Consumers’ Organisation (UNHCO) in Kampala, Uganda, among other organisations.

The purpose of RATN is to establish a regional network of training institutions to provide skills, training, upgrading extension services and technical assistance to health and allied workers in HIV and AIDS in the region.

It also:

• facilitates the building of capacities of training institutions in the network;

• develops and presents new training courses in response to identified needs;

• develops a network of technical experts; and

• serves as a focal point for discussing training issues and identifying training institutions.

Member institutions comprise five university departments, three management institutions, one public department, one research institute and 15 local and international non-governmental organisations. Some of these include the Family AIDS Caring Trust in Zimbabwe and the Malawi Institute of Management.

The Network has supported training of 3000 individuals in collaboration with member institutions in the region through the use of innovative approaches skills building, including:

• Facilitator Support and Exchange;

• Mainstreaming current issues like gender, antiretroviral therapy, stigma and discrimination into the courses;

• Working with marginalised groups such as the visually impaired;

• Counsellor Supervision Support Course; and

• Mobile Training Approach using mobile trainer teams.

RATN enhances partnerships for collaboration among its members. It provides access and facilitates information sharing and dissemination. It also facilitates the sharing of material resources, logistics, advocacy and visibility and provides member institutions with a common framework to tackle capacity development issues. This reduces institutions’ transaction costs and spreads risks while sharing responsibilities.

The network is currently in its second phase of programming, which began in 2004 and ends in 2008. During this period, it aims to achieve the following:

• Set up a sustainable and functioning network of training institutions in eastern and southern Africa.

• Provide quality training and capacity development programmes that respond to the HIV and AIDS training needs.

• Recognition of RATN as an effective source of information on, and advocate for quality sexually transmitted infections (STI) / HIV and AIDS training and capacity development.

• Ensure that Regional Economic Communities and national policies for HIV and AIDS have capacity building and human components. 

• Create a robust and functioning monitoring and evaluation system.

For more information, visit: www.ratn.org .  Top

Education sector responses to HIV and AIDS: Learning from good practices in Africa

The Commonwealth Secretariat, in partnership with the Association for the Development of Education in Africa (ADEA) and the Human Sciences Research Council produced the “Education sector responses to HIV and AIDS: Learning from good practices in Africa” document that highlights the education sectors’ response to the HIV and AIDS pandemic in Africa.

Based on literature review and the regional workshop organised jointly by the Commonwealth Secretariat and ADEA, and hosted by Human Sciences Research Council (HSRC) in South Africa, the document:

• summarises key issues regarding HIV and AIDS and the education sector; and

• highlights lessons learnt to assist the Commonwealth Secretariat, ADEA and other stakeholders in enhancing their policy and programming activities in the education sector, drawing from available knowledge and experience.

Education is a powerful tool in response to HIV and AIDS. The Global Campaign for Education estimates that 700 000 annual cases of HIV infection in young adults could be prevented if all children received complete primary education. It also observes that the economic impact of HIV and AIDS could be greatly reduced.

Challenges posed by the pandemic on the education sector include:

• interference of discriminatory practices in the teaching–learning processes;

• ill-preparedness by teachers to cope with rapidly changing learning and learners’ conditions;

• disruption in the management of teaching personnel and overall organisation of schools due to death and absenteeism of teachers, discrimination and stigmatisation; and

• parents and community leaders ill-informed about, and unprepared to cope with, HIV and AIDS.

The document is divided into seven sections which focus on the following:

• HIV and AIDS and the need for an accelerated response;

• HIV and AIDS and education sectors’ responses;

• mass campaigns for HIV and AIDS prevention, education and advocacy;

• girls, gender and education;

• education in schools and out-of-school youth;

• teachers infected and affected and the role of teachers in impact mitigation; and

• community responses, care and support.

It gives a brief background of key issues followed by highlights of good practices under each theme. It also highlights the recommendations from the workshop jointly organised by the Commonwealth Secretariat and ADEA in September 2006.

The document:

• calls upon the Commonwealth Secretariat and ADEA to facilitate and encourage sharing of teaching and learning materials that already exist in different regions in Africa;

• recommends developing curriculum based on a broader country approach/framework which includes emphasis on human rights, social support for most vulnerable groups and creating a protective and safe environment;

• urges countries to review their teacher development programmes so as to incorporate life skills and HIV and AIDS.

For more information, visit:

www.thecommonwealth.org/Shared_ASP_Files/UploadedFiles/DF801B8D-4E9F-4753-865D-5AFB2FEEB004_HIV_AIDS_doc.pdf.   Top

Training of trainers workshop on educational planning and management in a world with HIV and AIDS: Kenya, 16-20 July 2007

The International Institute for Educational Planning and Management (IIEP) is organising a workshop to provide requisite skills to address the impact of HIV and AIDS on education sector.

The workshop aims to:

• heighten awareness of educational planning and management issues that the pandemic raises for the education sector;

• impart advanced planning techniques;

• assist trainers conceptualise and analyse the interaction between the pandemic and educational planning management; and

• plan and develop strategies to mitigate the impact of HIV and AIDS.

Targeted participants include representatives from different faculties of education and training centres that actively train educational planners and administrators across Anglophone Africa, especially in high prevalence countries.

Participants will be selected by a committee that will convene on 15 May 2007.

For more information, email: b.tourmier@iiep.unesco.org  or visit: www.unesco.org/iiep. Top

SHORTCUT LINKS

Zimbabwe launches the National Behavioural Change Strategy for prevention of HIV

Expanded Support Programme to scale up access to HIV and AIDS prevention, treatment and care in Zimbabwe

Stakeholders scale up response to HIV and AIDS in Zambia

Zimbabwe develops HIV and AIDS District Atlas

Zimbabwe’s National AIDS Council establishes HIV and AIDS Media Forum

Unleashing the Energy for Change: Life Skills for Vulnerable Adolescents in Mozambique

WHO and UNAIDS approve male circumcision as part of HIV prevention interventions

Male circumcision for HIV prevention in young men

SADC launches Capacity Building Initiative for Mainstreaming HIV and AIDS in member states

UNAIDS releases policy on greater involvement of people living with HIV and AIDS

Enhancing access to psychosocial support for children in eastern and southern Africa

Regional AIDS Training Network for eastern and southern Africa 

Education sector responses to HIV and AIDS: Learning from good practices in Africa

HIV and AIDS communication in selected African countries: Interventions, responses and possibilities

Online resources

Forthcoming Activities

END OF LINKS

Expanded Support Programme to scale up access to HIV and AIDS prevention, treatment and care in Zimbabwe

The Expanded Support Programme in Zimbabwe is a multi-donor programme under the National Strategy for HIV and AIDS, which aims to scale up access to HIV and AIDS prevention, treatment and care from 2007-2009.

It complements available resources (such as Zimbabwe government’s AIDS levy, the Global Fund, bi-lateral and multilateral support) and existing programmes in financing gaps towards:

• attaining reduced transmission of HIV;

• reducing impact and improving quality of life of those infected and affected by HIV and AIDS;

• strengthening coordination of the HIV and AIDS response at all levels.

This is a joint programme with a common funding mechanism which pools together resources from five bi-lateral donors of Britain, Canada, Sweden, Ireland and Norway.

The Fund is guided and managed by a Working Group that refers directly to the National Partnership Forum.

Implemented by the Ministry of Health and Child Welfare, the National AIDS Council and the United Nations agencies (UNDP, UNFPA, UNICEF, WHO, UNAIDS and IOM), the programme focuses on:

• HIV and AIDS prevention, treatment and care;

• Coordination Support at the district level;

• Procurement and Supply Chain Management; and

• Technical support, including capacity strengthening of national structures.

It covers 36 districts throughout the country, targeting national institutions, non-governmental and community-based organisations, underserved rural populations and people living with HIV and AIDS.

The selection of districts is based on recent Ministry of Health and Child Welfare Antiretroviral Treatment (ART) readiness assessments, suitability for immediate ART and the required minimum staff to initiate ART services.

Immediate beneficiaries from the programme will be 30 000 poor people living with HIV and AIDS who are currently unable to access ART.

The programme aims to:

• increase the number of people on ART programme from 52 000 to 72 000;

• strengthen the National Blood Transfusion Services capacity to screen donated blood for HIV; and

• address the difficulties experienced by poor people in accessing prevention, treatment and care services.

Zimbabwe is the only country in southern Africa that has experienced a decline in HIV prevalence rate. A significant share of the decline is attributed to real changes in behaviour, leading to lower exposure to the virus by high risk groups.

Behaviour change has resulted (partly) from a sustained programme of prevention activities based on consistent messages, increased availability of condoms and reduction in concurrent partners.

For more information, email:

emmanuel.baingana@undp.org.  Top

Zimbabwe’s National AIDS Council establishes HIV and AIDS Media Forum

The National AIDS Council in Zimbabwe has established an HIV and AIDS media forum, entitled “The Zimbabwe Journalists Forum on HIV and AIDS.” It comprises journalists from both the print and electronic media who report on HIV and AIDS and related issues.

The forum’s objectives include:

• capacity building around HIV and AIDS;

• media training;

• linking HIV and AIDS with other related issues including poverty, violence and gender;

• networking partners and stakeholders in the area of HIV and AIDS; and

• increasing and improving information flow on the pandemic.

Members of the steering committee consist of representatives from the National AIDS Council, the Zimbabwe Union of Journalists, Southern African HIV and AIDS Dissemination Service (SAFAIDS), the Zimbabwe Red Cross, the newspaper industry (public, private and community papers) and the broadcast media.

The media is the single most powerful tool to reach communities and influence populations, paticularly the young who represent the future and are key in the HIV and AIDS response.

An effective media has many roles that consist of, but are not limited to, the following:

• creating a channel for discourse on HIV and AIDS related issues;

• fostering sustainable behaviour change leading to a reduction in vulnerability to the virus;

• placing HIV and AIDS on the news agenda, thereby raising awareness levels;

• facilitating the removal of stigma and discrimination related to HIV and AIDS; and

• developing a supportive and enabling environment.

Through the club, journalists will be able to access and share information on HIV and AIDS in Zimbabwe and the region as a whole. The forum is expected to:

• improve HIV and AIDS reporting standards;

• encourage investigative reporting and in-depth coverage of AIDS issues;

• open communication channels between journalists and all stakeholders involved in the national and regional response.

For more information, email: cmajonga@nac.org.zw. Top

WHO and UNAIDS approve male circumcision as part of HIV prevention interventions

Following the announcements of the results of the Kenyan and Ugandan trial findings on male circumcision reducing risk of HIV infection, the World Health Organisation and the Joint United Nations Programme on HIV and AIDS held an experts’ consultative meeting to determine whether male circumcision should be recommended for the prevention of HIV infection.

Governments, civil society, researchers, human rights and women’s health advocates, young people, funding agencies and implementing partners attended the consultation held in Montreux, Switzerland from 6-8 March 2007.

Key recommendations called for the integration of male circumcision into a comprehensive HIV prevention package which includes the provision of HIV testing and counselling services; treatment for sexually transmitted infections; the promotion of safer sex practices; and the provision of male and female condoms and their correct and consistent use.

Other recommendations include:

• Counselling of men and their sexual partners to prevent them from developing a false sense of security and engaging in high-risk behaviours that could undermine the partial protection provided by male circumcision.

• Strengthening of health services to provide quality services safely without disruption of other healthcare services.
  • Provision of training and certification of male circumcision providers as well as monitoring and evaluation of programmes to ensure that quality and safe procedures are provided.

• Ensuring that male circumcision procedures are delivered in a culturally sensitive manner that adheres to medical ethics, human rights principles including informed consent, confidentiality and absence of coercion.

• Scaling up access to male circumcision in countries with high prevalence, generalised heterosexual HIV epidemics and low rates of male circumcision

• Prioritisation of highest risk groups (younger age groups) to ensure a more rapid public health benefit.

• Provision of male circumcision for free or at the lowest possible cost to the client.

• Continuing research to inform further development of male circumcision programmes.

All stakeholders in the HIV and AIDS response observe that the recommendations are a step forward in HIV prevention and provide countries with high rates of heterosexual HIV infection and low rates of male circumcision with an additional intervention which can reduce the risk of HIV infection.

Experts agreed that scaling up male circumcision will result in both short and long term benefits for countries, especially those with high HIV infections.

Modelling studies suggest that male circumcision in sub-Saharan Africa could prevent 5.7 million new cases of HIV infection and 3 million deaths over 20 years.

Three randomised controlled trials undertaken in Kisumu (Kenya), Rakai District (Uganda) and Orange Farm (South Africa) reported that male circumcision reduced the risk of heterosexually acquired HIV infection in men by approximately 60%.

This further supported findings of observational studies that suggested the existence of a correlation between lower HIV prevalence and high rates of male circumcision in some countries in Africa. Currently, an estimated 665 million men, or 30 % of men worldwide, are estimated to be circumcised.

For more information, visit: www.who.int or email: wintera@who.int; topory@unaids.org. Top

SADC launches Capacity Building Initiative for Mainstreaming HIV and AIDS in member states

The Southern Africa Development Community (SADC), in partnership with the United Nations Development Programme (UNDP) Regional Service Centre’s HIV and AIDS Unit, launched its first phase of the capacity building training initiative for mainstreaming HIV and AIDS in Windhoek, Namibia from 26 February-2 March 2007.

Six member states namely Botswana, Lesotho, Malawi, Namibia, Swaziland and the United Republic of Tanzania attended the training, conducted to:

• strengthen capacity for mainstreaming HIV and AIDS in member states; and

• equip a core group of trainers in each member state with skills and knowledge to effectively facilitate HIV and AIDS mainstreaming national response.

The training:

• encouraged the roll out of the same training in individual member states; and

• called upon member states to ensure that HIV and AIDS is fully mainstreamed into national and regional policies and programmes to enhance development goals.

It is expected that the participants of this training will become a nucleus in each member state that will drive the roll out for mainstreaming in each member state.

The initiative is part of the implementation of the SADC Business Plan on HIV and AIDS and the UNDP programme to help build capacity on HIV and AIDS mainstreaming through regional economic bodies.

The SADC Business Plan has, among its priorities, the strengthening of capacity building and mainstreaming of HIV and AIDS in the region.

Funded under the SADC/ European Union project on HIV and AIDS, the training initiative will be rolled out to all member states through a phased approach.

A set of representatives from four member states will be trained in April 2007 in Zambia and the last group will be trained in May 2007, in Mozambique.

Training is targeted at focal persons responsible for mainstreaming and training from different sectors such as agriculture, education, finance, local government and transport.

The initiative comes against the backdrop of the Brazzaville Commitment on Universal Access to prevention, treatment, care, support and mitigation which concurred that the roadmap to achieving Universal Access requires mainstreaming of the HIV response in all sectors. It is also in line with recommendations of the Maseru Declaration on combating HIV in the SADC region.

For further information, contact Mr. Innocent Modisaotsile or Dr. Vitalis Chipfakacha at the SADC Secretariat. Tel- 267 3951863 or email: vchipfakacha@sadc.int. Top

Enhancing access to psychosocial support for children in eastern and southern Africa

In an effort to improve access to psychosocial support for children affected by HIV and AIDS, poverty and conflict, the Regional Psychosocial Support Initiative (REPSSI) introduced a new strategic implementation plan for eastern and southern Africa from 2007 to 2011.

The plan seeks to contribute to mitigating the psychosocial impact of HIV and AIDS, poverty and conflict among children and youth in 13 countries including Angola, Botswana, Kenya, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe.

Developed through a process of self assessment, with focus on REPSSI’s goal and core objectives, it specifically aims to:

• develop and facilitate knowledge, skills and information exchange on psychosocial care and support;

• strengthen capacity of governments, civil society and other institutions to respond to psychosocial needs of children affected by HIV and AIDS, poverty and conflict; and

• strengthen the Monitoring and Evaluation system of REPSSI and its partners.

The primary purpose of the strategic plan is to provide direction for those responsible for making strategic decisions and mobilising resources within REPSSI. Its secondary purpose is to communicate components of the strategy to expand psychosocial support for children and youth affected by AIDS, conflict and poverty to external partner and stakeholders who support REPSSI’s work.

Through the plan, REPSSI will:

• assess current budget allocations against the priorities in the plan and realign spending;

• define unmet needs and realign the existing REPSSI organisational structure to meet stated goals and strategies articulated in the plan;

• allocate new resources, as they become available; and

• assess the annual performance of the REPSSI in meeting its stated goals and objectives.

REPSSI is a regional, non-profit organisation established in South Africa in February 2005 with sub-regional offices in Tanzania, Zimbabwe and Zambia under the overall managerial stewardship of its head office in South Africa. It was originally conceived as a regional initiative to scale up psychosocial care and support for children affected by AIDS in 2001.

With financial support from a consortium of three donors – the Swiss Agency for Development Cooperation (SDC), the Novartis Foundation for Sustainable Development (NFSD) and the Swedish International Development Agency (Sida) – REPSSI was formally launched as a project to improve and scale up psychosocial support for children affected by AIDS in the region.

HIV and AIDS, poverty and conflict in the region continually reinforce each other to create an unprecedented catastrophe. The region bears the greatest burden of HIV infections with nine of the ten worst affected countries (Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe) found in eastern and southern Africa.

For more information, visit: www.repssi.org.   Top

HIV and AIDS communication in selected African countries: Interventions, responses and possibilities

In an effort to guide future support interventions in the area of HIV prevention communication, the Swedish International Development Cooperation Agency (Sida) commissioned a study to inform understanding of the relevance of focused HIV prevention activities in the region.

The study reviewed activities in 11 countries, namely, Botswana, Ethiopia, Kenya, Malawi, Mozambique, Namibia, South Africa, Tanzania, Uganda, Zambia and Zimbabwe. The review examined the following:

• a synopsis of epidemiology;

• indicators of knowledge;

• behaviour and service uptake; and

• information on HIV and AIDS prevention communication activities, approaches and funding.

It draws the following broad conclusions in relation to national HIV prevention communication interventions:

• Overall delivery of communication messages pertaining to awareness of AIDS and knowledge of key aspects of the disease are extensive.

• A number of communication interventions are well theorised, engage audiences in appropriate languages, and achieve a high-reach through the mass media.

• International and non-indigenous organisations provide an important contribution to country-level communication interventions.

• Several indigenous interventions have been sustained over long periods, and some have expanded to other countries (e.g., Straight Talk and Soul City).

• Considerable expertise for prevention communication exists in the region.

The implications of these conclusions are that prevention goals and strategies need to be aggressively set in relation to short-term outcomes and impacts that are specific to HIV risk.

These should be prioritised at country level and led by national governments. The promising findings of prevalence reduction in Malawi, Kenya, Uganda and Zimbabwe illustrate the fact that impacts can be made over short periods if the key epidemic drivers are addressed. Important focal areas for prevention include, among others:

• changing the proportions of young people having sex before the ages of 15 and 8;

• promoting correct and consistent use of condoms (and not just condom uptake);

• framing goals towards limiting an individual’s lifetime number of sexual partners and partner turnover; and

• promoting understanding of the high risks of having concurrent sexual partnerships.

HIV prevention communication needs to be led by a comprehensive understanding of HIV epidemiology within each country. Prevention communication interventions should also be designed with specific epidemiological changes in mind. This approach needs to focus on very specific short-term goals related to achieving declines in HIV prevalence and incidence nationally, sub-nationally and in relevant groups and sectors.

It further recommended that specific focus on addressing the disproportionate risk to girls and women requires expanding monitoring and evaluation indicators to inform the design of communication interventions and to monitor its impacts.

For more information, email: warren@cadre.org.za. Top

Announcements

UNAIDS develops guidelines for HIV and terminology.

Language shapes beliefs, influences behaviours and is principal in response to HIV and AIDS. Considered use of appropriate language therefore has the power to strengthen the response. In line with this, the Joint United Nations Programme on AIDS (UNAIDS) developed, in March 2007, a document giving a list of preferred terminology and recommendations on the use of different terms related to HIV and AIDS. The document provides a summary of important preferred terminology and errors to avoid, commonly used terms, acronyms and abbreviations, and further resources.

For more information, email: terminology@unaids.org or visit: data.unaids.org/pub/Manual/2007/20070328

_unaids_terminology_guide_en.pdf.    Top