Positive Prevention Siyayinqoba Beat It! A distinct approach to HIV prevention communication UNAIDS Technical Consultation on Social Change Communication Vuyani Jacobs Community Health Media Trust
Positive Prevention HSRC report on teenage fertility December 2006
Siyayinqoba Beat It / Positive Prevention � Mid 80s about 60 000 births to teen mums � Mid 90s (96) about 80 000 births to teen mums; � 2001 about 65 000 births to teen mums � Half of all young people between 15 and 19 years of age report having had sex. By 19, close to 80% of South African women have had sex and about 37% have been pregnant (DoH 1998)
Siyayinqoba Beat It / Positive Prevention � Conventional prevention is not showing clear results in South Africa � The truth is we cant be sure what works when it comes to keeping people HIV negative � There is a need for additional approaches to prevention
Siyayinqoba Beat It / Positive Prevention What is positive prevention: � Recognizing that you are at risk – VCT � Openness about HIV status � Disclosure to regular partners � Regular consistent prevention behaviour and condom use � Understanding that HIV is a manageable chronic condition.
Siyayinqoba Beat It / Positive Prevention � That you can lead a normal life and even have a normal life span with HIV � Regular Cd4 and viral load testing � Early and effective treatment of opportunistic infections � Commencement of ART at the right time � Mother to child prevention of HIV transmission either with full ART or dual PMPTCT Protocol…… And that is a LOT of BEHAVIOUR CHANGE! ☺
Siyayinqoba Beat It / Positive Prevention � In every new HIV infection there is a person who either doesn’t know his or her status or is in denial � Siyayinqoba Beat It encourages and supports people to come out of denial into positive living
Siyayinqoba Beat It / Positive Prevention � Targeting the rational fear of death as the underlying cause of denial and stigma through treatment ; � A treatment based approach to HIV communications breaks the chain of fear > denial > stigma > discrimination; � Siyayinqoba Beat It’s mission is to provide scientifically based information for people living with HIV and AIDS, their partners, families, friends, care givers and health workers.
Siyayinqoba Beat It / Positive Prevention � Positive Prevention has to be about creating society wide � Positive Prevention has to be about creating society wide empowerment (beyond awareness) to respond to: empowerment (beyond awareness) to respond to: � Heath challenges (e.g. herpes / STI, TB, cervical � Heath challenges (e.g. herpes / STI, TB, cervical cancer, etc.) cancer, etc.) � Health system issues (stock outages, corruption, � Health system issues (stock outages, corruption, HR shortages etc. HR shortages etc. � Socio � Socio- -economic conditions (e.g. water, sanitation, economic conditions (e.g. water, sanitation, housing, food security; social security etc. ) housing, food security; social security etc. ) � Examples of topics covered by � Examples of topics covered by Siyayinqoba Beat It Siyayinqoba Beat It : :
Siyayinqoba Beat It / Positive Prevention Siyayinqoba Beat It / Positive Prevention PREVENTION POSITIVE LIVING Circumcision (2006) Books & Media (2006) Condoms in School (2006) HIV Communication Strategy (2006) Tertiary Institutions (2006) Faith Based Communities II (2006) Faith Based Communities I (2006) Youth and Parents Talking about Sex II (2006) Meet the Support Group (2006) Youth & Parents Talking About Sex I (2006) Food Gardens & HIV (2006) Alcohol (2006) Living with PLWHA (2006) Injecting Drug Users (2006) Nutrition (2005) Female Controlled Prevention (2005) Handling Death Loss (2005) Sex Workers & HIV (2005) Mental Health (2005) Transactional Sex (2005) Disabilities (2005) Traditional Circumcision @ HIV II (2004) Middle Class Disclosure (2005) Traditional Circumcision @ HIV I (2004) Disclosure (2005) Adherence & Substance Abuse (2004) Community Home-based care (2004) Teachers & Learners (2004) Traditional Healers (2004) Sex & the Positive Person (2004) HIV Action Committees at Schools (2004) Support Groups (2004) Positive Living (2004)
Siyayinqoba Beat It / Positive Prevention Siyayinqoba Beat It / Positive Prevention OIs / TREATMENT HUMAN RIGHTS Voluntary Counseling & Testing (2006) Water & Sanitation (2006) Curative Claims (2006) HIV & Media (2005) Disseminated TB & HIV (2006) Treatment in Africa (2005) Cervical Cancer (2006) Prison & HIV (2005) Vaccines and Prophylaxis (2005) SANDF (2005) VCT & Routine Testing (2005) Orphans (2005) TB & HIV (2005) Good Leaders Lead (2005) Treating Opportunistic Infections (2005) Rights at Work (2004) Oral Hygiene (2005) Social Grants (2004) Palliative Care (2005) Beat It! At Work (2004) Opportunistic Infections (2004) Orphans (2004) False & Fraudulent Cures (2004) PMTCT Health Care Workers & HIV/AIDS (2004) Pregnancy & HIV (2006) Sexually Transmitted Infections (2004) Breast vs Bottle (2005) Children without ARVs (2004) Prevention of MTCT (2004) TB & HIV (2004)
Siyayinqoba Beat It / Positive Prevention Siyayinqoba Beat It / Positive Prevention ART Teachers & HIV (2006) ARV Resistance and New Regimens (2006) Side Effects of ARTs (2006) ARV Treatment Sites (2005) Children on ARVs (2005) ARV Trestment Sites (2005) Substance Abuse and Adherence (2005) Side-Effects (2004) ARV Rollout (2004) GENDER Gender Violence II (2006) Gender Violence I (2006) Gender Inequality (2005) Women, HIV & Violence (2004)
Siyayinqoba Beat It / Positive Prevention � In learning to take control of our health we are also empowered to understand our position in society more broadly – in short…. � Through the HIV experience gaining AGENCY for change in your own life and the lives of those around you.
Siyayinqoba Beat It / Positive Prevention � When people living with HIV have this positive perspective we have seen evidence that behavior can really change; � Paul Farmer in Haiti and MSF and TAC in Khayelitsha, Lusiksiki and now increasingly in all SADC countries, we see a treatment based approach supported by treatment literacy communications can produce lasting change.
Siyayinqoba Beat It / Positive Prevention A typical Siyayinqoba Beat It viewer wrote to the programme: “I was diagnosed HIV positive and was in shock as I was also five months pregnant. I told my older sister about my status, she supported me and advised me not to tell my husband as it will cause a divorce. My husband is a dagga smoker ,he is always angry and he doesn’t want to go to the clinic when he is ill and he also doesn’t want to listen to HiV/Aids related issues. He doesn’t even want me to go to the clinic when I am sick .This situation makes me fail to care for my health. I don’t know what to do because ,I am unemployed and I depend on my husband who is a security guard that is why I doubt and I am scared of divorce. In my experience most of the time when the women is diagnosed HIV positive and tells her husband, he leaves her. I am scared of this because there is no one who will take care of me and my baby boy who is now eight months old. Can you please help me with and advise me…” Worried T – Witzieshoek
Siyayinqoba Beat It / Positive Prevention My name is Xolile. I enjoy looking and listening to your program Your stories are amazing and encouraging to us people who are HIV positive. Early 2004 I was diagnosed HIV positive. I am married for five years, my wife is also positive too. I have a baby who is six years, I am not sure whether she is positive or negative. When I got sick in 2004 Feb, my cd4 count was 26 and my doctor recommended me for ARV’s. I am not smoking nor drinking alcohol and they seem to wok very well, cause now my cd4 count is 374. .
Siyayinqoba Beat It / Positive Prevention � Positive prevention goes hand in hand with the extension of access to treatment; � The new NSP sets a target of 80% access by 2011 � This will mean 1.5 million people on treatment – people have to get onto treatment 4 times faster than they did in the period 2004-07! � Massive public education and support with targeted and specific messaging. � Massively expanded use of Community Health Workers for basic public health education AND community mobilisation!
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