AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #115 - Changing the social context through community conversations to enable HIV risk reduction
Authors: Presenting Author: Dr. Jane Chege - World Vision International
Additional Authors: Dr. Elizabeth Meassick, Dr. Senait Afework, Ms. Ann Claxton, Mr. Tesfaye Jima,
Method / Issue: Issue: Critical discourse surrounding HIV prevention faults conventional behaviour change programming for failing to reflect the reality of broader social forces and structural factors that constrain individual behaviour change: and for treating people as objects of change rather than the agents of their own change. Consequently, methodological frameworks that address social norms and other structural factors have been developed and applied to address HIV prevention. However, few of these have been systematically evaluated to document their impact on HIV risk behaviour change or on reducing HIV infection.
Results / Comments: Project: Findings from operations research assessing the effectiveness of World Vision’s school-and community-based HIV prevention life-skills model confirmed earlier findings on school-based HIV prevention programmes in Africa that indicated improvements in knowledge and attitudes but limited change in HIV infection risk behaviours. In 2008, the organisation designed and implemented a project to pilot and assess the effectiveness of a combined model incorporating the value-based life-skills and peer education approaches with the UNDP Community Conversation model in three intervention sites in Ethiopia. Taking an explicit rights-based approach, the project facilitates community understanding and debate on a range of children’s and women’s rights and socio-cultural and gender issues that increase vulnerability to HIV infection. During a period of 2 years, the project supported the implementation of 60 community conversation groups, comprising of boys, girls, women and men of varying socio-demographic and economic status in 20 Kabeles in Ethiopia.
Discussion: Lessons Learned: A community can be agents of their own change through community-led facilitation, reflection and dialogue. The methodology has enormous potential in effecting rapid change in cultural and gender norms. The process provides a voice to women and young people empowering them as well as enhancing their decision-making role in sexual and reproductive health without creating a gender partition in the community. Almost all the community conversation groups identified gender-based violence (including intimate partner violence, sexual abuse, and female genital mutilation), denial of women and girls’ rights to property and choice of a marriage partner as some of the factors that increase vulnerability to HIV infection in their communities. Community Action plans developed at the end of the 12 months community conversation process focused not only on the conventional HIV prevention activities of HIV&AIDS awareness, education, risk reduction and increasing access to VCT but also activities aimed to create an enabling environment such as new Kabele by-laws against abduction of girls and early marriage, forced widow inheritance, female genital mutilation, domestic violence and sexual abuse. Some communities created community-led social support systems to prosecute and penalise perpetrators and support individuals who choose to go against disempowering and risk enhancing social norms. Conclusion: Results from an operations research project relying on a quasi-experimental design will be used to establish the extent to which these community actions have translated to individual knowledge, attitude and behaviour change.
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