web of influence as a tool in combating stigma towards hiv aids zambia emory hiv research project
TRANSCRIPT
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Web of Influence as a Tool in Combating Stigma Towards
HIV/AIDS
Chilumba SikombeINA/INL Trainer
Zambia-Emory HIV Research Project
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Organisation
Zambia Emory* HIV Research Project (ZEHRP)
Postnet 412,P/B E891,
Emmasdale, Lusaka, Zambia
Telephone Contact:260-966-710913
*Emory University, Atlanta, Georgia, USA
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Key Terms
• CVCT – Couples Voluntary Counseling and Testing
• CLO – Community Liaison Officer
• INL – Influential Network Leader
• INA – Influential Network Agent
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Background Information
• In 2004 ZEHRP adopted an innovative promotional strategy of inviting couples for voluntary counseling and testing (CVCT).
• This model uses community Influential Network Leaders (INLs) from four sectors– Health– Religious– NGO/CBO– Private
• These influential persons are responsible for selecting Influential Network Agents (INAs) who are responsible for CVCT recruitment.
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Selection StrategyCommunity Liaison Officers
Influential Network Leaders
Influential Network Agents
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Multi-Sectoral Approach
• Health Related– Clinics, Home-based Care, Community Health
Workers
• Religious– Pastors, Church Elders, Christians/Muslims
• CBO/NGO– Schools, Clubs
• Private– Markets, Trading Centers
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INL Roles
• INLs provide feedback to ZEHRP on concerns arising in their communities.
• INLs receive intensive training on community sensitization methods for the endorsement of CVCT.
• INLs are responsible for identifying Influential Network Agents (INAs) from their sectors.
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Sensitization Strategies
• One-on-one within the community• Door to Door• Public Endorsements
– Churches– Market Places– Bars/Taverns– Sporting Events– Women’s Groups– Work Places
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INA Roles• Attend an intensive 4 day training on
CVCT and recruitment methods.
• Responsible for CVCT recruitment through use of an anonymous invitation system.
• Reimbursed per couple that chooses to attend CVCT (whether or not they decide to test).
• Given a 4 month contract.– Exhaust their “Web of Influence”
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Agnes ChilufyaMother
Wife
Community Member
Church Member
Business Woman
PTA
Husband’s Work
Fellow Parents
Teachers
Business Association
Neighboring Businesses
Customers
Suppliers
Husband’s Friends
Political / neighborhood
Leaders
NeighborsWoman’s
Association
Farmer’s Cooperative
Church Leaders
Chorus
Woman’s Association
Husband’s Football Club
Football Association
Fellow Parents
Church Group
Relatives
Youth Groups
One INA’s Web of Influence, , , .
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Stigma in Zambia
• HIV is a stigmatized disease world wide and has proven to be a challenge in Zambia.
• High levels of stigma discourage people from testing, disclosing status, and accessing and adhering to interventions such as ARVs and PMTCT.
• ZEHRP faces the additional challenge of convincing couples of the benefits of testing and being counseled together.
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Couples Tested 2003-2007
* 2008 projection based on first quarter uptake and targets
0
2,000
4,000
6,000
8,000
10,000
12,000
2003 2004 2005 2006 2007 2008*
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Key Findings
• In 2007 a total of 429 INAs and INLs were trained.
• In 2007 over 9,280 invitations were distributed by the INA/INLs. Out of these invitations 1,407 couples attended CVCT and 67% of couples tested at ZEHRP.
• In 2008 INAs have already delivered 10,515 invitations with the target of testing 10,000 couples.
• In 2008, over 2,800 couples have attended CVCT with over 2,300 choosing to test.
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Key Findings cont.
• Through the utilization social networks and community leaders, ZEHRP has built trust and helped to change attitudes on HIV/AIDS in the communities.
• The increase in CVCT uptake when the INA/INL model was introduced, indicates that this model is successful and that the community based model is combating stigma.
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Lessons Learned
Promotional strategies where community leaders are the predominate spokespersons of HIV/AIDS prevention and treatment messages are most likely to be successful and sustainable.
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Recommendations
If stigma towards HIV/AIDS is to be eliminated, a community-based, multi-sectoral approach should be adopted that draws influential leaders of the communities to spearhead the sensitizations on HIV/AIDS and the promotion of VCT.
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Thank You
The Victoria Falls, Zambia