Web of influence as a tool in combating stigma towards hiv aids zambia emory hiv research project
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Transcript of Web of influence as a tool in combating stigma towards hiv aids zambia emory hiv research project
Web of Influence as a Tool in Combating Stigma Towards
HIV/AIDS
Chilumba SikombeINA/INL Trainer
Zambia-Emory HIV Research Project
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
Key Terms
• CVCT – Couples Voluntary Counseling and Testing
• CLO – Community Liaison Officer
• INL – Influential Network Leader
• INA – Influential Network Agent
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.
Selection StrategyCommunity Liaison Officers
Influential Network Leaders
Influential Network Agents
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
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.
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
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”
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, , , .
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.
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*
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.
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.
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.
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.
Thank You
The Victoria Falls, Zambia