Web of influence as a tool in combating stigma towards hiv aids zambia emory hiv research project

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  • CVCT – Couples Voluntary Counseling and Testing. Spouses receive pre and post test counseling together. Results are disclosed to one another with a counselor present.
    INL – Influential Network Leader. Recognized leader in the community, trained in CVCT sensitization methods.
    INA – Influential Network Agent. Nominated by INLs, responsible for CVCT recruitment.
  • 2004-2005 INA Study: success of this model is evidenced by the increase in couples testing at CVCT
    2006-2007: the INA study ends and as a result CVCT uptake markedly diminishes
    2008: new funding mandates a target of 10,000 couples tested per year. Through a major scale-up in the INA/INL program we are already beginning to see a major increase in couples testing at our sites
  • Web of influence as a tool in combating stigma towards hiv aids zambia emory hiv research project

    1. 1. Web of Influence as a Tool in Combating Stigma Towards HIV/AIDS Chilumba Sikombe INA/INL Trainer Zambia-Emory HIV Research Project
    2. 2. 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
    3. 3. Key Terms • CVCT – Couples Voluntary Counseling and Testing • CLO – Community Liaison Officer • INL – Influential Network Leader • INA – Influential Network Agent
    4. 4. 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.
    5. 5. Selection Strategy Community Liaison Officers Influential Network Leaders Influential Network Agents
    6. 6. 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
    7. 7. 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.
    8. 8. 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
    9. 9. 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”
    10. 10. 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 Neighbors Woman’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, , , .
    11. 11. 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.
    12. 12. 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*
    13. 13. 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.
    14. 14. 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.
    15. 15. 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.
    16. 16. 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.
    17. 17. Thank You The Victoria Falls, Zambia

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