Dr. G. Weerasinghe Consultant Venereologist, National STD/AIDS Control Programme

1. Strategic Communication in HIV
prevention
Dr. G. Weerasinghe
Consultant Venereologist
National STD/AIDS Control Programme
15th October, 2016

2. Areas of discussion
• Background of HIV epidemic in Sri Lanka
• Goals and targets – global and local
• Role of communication in HIV
• Making strategic decisions for communication
to achieve goals and targets

3. HIV epidemic in Sri Lanka - background
Sero – positivity rates among blood donors 2009 - 15
year Number of donors
tested
% of Sero-positivity
2009 309,909 0,005
2010 302,883 0,004
2011 333,200 0,002
2012 351,605 0,004
2013 380,808 0,004
2014 380,367 0,007
2015 395,500 0,005

4. HIV epidemic in Sri Lanka - background
• Sero-positivity rates among pregnant mothers
attending DMH & CSHW
year Number of
pregnant mothers
tested
% of Sero-positivity
2012 11,600 0.02
2013 18,000 0.01
2014 16,500 0.02
2015 15,000 0.03

5. HIV epidemic in Sri Lanka - background
(IBBS – 2014)
Category Prevalence
FSW 0.8%
MSM 0.9%
DU 0
Beach boys (Galle) 0
Among adults (general population) < 0.02%
(based on estimates).

6. HIV epidemic in Sri Lanka - background
Sri Lanka remains a low prevalence country
since 1987
It looks like that the probability of moving the
epidemic to next level (concentrated epidemic
among MARP groups) is extremely low.

7. Goals & targets, global & local
• Ending AIDS by 2030 (global - SDG)
The UNAIDS has defined Ending AIDS epidemic by 2030 as
follows;
‘by 2030, the number of new HIV infections and AIDS-related
deaths will need to decline by 90% compared to 2010’.
• 90 – 90 – 90 targets by 2020 (global)
• Sri Lanka goals -
‘Prevent new HIV infections and provision of comprehensive
care and treatment for people living with HIV’.

8. communication in HIV
• Communication has to play a major role in
achieving these objectives and it is high time
for country to make them strategic to achieve
the set objectives.
• It is important to understand present
communication activities that happen in the
country
• If there are gaps we need to fill them

9. Routine communication work
by NSACP and STD clinics
There were nearly 3000 such programs in year
2015 and over 400,000 persons were covered
through them.

10. Communication work
through peer-led targeted interventions
• Around 17,600 members of MARP groups
were communicated by peer-leaders on
STIs/HIV/AIDS from 2012 – 2015 and over 3.7
million of condoms were distributed during
2013-2015.
Population size estimation of FSW, MSM, DU &
beach boys 2013 – Total number ; 41,631
• (FSW estimation – 9,947 to 14,132, MSM estimation – 6547 to
8554, DU estimation – 12,618 to 17,459, BB estimation – 873 to
1486)

11. Making strategic decisions for communication to
achieve goals and targets
• The last 100 cases registered at Central Clinic
for HIV care up-to 31st March 2016 revealed
that there were 29 MSMs and 2 female sex
workers. The remaining 69 persons belong to
general population.
What strategic decision we need to
make here?

12. What strategic decision we need to
make?
Again let us look at “Goals & targets, global & local”
• Ending AIDS by 2030 (global - SDG)
The UNAIDS has defined Ending AIDS epidemic by 2030 as
follows;
‘by 2030, the number of new HIV infections and AIDS-related
deaths will need to decline by 90% compared to 2010’.
• Sri Lanka goals
‘Prevent new HIV infections and provision of comprehensive
care and treatment for people living with HIV’.
• 90 – 90 – 90 targets by 2020 (global)

13. Mass communication
A method to reach as many individuals as possible
using various kind of mass media to
• generate discussion
• change in knowledge
• change of attitude
• change of skills
• change of behaviour

14. MASS COMMUNICATION
Mass communication approaches; some
examples
• Education programmes including life skills
• Edutainment
• Social-marketing
• IEC / Public health campaign

15. Mass communication strategy
It is a planned
combination of
• Methods
• Media
• Messages
to achieve set objectives
How it work at different
levels
• Individually – change
knowledge, attitudes,
improve skills and
behaviours
• Environment; centrally &
locally- mobilize support,
create debate & enabling
environment for change
of behavior

16. Steps of mass communication
project formulation
• Identification of the problem
• Analysis – cause & effect, audience,
stakeholders
• Formulation of SMART objectives
• Developing (SMART) core messages
• Choosing methods & developing materials
• Developing action plan & implementation
• Monitoring & evaluation

17. Summary
• Routine communication work of the NSACP and district level STD
clinics covers many persons.
• Peer-led targeted interventions have reached many thousands of
members of most-at-risk population groups.
• While HIV epidemic in Sri Lanka remains at low prevalence, it is
unlikely that it will move to next stage of the epidemic (concentrated
epidemic)
• SDG goals compel us to take measures to bring down new
infections and HIV related deaths by 90% compared to 2010 figures
to end AIDS by 2030.
• Since majority of HIV patients are coming from general population it
is logical to conclude that we need to carry out mass communication
programmes targeting general population to achieve above targets.