TingimLaipPNG_lo

Success Stories from Papua New Guinea
Tingim Laip
John Engels
With a foreword from Romanus Pakure

The Tingim Laip
Project at a glance
Objective: Increase safer sex
practices among people in the
following high-risk settings or
circumstances: where sex is
negotiated; highways and ports;
uniformed services; mining,
petroleum, and other industries;
and at-risk youth
Goals: Increase access to condoms,
refer people to clinics for diagnosis
and treatment of sexually
transmitted infections, increase
voluntary counseling and testing,
and provide HIV care and support
Methods: Mobilization, training,
and onsite support for communities
to plan and manage their own
HIV response
Funding: The Australian
government through AusAID
Coverage: 36 sites in 11 provinces
Key partners:
Burnet Institute
Family Health International
Save the Children
World Vision
National AIDS Council Secretariat

Tingim Laip

All images by John Engels, 2008, unless noted.
Front cover: Koki na Perot Stori Istap (Cockatiel and Parrot Telling Love Stories),
by Apa Hugo, 2008.
Back cover: Youth group performs anti-HIV/AIDS song at Minj, near Mount Hagen.
Appearance in photos does not indicate health status.
© 2008 by Family Health International.

Tingim Laip: Success Stories from Papua New Guinea • iii
Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1. Welcome to Joyce Bay. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2. Keeping the Fire Burning at Lombrum Patrol Base. . . . . . . . . . . . . . 13
3. Picking Up, Dropping Off in Mount Hagen. . . . . . . . . . . . . . . . . . . . 21
4. Welcoming the Marginalized in Kerowil. . . . . . . . . . . . . . . . . . . . . . . 27
5. Attacking the Problem from All Angles in Waipa Zone. . . . . . . . . . . 33
6. A Gallery of Heroes in Western Highlands. . . . . . . . . . . . . . . . . . . . . 39
7. Creating Demand for Services in Umi Market. . . . . . . . . . . . . . . . . . 45
8. Sustaining Innovation and Self-Reliance in
Wagang (Sipaia) Village. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
9. Promoting ‘Nogat Condom, Nogat Kuap’ in Madang. . . . . . . . . . . . 57
10. Raising Awareness in Wewak through
Conversation, Play, and Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
11. Marketing Behavior Change in Goroka. . . . . . . . . . . . . . . . . . . . . . . 75
COntents

Tingim Laip: Success Stories from Papua New Guinea • v
Acknowledgments
FHI/Papua New Guinea would like to express sincere gratitude to all who have
actively contributed to the production of this unique publication:
• The Australian government through AusAID
• The National AIDS Council Secretariat
• The Provincial AIDS Committees
• The Provincial and District Health Clinics
• Tingim Laip site committee members and, in particular, the volunteers
• Tingim Laip project officers and partners, including Burnet Institute, Save the
Children, and World Vision
• FHI staff in PNG, especially Program Officers Garry Laka and Darryl Raka,
and Assistant Program Officer Eddie Oa
• FHI Associate Director for Information Programs John Engels (USA)
We look forward to continuing our partnership and efforts in community-driven
responses to HIV in Papua New Guinea.
Sincerely,
Nayer Kaviani
Country Director, Family Health International

Tingim Laip: Success Stories from Papua New Guinea • vii
Foreword
The Tingim Laip partnership is an excellent example of what Papua New
Guineans can achieve when donor funds are thoughtfully invested. From the
beginning, AusAID agreed with our view that when communities lead their own
response to HIV, the results are effective and sustainable.
AusAID and the key Tingim Laip partners—Burnet Institute, Family Health
International, Save the Children, World Vision, and the National AIDS Council
Secretariat—also recognize that communities need ongoing encouragement
and support in understanding the technical aspects of preventing and mitigat-
ing transmission of HIV and other sexually transmitted infections, organizing
and planning activities, and managing the financial aspects of their response.
Participation from all sectors—public, private, and faith-based—is also needed,
as is coordination of activities by the provincial AIDS committees on behalf of the
National AIDS Council Secretariat.
The Tingim Laip success stories and personal profiles presented here prove that
this vision is working. We hope these stories and photographs will inspire and
inform others who wish to undertake similar initiatives or to join the Tingim
Laip partnership. For ourselves, we intend to apply the lessons learned from the
Tingim Laip Project as we expand community-driven responses to HIV in Papua
New Guinea. We want to expand this model deeper into the rural areas and
increase the range of activities and services offered. We would also like to expand
the number and depth of training opportunities available to site committee

viii • Tingim Laip: Success Stories from Papua New Guinea
members, including training of trainers and training of more committee members
in behavior change communication, alcohol and drug awareness, and issues
related to gender and family violence. In doing so, we will remain mindful of the
need to sustain the progress already achieved by current Tingim Laip Project sites.
I would like to thank AusAID for supporting our vision and the very successful
Tingim Laip intervention. I would also like to thank Tingim Laip key partners for
their creative and collegial approach, and for their wise management of human
and financial resources. I am truly proud of this genuine partnership, and am
confident that together we will strengthen it for the long-term betterment of
Papua New Guineans’ health and development.
Sincerely,
Romanus Pakure
Chairman of the Tingim Laip Steering Committee
Acting Director, National AIDS Council Secretariat

Tingim Laip
PAPUA NEW
GUINEA
Lae
Port Moresby
Madang
Wewak
Goroka
Mt. Hagen
Lorengau
Vanimo
Kiunga
Tabubil
Popondetta
Alotau
Areas where the Tingim Laip Project has sites. Those in red are featured in this publication.

ABOVE: Youth representatives Kinime and Nicky Daniels met through Kakaruk Market
Tingim Laip site committee activities in Goroka. RIGHT: The Tingim Laip logo was
developed by committee members and volunteers.

Tingim Laip: Success Stories from Papua New Guinea • 1
introduction
The Tingim Laip Project is Papua New
Guinea’s largest community-based HIV
prevention initiative. Operating in 36 sites in
11 provinces, it was designed by the National
AIDS Council Secretariat and the National
HIV/AIDS Support Project, and is supported
by the Australian government through
AusAID. It began in 2004 as the High-Risk
Setting Strategy, but to emphasize that the
intervention is aimed at people and com-
munities, it was renamed Tingim Laip, Pidgin
English for “think about life.”
Tingim Laip builds capacity and empowers
communities at higher risk of HIV infection
by providing them with knowledge, tools, and
ongoing support to design and manage their
own responses to the epidemic. It focuses on
men, women, and youth who congregate in
“hotspots” where sex is negotiated: markets, lodgings, and entertainment sites
along major highways and near ports; villages near mines, other industries, and
military posts; and settlements around urban areas.
KEY ideaS
Tingim Laip (“think about life”),
designed by the National AIDS
Council Secretariat initially
through the National HIV/AIDS
Support Project and supported
through AusAID, is Papua New
Guinea’s largest community-
based HIV prevention initiative.
Communities form Tingim
Laip site committees and
design interventions for
men, women, and youth who
congregate in “hotspots”
where sex is negotiated.
Volunteers are given training in
basic facts about HIV and such
areas as STIs, behavior change
communication, peer education,
gender issues, drugs and alcohol,
and community mobilization.

2 • Tingim Laip: Success Stories from Papua New Guinea
The intervention aims to increase
• knowledge of high-risk sexual behavior
• availability and access to male and female condoms
• signs and symptoms of HIV and other sexually transmitted infections
• voluntary HIV counseling and testing
• referrals for diagnosis and treatment of sexually transmitted infections
• referrals to care and support for people and families living with or affected
by HIV
Communities form Tingim Laip site committees, whose dozen or so members
represent women, youth, churches, sex workers, men who have sex with men,
local-level government, the business community, and other constituencies.
Volunteers are provided with training in basic facts about HIV and other sexually
transmitted infections, behavior change communication, and peer education.
They use this knowledge and capacity to develop and carry out interventions that
promote safer sex, based on their own analysis of the problems in their communi-
ties and of the solutions they think will best address them.
Communities are further supported in their efforts by the National AIDS
Council, which provides millions of the condoms being distributed through
Tingim Laip sites. They are also assisted by the provincial AIDS committees that
coordinate stakeholder activities in each province, who make sure activities align
with national and provincial priorities, and that increased community demand for
services is matched with an adequate, user-friendly, and easily accessible supply of
services from governmental, nongovernmental, and faith-based facilities.
These stories show a range of successes achieved by Tingim Laip sites across
the country, and cover a range of target audiences, settings, and interventions.
Stories were selected to illustrate success in mobilizing the grassroots, addressing
stigma and discrimination, integrating behavior change communications into
community activities, creating a “condom culture,” overcoming obstacles, and
mobilizing resources outside of the Tingim Laip Project to support and sustain
activities. Tingim Laip sites nominated themselves and finalists were selected in
consultation with key partners.

Because we were not able to visit all 36 Tingim Laip Project sites, we consider this
report illustrative, not comprehensive. We welcome comments on this publica-
tion and look forward to the next opportunity to share success stories from sites
that are achieving Tingim Laip Project objectives in their communities.
Send comments or requests for additional copies to
Nayer Kaviani, Country Director
FHI/Papua New Guinea
nkaviani@fhipng.org •
Abi Michael and Doreen Mambu are teachers and Tingim Laip site committee members
in Wagang (Sipaia) Village, near Lae.

Don Ole is the Tingim Laip site committee coordinator for Joyce Bay, a Port Moresby
neighborhood. He began volunteering in 2004 as a youth counselor, but before that he
was a self-styled “bad boy.”

Don Ole is an ex-con and former “bad
boy” of a Port Moresby neighborhood once
known as Horse Camp, which was notorious
for its high rates of crime, violence, and
drug use. Until 2004, Don says, his attitude
was “anti-everything”: HIV, homosexuality,
and women. “I used to order girls around,
threaten them.”
But in 2004, Don joined Tingim Laip’s
predecessor program, the High-Risk Setting
Strategy, which targeted out-of-school youth
like him. Through the program’s educational
and behavior-change interventions, Don’s
attitudes changed completely. He eventually
began working as a youth counselor and
later became a Tingim Laip site committee
coordinator. He now leads a committee of 13 volunteer members who cover
this neighborhood of about 7,000. The committee organizes various formal
and informal peer education activities to increase awareness of HIV, distribute
condoms, refer people for diagnosis and treatment of sexually transmitted
infections, and promote counseling and testing for HIV.
Chapter one
Welcome to Joyce Bay
Joyce Bay Successes
Site committees in Joyce Bay
organize peer education activities
to increase awareness of HIV,
distribute condoms, provide
referrals for diagnosis and
treatment of STIs, and promote
counseling and testing.
Committees reflect the diversity
of the neighborhood, including
members who are unemployed,
who have not completed formal
education, or who engage in
transactional sex. Members also
include men who have sex with
men, and HIV-positive individuals.
Tingim Laip’s involvement has
made the neighborhood safer and
decreased drug use, violence,
and unwanted pregnancies,
prompting residents to change
the neighborhood’s name from
“Horse Camp” to Joyce Bay.

The committee is supported by the Tingim Laip Project with training in
counseling, peer education, advocacy, gender relations, behavioral change, and
monitoring and evaluation. The Tingim Laip Project also funds the coordinat-
ing committee to plan activities suitable for the community, such as sports and
music events for youth, teaching of HIV awareness in schools, and “coffee-night
outreach” events for youth participating in sports activities. Programs aimed at
women include sewing and cooking clubs that integrate HIV messages into skill-
and income-building activities. Committee members also distribute pamphlets
and condoms supplied by the country’s National AIDS Council.
Committee members meet every two weeks to discuss issues, plan events, and
work on the monthly reports of activities and referrals they submit to their
Tingim Laip program officer. The Tingim Laip Project management uses these
reports, along with quarterly work plans and budgets, to determine the funding
and types of training the committee will need.
From left to right: Nelson Ito, Joe Mirou, Ilap Suve, Tinus Mino, and Don Ole,
Tingim Laip site committee members, Joyce Bay; and Garry Laka, FHI/Papua New
Guinea Program Officer

Offering Women Warnings
Nelie is the Joyce Bay site committee
treasurer and women’s representative.
Her approach to behavior change
communication is to target young
women one-on-one. She has worked
with five young women this year, and so
far two have completely changed their
lives. Nelie says she helped them by
talking to them and offering warnings about the dangers of smoking,
drinking, and unsafe sex. Nelie knows what she’s talking about:
she used to love drinking. But about three months into her last
pregnancy, she got very sick from her alcohol use, and after that, she
never wanted to drink again. Nelie also used to love gambling. Her
habit eventually got so out of control that her husband had
her arrested.
Nelie loves working for the Tingim Laip Project, but says it’s
sometimes so much work that she doesn’t have time to look after her
own children and home. She now counsels women who have been
victims of family violence; she refers them to the welfare department
and even accompanies them there if necessary. She’s sent so many
women there this year—eight so far—that she thinks “they’re tired
of seeing my face now.” She says that jokingly, though, because she
believes the welfare department is glad to get the referrals and is
supportive of victims of family violence. Because of her work, Nelie
says, her photo can’t be published. “If some husbands saw my
picture,” she says, “I would be in danger.”

Sitting on a few benches in a shady yard of committee member Nelie’s home,
Don is joined by Ilap Suve, Tinus Mino, Nelson Ito, and later Joe Mirou. The
group represents the diversity of the neighborhood and its vulnerability to HIV:
some have lived there their whole lives, while others just a few years; most are
unemployed; most have not completed formal education; all have engaged in
transactional sex; and two have sex with other men. At least one is HIV-positive.
Tinus estimates he spends about two full days a week working on committee
activities. He says the committee has made an obvious difference in the neighbor-
hood. “You will hear lots of scary stories [about this place], but because of our
group, we’ve made changes.” For example, they have no problems distributing all
their condoms. “Condoms are now taken seriously,” Don adds. “We used to have
to give them out; now people ask us.”
Ilap says he is making progress at the school: “We did our program, then they
were having examinations and were asked questions about HIV/AIDS, and
they passed the examinations.” Other changes the site committee members
note are a drop in the number of school girls selling sex and lower numbers of
unwanted pregnancies.
The group works through the organized activities mentioned earlier, and through
informal methods such as individual or focus group discussions. Group members
start by sharing buai (betel nuts) and developing trust with young people.
Their messages include how to recognize a sexually transmitted infection, the
symptoms of AIDS, and the importance of “knowing your status early so you can
manage it.” Other messages are to limit the amount of alcohol consumption to
“your personal limit” and not to use more than one substance at a time.
The changes committee members have observed have
not just been in the community at large, but have been
personal as well.

The changes committee members have observed have not just been in the
community at large, but have been personal as well. Don, speaking of his former
bad-boy life, says, “I left all those things.” Ilap says that, as a “fallow” or a “palopa”
(homosexual), he “used to be scared” and was accustomed to “having no human
rights,” but now “I can be who I want, I feel free, and by joining this group I feel
accepted.” Nelson, who also has sex with men, says that stigma and discrimination
remain strong, but that other men who have sex with men “feel they can approach
us. They have to hide from their families, but we can talk to them.”
Joe, who is HIV-positive, says he learned how to speak in public. He tells people,
“You see us, we are here. Learn that HIV people aren’t bad people.” Joe says, “At
first my family chased me out, but then they realized that the sickness doesn’t just
happen to bad people. That’s why I came out publicly—I wasn’t afraid.” Later, as
the group strolls through the neighborhood, Joe introduces his wife, whom he
proudly says remains HIV-negative.
Nelson Ito and a street scene in Joyce Bay, Port Moresby, which was formerly known
(and feared) as Horse Camp.

The committee members say they want to branch out and bring people more ser-
vices, such as providing care and support, but that to do so they will need training
in community and home-based care. They also suggest that their other training
be reinforced and refreshed. As Don says, “People forget…and we have to keep
reminding them.”
It is sometimes a challenge to maintain the motivation of Tingim Laip site com-
mittee volunteers, and Don, now in his fifth year, is no exception. Beyond the
desire for recognition, members would like the Tingim Laip Project to help them
become more effective in referring people for diagnosis and treatment. According
to Nelson, members sometimes must use their own resources to enable a referral
to access services. “That’s a real burden for us.”
Judy Tokeimota, Tingim Laip regional coordinator for the National Capitol
District (NCD), agrees that the volunteers need to be acknowledged properly.
She thinks spending more time with committee members will help, as well as
Joe Mirou and Ilap Suve took the brave step of “coming out” publicly, Joe as HIV-
positive, and Ilap as a man who has sex with other men.

reinforcing the idea that the site committees, Tingim Laip Project management,
and service providers are working in partnership. Judy says, “The committees do
the activities and take the risks. When we go in and ask them for more, they say,
‘Sure, but can you spend some time with us?’”
The committee members share an obvious pride in having brought about
dramatic changes in the knowledge, attitudes, and behaviors of neighborhood
residents. “Everyone knows who we are, and they all come to us” says Tinus. The
committee has achieved 100 percent coverage of the neighborhood with a very
modest budget.
Horse Camp has been renewed through Tingim Laip’s successes in supporting
development of strong community leadership, disseminating information about
HIV prevention, reducing stigma and discrimination, and implementing effective
behavior change interventions. The neighborhood is now considered safe; drug
use, violence, and unwanted pregnancies are way down; and residents have a
newfound pride. As a result, they decided recently to wipe Horse Camp—and its
reputation as “the place nobody wanted to go to”—off the map. They’ve changed
its name, and are now able to say: Welcome to Joyce Bay. •

Lombrun Patrol Base Commanding Officer Philip Polewara says preventing transmission
of HIV is a national security issue.

Chapter two
Keeping the Fire Burning at
Lombrum Patrol Base
The problem in Lombrum Patrol Base, near
Lorengau on Manus Island, is that the soldiers
are away on patrol for such extended periods
that “their wives and children are alone and
a lot goes on,” says Lynne Jonah. Lynne is a
member of the Seventh-day Adventist Church,
a key institution in this community’s response
to HIV. Lynnecontinues, “Children get drunk
and wives don’t sleep at home.” It’s well known
that many women in this isolated community
engage in recreational or transactional sex
while their husbands are away. The soldiers,
too, engage in extramarital sex. Thus, the
community is considered more vulnerable
than some others to HIV transmission.
According to Lombrum Patrol Base Tingim
Laip Site Coordinator David Dena, the
solution will come through the self-motivation and empowerment of a broad
cross-section of the village, the mobilization of already existing institutions, such
as the church, that “have the organization and the interest,” and the engagement
of the command structure of Lombrum Patrol Base to change people’s attitudes
toward unsafe sex and excessive use of drugs and alcohol.
LOMBRUM Successes
At Lombrum Patrol Base, soldiers
away for long periods engage
in extramarital sex; their wives
also engage in recreational or
transactional sex. The base’s
commanding officer supports the
Tingim Laip Project, seeing it as
critical for the health of the men,
the strength of the armed forces,
and the security and prosperity of
the country.
The local site committee includes
youth and church representatives,
a village court official, an
employee at the local dispensary,
as well as women who offer
advice to other women on health
matters, family problems, and
finding alternatives to selling sex.
The Seventh-Day Adventist
Church was a natural entry point
for intervention, given its already
active women’s and youth groups.

David began reorganizing the Lombrum Patrol Base site committee in 2006, hav-
ing first begun work there as a youth representative. Because of high turnover due
to the nature of military work, membership on the committee is unstable. David,
who is a mechanic and not in the armed forces, eventually found he was the only
committee member. In mid-2007 he took over, and “starting from nowhere began
putting things in order.”
Profile of a Committee—and Community
The site committee now has 13 members, representing all segments of the
community. For instance, Martin Pope, the youth representative, meets with
the school principal twice a month to discuss the school’s program. So far, he
has distributed condoms among students, provided students with educational
materials, and organized life skills training programs. Martin says he’s already seen
some changes among the students, particularly that they ask for condoms and
report reduced consumption of drugs and alcohol. He’s also found that, when
questioned, “the students reveal a good understanding of these topics.”
A few site committee members came to volunteer on the committee by accident.
Nelson Waiki, the committee’s church representative, says he had not heard of
the committee until the patrol base was selected for the Tingim Laip initiative.
But after receiving induction training and an introduction to the basics of HIV,
he began sharing behavior change messages with his church, community, and
family. Nelson is helping distribute condoms on the ships based here that patrol
the country’s waterways, and educating the soldiers on how to use them. He is
also encouraging soldiers to get counseling and be tested for HIV. Though the
intervention is in its early stages, Nelson says testing has revealed that HIV infec-
tion rates are holding steady among those who agree to be tested.
Gwen says that participation in the committee
has taught her a lot, especially about gender and
family violence.

Another “accidental” committee member is Gwen Kaiguguia, who says her
husband nominated her because he could not keep his volunteer commitment
due to his work schedule. Gwen says that participation in the committee has
taught her a lot, especially about gender and family violence: “I learned there are
some other ways to solve problems so [my husband] doesn’t belt me anymore.”
She has become a resource for other women, who seek her advice on personal
health matters and family problems: “Some sisters tell me how they’re pressurized
[to have sex outside of marriage], knowing their husbands also have multiple
partners. ‘Bekim bek!’ [pay him back] some say, or ‘Break away!’ [divorce], but
I emphasize the knowledge, advise them to forgive, and tell them it’s not right.”
Another woman once complained to her about genital itching. “I said, ‘That’s a
sign of an STI!’” Before, Gwen says, women wouldn’t have even talked about such
matters, and if they had, “we would have thought it was just normal,” not an STI.
Betty Lucas provides one-on-one peer counseling and skills-building advice to other
military wives who live on the patrol base.

Betty Lucas, who is also married to a military man, was motivated to join the site
committee because she felt sorry to “see so many problems affecting families”
and wanted to help others live a good life. She advises women on alternatives to
selling sex for extra income, such as learning sewing and cooking skills. (Betty is
an accomplished cook and part-time fisherwoman.) With the training she has
received through Tingim Laip, she has plunged headlong into the work, “even
though it’s my first time doing such activities.” Betty feels she is most effective as
a peer counselor. People come to her house, or she meets them on the road or at
the market, where she “gives ideas to them,” especially on the dangers of multiple
partners and “the importance of focusing on their families.” Betty is expecting the
Tingim Laip Project to continue to strengthen her skill base and support her to
expand into making referrals and providing home-based care and support.
Hedwig Joseph, a military nurse in charge of the clinic on the patrol base, is not
yet a member of the site committee, but she decided to participate informally out
of a sense of “not having done enough.” At first, she says, the frank language used
to discuss behaviors that contribute to HIV transmission “put me off.” But, she
continues, “last year I began to feel I haven’t contributed anything to my profes-
sion, my community, or my family.” As a sign of her newfound commitment, she
overcame her fear and reluctance to discuss sex, drugs, and HIV with her three
sons when they came home for the Christmas holidays. Though she knew they
had probably already heard the information elsewhere, she thinks it was impor-
tant for them to hear the messages directly from their mother.
Rounding out this cross-section of the Lombrum community are Andrew Waki
and Bill Putlieu. Andrew is a village court official who had been thinking about
how to deal with the issues of violence in marriages, along with drug and alcohol
use, since so many of his cases spring from these problems. When David asked
him to join the site committee, he was happy to gain the skills and support he
needed to address the problems he was encountering at work. Bill, who works at
the dispensary, provides his customers with private and discreet counseling on
sexual health problems, and condoms for those who are hesitant to take them
from a public dispenser or from a female nurse-clinician.

The Church—a Force for Change
David notes that the Seventh-day Adventist Church is just one of many Christian
churches in the area, but because it already had active women’s groups and a
youth group that were carrying out activities in the community, he thought it
would be an ideal institution to integrate HIV messages and “serve as an entry
point for intervention.”
One of the ways the church group is addressing HIV is by adding prevention mes-
sages to its community outreach work. When they visit people door to door, they
share bible stories and songs to “keep people’s minds on track.” The church also
makes use of “block leaders” to mobilize the community. They organize public
Nelson Waiki, a church representative, supported efforts to incorporate Tingim Laip
activities into his church’s own outreach programming.

showings of a video series, O Papa God, which is very popular in Papua New
Guinea and incorporates HIV messages into the storyline. Finally, according to
Nelson, the church has added training in trades, including mechanics and electri-
cal, using trained community volunteers.
Support from the Top
Lombrun Patrol Base Commanding Officer Philip Polewara is pleased with the
approach the Tingim Laip Project has taken. “I like to see the children walking
around singing—that’s where you have to start.” He admits that it took him a
while to get used to people openly discussing “sex and sex organs,” and using
slang words for sex, such as kuap, in public as well as on radio and television, but
he sees it as critical for the health of the men, the strength of the armed forces,
A view from Manus Island near Lorengau, home of a patrol base that guards the Papua
New Guinea coast.

and, in turn, the security and prosperity of the country. “With HIV, we cannot
have a fit and healthy fighting man. It’s a security issue that is as big, or even
bigger, than corruption.”
Commander Polewara thinks the army should do more than promote
prevention and support behavior change, but sees understaffing as a
contributing factor: “We need to expand the manpower so men don’t have
to spend so much time away from their wives at sea. Our technology is
not enough—we have to look after the men as well.” Part of that, he says,
is looking after their families, “the basic unit of society.” Polewara recently
proposed spending 29 million kina (about $US 10 million) to strengthen the
infrastructure at the base, including refurbishing or rebuilding the existing but
neglected health clinic. He is recruiting doctors and other support staff to run
the clinic. Polewara is appreciative of the Tingim Laip initiative: “Only in this
place, thanks to you, is this fire kept burning.”
David doesn’t mind the large time commitment it takes to keep this community
mobilization initiative moving forward. “I give enough time to my job, but
Tingim Laip takes almost as much. As soon as I finish one, I start the other.”
According to him, the success at Lombrum Patrol Base is the ownership taken
by the community, and the visibility of and interest in the activities on the base.
He sees his work as continuing to “build capacity, organize and motivate the
community to respond creatively, identify local resources and systems, and
not look just to donors.” He believes the church has been successful because
“they’ve integrated the program into their own activities.” Donors can help, he
says, but over the long term, “it’s up to us to manage it.” •

Containers in storage at Wagi Valley Transport, a major trucking firm in Mount Hagen,
and the focus of a successful Tingim Laip behavior change activity to promote the use
and distribution of condoms.

Chapter three
Picking Up, Dropping Off
in Mount Hagen
Wagi Valley Transport office manager
Naomy Farapo calls her drivers, mechanics,
and other staff “my boys,” and the affection
is mutual. The company’s Mount Hagen
headquarters are typical of most businesses
surrounding downtown. It’s not immaculate
by any means—the grounds could use some
grooming and the building’s front picture
window has had a stone through it—but there
are clear signs of a thriving business: all but
three or four drivers are on the road, and just a
few trucks are in the yard for servicing.
Wagi Valley Transport, which employs 25
drivers, is a Tingim Laip intervention site
with great potential to contribute to slowing
the rate of HIV transmission. Mount Hagen
is Papua New Guinea’s third-largest city and
the center of a rich agricultural area, and of the
coffee and tea industries. Those products, and a huge variety of fruits,
vegetables, and other items travel by truck on the single overland route to the
port of Lae, 450 kilometers to the southeast, for export or distribution to other
parts of the country.
Mount Hagen Successes
Mount Hagen is Papua New
Guinea’s third-largest city and
the center of a major agricultural
area. Truck drivers passing
through contribute to the
spread of HIV.
Wagi Valley Transport, a local
company, has great potential to
contribute to slowing the rate of
HIV transmission; its office man-
ager, Naomy Farapo, serves as a
“gatekeeper”—an opinion and
community leader who provides a
link to the private sector.
Naomy has introduced drivers
to The Love Story Book, an FHI-
developed interactive awareness-
raising tool, and encourages
them to be tested for HIV. She
and her drivers carry and distrib-
ute condoms, and other transport
companies seek her advice on
instituting their own counseling
and testing programs.

Truckers and HIV Transmission
Truck drivers contribute to the spread of HIV along the route as they stop at
“hotspots”—small towns, markets, and food stops—where they may offer women
rides in exchange for sex. The journey to Lae and back by truck takes three days,
and Bobby Yere, a Wagi Valley Transport mechanic who goes on the road to fix
trucks that have broken down, says most drivers pick up two or three women on
each trip. The system is called “pick up, drop off.” It’s also called “free lift,” though
Bobby gets a big laugh when he declares, “Nothing is free—they know the price!”
Naomy is Tingim Laip’s private sector site committee representative in Mount
Hagen. During the intervention design process she was identified by the provin-
cial AIDS committee, community leaders, and a “social mapping” process as a
“gatekeeper,” an opinion and community leader who could serve as a vital link to
the private sector, in particular the transport industry.
Naomy says that at first, Bobby and the drivers did not embrace the ideas of coun-
seling and testing or of using condoms when they’re on the road. She organized
numerous lunchtime meetings for the drivers and mechanics to talk about the
issues and offer the services, but attendance was low. “It was very hard to get the
boys to come in, but we kept holding the meetings until the willing ones finally
came forward.” Naomy’s breakthrough came when she introduced the drivers
to The Love Story Book, an interactive awareness-raising tool developed by key
Tingim Laip partner Family Health International. The Love Story Book follows
a family and community as they cope with HIV and AIDS. Participants give
the characters names and imagine relationships and scenarios that make them
real, and the facilitator interweaves into the discussion the different ways HIV is
The Love Story Book follows a family and community
as they cope with HIV and AIDS. Participants give
the characters names and imagine relationships and
scenarios that make them real.

transmitted; strategies to prevent transmission; information about counseling and
testing; and encouragement of positive attitudes toward people living with HIV.
The guide was such a hit with the drivers “that they keep asking us when we are
going to introduce volume two,” says Nayer Kaviani, Papua New Guinea country
director for Family Health International.
“It was a headache for me,” says Bobby, explaining why he didn’t attend the
meetings at first, despite knowing he engaged in high-risk behaviors. “We do ‘go
around,’ especially myself, at least until I got my counseling and testing.” It was
clear, he says, that “some of the free-ride women were positive. I could see the
signs, or their husbands were dead.” Asked why he found it so troublesome to
get tested, Bobby replies, “To be honest, I didn’t care at first. But now I’m seeing
older and younger men and women getting HIV, so I’m concerned and want to
get involved.” Since getting his test, Bobby has also started “to make my family
my first priority.”
Bobby Yere, second from right, shares a laugh with his workmates. Bobby has become
an enthusiastic proponent of condom distribution as a result of Tingim Laip behavior
change interventions at his workplace.

Bobby was tested in mid-2007. When he got the results, he says, “I was so
relieved. I was floating. I thought, ‘Thank God!’” Bobby then encouraged his wife
to get tested. “Now I’m a different person,” he says.
A Beneficiary Becomes a Volunteer
Now Bobby has become a voluntary behavior change communicator, though
he has not been formally trained. He helps distribute the condoms that Naomy
makes sure are always in plentiful supply. “I tell my relatives, neighbors, all about
them.” He gives them to drivers, telling them, “They’re for yourself, or give them
to another driver.” Bobby says that recently, pick-up drop-off ladies have begun
asking Wagi Valley Transport drivers for the “hotcakes.” Bobby even showed his
four-year-old son a condom, promising to tell him all about them later.
Bobby doesn’t like to use condoms, so he has stopped picking up “party girls”
altogether. He says if he kept condoms with him, he’d be tempted to use them,
“so I give them all away.” The message Bobby gives condom recipients is, “Don’t
pretend, take it! Or give it away. Save somebody’s life.” Bobby has also participated
in condom demonstrations and leads debates on their pros and cons.
Naomy distributes about 400 of the 12-packs of condoms she gets from the
Provincial AIDS Council each month to Bobby and the drivers. The reason she
handles distribution, even though condoms are widely available, is that the drivers
are embarrassed to be seen buying condoms from shops or helping themselves
from a public dispenser. Of the 25 drivers employed by Wagi Valley Transport, 15
have been tested at work through the Tingim Laip initiative, and Naomy thinks
some of the others have been tested elsewhere.
The Business Case for Wagi Valley Transport
“People know that Wagi Valley drivers have condoms,” Naomy says, and this
raises the visibility of the company and its reputation as a caring workplace. This
has encouraged other transport companies to seek Naomy’s advice on instituting
their own counseling and testing programs.

Like Captain Polewara on Lombrum Patrol Base (see pags 13–19), Naomy
believes health is as important as technology and infrastructure: a healthy driver
is a better driver, so Wagi Valley Transport gains a competitive advantage by
concerning itself with employees’ health. Bobby agrees. “It’s expensive to get new
drivers and fix trucks damaged by inexperienced drivers,” he says, climbing aboard
his truck to rescue a driver who has called in a breakdown. •
Naomy Farapo, office manager for Wagi Valley Transport in Mount Hagen, is a local
change agent. Her persistence catalyzed a sea change in attitudes and behaviors
among her company’s truck drivers.

Paul Gual (left), the Kerowil Tingim Laip site committee chairman, helped organize over
20 awareness meetings to gain the trust of community members and encourage them
to get counseling and HIV testing.

Chapter four
Welcoming the Marginalized
in Kerowil
Turn off the Highlands Highway from
Mount Hagen town and follow a road that for
some kilometers is lined by scores of villagers
who are weeding the road shoulders. The
roadsides are a riot of coleus, marigold, and
begonia. Continue with the garden theme
all the way to Kerowil, where visitors are
led along a driveway lined with amaryllis
and orchids, welcomed with garlands of
bougainvilleas, and shown to a table groaning
with local produce from pineapples to
cabbages. This effusive welcome is one that
Kerowil now extends to all, no matter what
their profession—or HIV status.
Kerowil is just a few kilometers from the
Kerowil Military Detachment Base, which
has attracted a large number of locally based sex workers. Sex workers in this
area do not all work full time—many do the work on occasion to supplement
their incomes or pass the time while their husbands are away. This makes the
village a “hotspot” for HIV transmission.
Kerowil Successes
The Kerowil Military Detachment
Base has attracted a large num-
ber of female sex workers, many
of them part time. FHI’s behavior
change training has taught site
committee members strategies
for encouraging female sex work-
ers to take advantage of mobile
The committee also works to
fight stigma and discrimination
and integrate People living with
HIV into the committee.
With the Tingim Laip Project’s
support, Kerowil is changing its
discriminatory attitudes about
People living with HIV and sex
workers, increasing demand
for counseling and testing, and
helping to create a culture of
condom use.

A Patient Approach
Site committee coordinator John Kosam and committee member Agnes Go
were early beneficiaries of Family Health International’s behavior change com-
munication training. The training taught them options for approaching their
target audience—female sex workers—and gaining their trust over time so that
they would eventually take advantage of the mobile counseling and testing being
offered. The training also taught John and Agnes patience and creativity. John
says, “You don’t just call a meeting and expect people to come out.” In fact, the
committee organized more than 20 mass awareness meetings to prepare the way.
When the day finally came, 78 people showed up for the mobile counseling and
testing, and of those, 22 were sex workers. Test results were not expected for a few
more weeks, but the committee is planning for more people to be counseled and
tested now that villagers have seen for themselves how easy it is. The committee
will continue holding frequent awareness trainings and has scheduled mobile
counseling and testing services to occur every three months.
Fighting Stigma
Kerowil’s site committee has done much to fight stigma and discrimination and
integrate people living with HIV into the committee and its activities. John
says they did this with simple, straightforward messages: “We just told people
you don’t have to feel ashamed, and they heard the message that there’s no
stigma.” Peter Kerenga, an HIV-positive site committee member, affirms that
community attitudes are changing. When Peter asked to join the site committee,
he was welcomed. Agnes says, “When Peter came, it opened our eyes to see that
a person can live with the virus.” Peter, who is on antiretroviral therapy, supports
Kerowil’s site committee has done much to fight stigma
and discrimination and integrate people living with HIV
into the committee and its activities.

behavior change activities with his testimonials. He sees his primary role as
offering a warning to others: “I tell them, ‘I’ve got this, I’m living with it, and
it’s your choice.’”
Peter is also applying the training he received in home-based care, which he
believes should be a Tingim Laip Project priority to expand as more and more
people are diagnosed with HIV. His volunteerism reflects his desire “to live a
productive life, despite HIV.” He says that things won’t change overnight: “We’re
still mountain people, but I’ve learned how to live a positive life. I’ve left some
things—like drinking and gambling—and do other things now,” such as eating
more nutritious foods. “I feel healthier.”
When an HIV-positive man asked to join the Tingim Laip site committee, fellow
committee member Betty Aipe said “it opened our eyes.”

Celebrating Positive Living
The committee members relate the story of “Regina,” who was in the late stages
of AIDS. “Nobody here wanted to help her out,” they say, because of fear. She
had to be carried to another healthcare center for life-saving treatment, and
even her immediate family wanted nothing to do with her. But then she started
antiretroviral therapy and improved, and the community eventually embraced
and supported her. Everyone was thrilled to hear that she recently married
another HIV-positive person. She now lives in Minj, a small village just across
the ridge to the north. John concludes that in the old days, “people wouldn’t
want to come close to people with the virus.” Now, he says, people come right up
to Peter and Regina.
Kerowil community members support the Tingim Laip Project site committee, in front
of the resource center, which they built on donated land.

With Tingim Laip’s support, Kerowil, which once frowned upon sex workers
and shunned people living with HIV, is succeeding in changing attitudes, along
with increasing demand for counseling and testing services and encouraging
development of a culture of condom use. The site committee’s willingness to stay
the course instead of getting discouraged, seek training and resources instead of
giving up, and welcome people with HIV to contribute to the effort has made a
huge difference. •

Julie Levie, Duty Manager at Hotel Poroman, Mount Hagen, says staff are enthusiastic
about distributing and promoting condoms at both the hotel and its dance club,
Waipa Zone.

Chapter five
Attacking the Problem from
All Angles in Waipa Zone
Hotel Poroman, in the middle of Mount
Hagen town, is surrounded by a lush tropi-
cal highlands garden. The main entrance is
just past a footbridge that crosses a shallow
stream flashing coppery with tiny fish. Across
from the hotel entrance, about 100 meters
down a gravel pathway and past some fran-
gipani trees, is Waipa Zone, a bar and dance
club considered the hottest nightspot in
town. By day it’s a simple tin-roofed shell, but
on Wednesday, Friday, and Saturday nights,
more than 250 dancers and drinkers from
town and surrounding settlements pack the
dance floor until nearly 4 o’clock in the morn-
ing. Sometime before then, couples may peel
off and head to the hotel or other places for
casual sex. The combination of alcohol and
marijuana, dancing, and late hours can impair judgment about safe sex. Waipa
Zone, the only dance club within Mount Hagen’s town limits, is considered one
of Western Highlands Province’s HIV “hotspots.”
Waipa Zone Successes
Waipa Zone, a popular nightclub
near Mount Hagen town’s Hotel
Poroman, is one of the Western
Highland Province’s HIV hotspots.
Hotel staff hand out condoms,
provide condom demonstrations,
stock the condom dispensers
in the hotel, and spread safe-
sex messages.
Site volunteers also staff a
Help Desk, where they provide
information, counseling,
brochures and educational
materials, and condoms.
The committee has received
requests from other local
hotels and nightclubs to
make presentations, and has
organized a meeting attended
by hotel and motel managers
representing more than half of
all such businesses in town.

Laying the Groundwork
Maggie Wilson, the hotel owner, was identified by the Provincial AIDS
Committee, community leaders, and a “social mapping” process as a “gatekeeper,”
or community leader who could work with a Tingim Laip Project site committee
and its partners as a point of access to the private sector. When Julie Levie, duty
manager at Hotel Poroman, agreed to participate, the Tingim Laip project officer
for Western Highlands Province, James Sakul, met with the hotel management
to suggest it form a site committee. The owner was enthusiastic, and Julie was as
well. Julie says management supported the idea “because we deal with people
and wanted to help in any way we could.” And they got right to work, coming up
with a variety of creative strategies, services, and messages to bring the safe-sex
behavior change message to Waipa Zone customers.
A Variety of Interventions Get the Message Across
Julie says some of the hotel staff provide demonstrations to club patrons and
hotel guests on how to use a condom. Other staff, from the receptionist to
cleaning staff to barmen, hand out condoms on request or stock the condom
dispensers in bathrooms and other public places throughout the hotel. Hotel staff
also spread safe-sex messages. She’s observed staff telling men, “If you go with her,
please take this first, because we don’t know her position.” Julie says that usually
the men leave when they hear that, but sometimes they take the condom. The
barmen serve behavior change messages with the drinks: they put beers on coast-
ers with messages printed on them such as “SSS: Safe Sex Saves” or “I care, do
you? Get tested.” Waipa Zone site committee members approach patrons during
the evenings for one-on-one peer counseling and education sessions on safe sex
and reproductive health. And once each night, committee volunteers are given 10
Committee members approach patrons during the
evenings for one-on-one peer counseling and education
sessions on safe sex and reproductive health.

minutes of dance time to make a presentation. Site committee member
Maggie Numdi, who works with the Chamber of Commerce, says the entire
crowd becomes “very quiet, because it’s still something new to them, and
they’re curious.”
The Help Desk
Maggie says the committee’s volunteers mainly focus on stocking the condom
dispensaries they had installed in the men’s and women’s bathrooms, and on staff-
ing the Help Desk, where committee members provide information, counseling,
brochures and educational materials, and condoms. The Help Desk is open three
days a week for seven hours, but the committee would like to expand the opera-
tion, and have a plan and budget to do so in 2009. James relates the story of a
young woman he met at Waipa Zone. On that night, she was very drunk. “But she
said she was so happy about the Help Desk, and she thought this was very good,
and she said, ‘From now on I’ll try my best to negotiate a condom.’”
Site committee members Robert Noki and Maggie Numdi explain how the site
committee staffs and operates the Help Desk.

In addition to stocking the dispensaries, the committee makes sure the barmen
have a plentiful supply of condoms. According to Julie, because they are men,
other men will feel free to approach them to ask for some “safety.” They might also
ask for a “sock,” “karamap,” “gumi,” “rubber,” “hotcake,” or “lifejacket,” just some
of the many slang names for condoms. Asked how she knows the condoms are
actually used, Julie says, “because we find them in the bins in the morning.” Also,
when people ask staff for condoms, she knows they will be used.
Site committee chairman Willie Goi and Maggie tell a story about how some
HIV-positive women volunteered to act as “plants” and invite men to their rooms.
“When they got to the room, they told the guy, ‘Sorry, but I’m positive, so you
should always use a condom.’ The young men fled.” On another night, one of
Maggie’s volunteers snagged two young men she knew from her village. At the
appointed time, Maggie entered the room and said, “Rose and Julie, why don’t
Youth representative Mawa Koka says the site committee is focusing sensitization
efforts on youth who come to Waipa Zone from out of town.

you introduce yourselves?” The young women then revealed to the young men
that they were HIV-positive.
Mawa Koka, one of the committee’s two youth representatives, says a lot of young
people come to the dance club from settlements outside of town. Sensitization
efforts for this group include one-on-one and peer counseling offered during the
dancing, and T-shirts with safe-sex and testing messages screen-printed on them.
The committee is sponsoring a contest for the best message to screen-print onto a
new T-shirt design.
Willie says the committee has received many requests from other hotels and
nightclubs in the area to make their presentations in other settings. As a result, the
committee organized a meeting of hotel and motel managers. Eighteen attended,
representing more than half of all such businesses in town, clear evidence of the
Tingim Laip Project’s positive impact on the community.
Why They Do It
Site committee member and longtime provincial AIDS committee volunteer
Robert Noki says he is motivated to volunteer for long hours because “we love
our fellow man and the upcoming generation.” Julie says she and the hotel do it
because “we are worried about our clients. We see it as a business investment.”
Identifying Waipa Zone as a hotspot, finding a gatekeeper to take on the issue,
training dedicated committee members such as Julie, Maggie, Robert, and others
to champion the intervention, and supporting a committed and creative Tingim
Laip site committee was a huge investment. But the results to date have shown
that it has been well worth the effort. •

Western Highlands Provincial Care Counselling Coordinator Apollos Yimbak coordinates
the overall response of the province’s districts.

Apollos Yimbak
Apollos Yimbak is the provincial care counsel-
ing coordinator for the Western Highlands
Provincial AIDS Committee—more
commonly known as the PAC. His role is to
coordinate the HIV response over all of the
province’s seven districts, with the goal of
bringing more counseling and testing services
to the site level. Most people in Tingim Laip
sites are within an easy walk to counseling
and testing centers. Other sites are served by
mobile clinics. “We also want to bring services
to people’s doorsteps,” Apollos says. He is
pleased with the progress in the five Tingim
Laip sites in the province: “We see some good
and bad things, but we’re learning, and we will
make changes to make the program even more
effective. Tingim Laip will be a good model for
us to work from” to expand the availability of
local services in all districts.
Chapter six
A Gallery of Heroes in
Western Highlands
Western highlands Heroes
Apollos Yimbak coordinates the
HIV response over all seven dis-
tricts on the province, with a goal
of bringing more counseling and
testing services to the site level.
James Sakul provides technical
support and advice to site com-
mittees, ensures their activities
align with their purpose, and
helps them manage their funds.
Willie Goi sought out the Tingim
Laip Project when he noted that
in his area, people weren’t talking
openly about sex, men shunned
vasectomies, and women were
not assertive in their healthcare
seeking. He saw that the Tingim
Laip Project was able to people
successfully address these issues.
Agnes Kerry supports a youth
center that offers activities, edu-
cation, and resources. The cen-
ter’s youth entered a song they
composed in the 2007 Tingim
Laip Youth Music Competition
organized by FHI. Agnes and her
site committee have also made it
a priority to support people living
with HIV.

James Sakul
James Sakul (shown above), Tingim Laip project officer for Western Highlands
Province, provides technical support and advice to site committees, ensures
their activities align with their purpose, and helps them manage their funds. He
sees committees reducing stigma and discrimination by working with female sex
workers, such as in Kerowil (see pages 26–31). Other committees have organized
activities to engage their target groups while building in prevention and behavior
change messages. These include sports interventions for youth and training in
skills such as baking and sewing for girls and women. The Minj site committee
has built a youth-friendly center with a television donated by UNICEF, musical
instruments, and information on sexual health. But James thinks that the Tingim
Laip Project’s success in helping create a culture of condom acceptance and usage
“has been the biggest, biggest, biggest breakthrough” in Western Highlands.
The PAC was instrumental to the Tingim Laip Project’s success in Western
Highlands province and is “the backbone of this whole setup,” James says. For
example, when Tingim Laip was just a concept, the PAC invited Tingim Laip
staff “to make the concept a reality,” worked with them and other stakeholders to

identify HIV “hotspots,” and appointed an employee to help coordinate the pro-
gram. Even before Tingim Laip was operational, the PAC began narrowing down
the number of sites with the potential for establishing committees.
Once Tingim Laip was up and running, its staff met with gatekeepers in high-risk
settings. Gatekeepers are community leaders including shopkeepers, club owners,
church leaders, and managers of transport companies (see pages 20–25). James
says: “We introduced the idea and gave them the key messages. From that point,
the gatekeepers suggested site committee members.” James says communities
were excited by the Tingim Laip Project’s unique bottom-up approach and the
opportunity to take ownership of their HIV response. Their reaction was, “Man,
we can do it! This is ours! Why don’t we run with it!”
Willie Goi
Willie Goi, site committee chairman for Waipa Zone (see pages 32–37), works
with Marie Stopes, a civil society health organization that operates mobile health
clinics in Western Highlands. He had seen that “establishing a new network to
Willi Goi

provide services would be hard,” so he was looking for an existing network and
had heard about the Tingim Laip Project. When Willie visited some sites operat-
ing in the same areas as Marie Stopes, he noticed something different: “People
here don’t talk openly about sex, but they did in Tingim Laip sites.” He also
observed that men generally shun vasectomies—except in Tingim Laip Project
sites. Finally, he says that women in Tingim Laip areas were assertive in their
healthcare seeking. Most women in Papua New Guinea describe their symptoms
and receive a strong antibiotic that can treat multiple microbes. But Willie says
that “Tingim Laip women were asking, ‘Why don’t you check us before you treat
us?’” Willie says this was another big breakthrough.
Agnes Kerry

Agnes Kerry
Agnes Kerry, site committee coordinator for Minj, wants people to know that
the site’s name is Wikep, and “it is our unique home.” She is particularly proud
of the Kinim Kinim Wikep Youth-Friendly Center, a large building made of
local materials whose entrance is adorned with hundreds of pig jawbones. She’d
like this success to be “spread far and wide.” Inside the youth center are musical
instruments, posters and brochures, chairs, a blackboard, and a meeting table.
UNICEF recently donated a television and DVD player. The youth composed a
song and entered it in the 2007 Tingim Laip Youth Music Competition organized
by FHI. While it did not win—because of technical problems, says Agnes, not
lack of merit—the song is clearly a local hit. As the young men sing the words, the
audience joins in:
HIV and AIDS
take a challenge to do something.
We are the future of PNG.
Take a challenge to be.
Agnes and the site committee have made it a priority to include and support those
living with HIV. “Regina” (see page 30), now living in Wikep, is a committed
behavior change volunteer recently married to another site committee member,
who is also HIV-positive. Agnes says the committee is doing whatever possible to
support Regina and her husband.
Agnes has electrifying charisma and leadership qualities: not only has she built
the site committee into a formidable local presence, but she has also developed
strong relationships with UNICEF, the West Highlands Provincial AIDS
Committee, and service providers to broaden the array of services available
in Wikep. One illustration of her leadership is that the visitors in charge of
documenting Minj’s success story are met by a group of dancers in full-feathered
regalia, two singing groups, and no fewer than seven groups of constituents
from nearby villages—ranging from what she calls “the druggers” to high school
students to church groups—who also wish to start site committees based on the
Tingim Laip Project model. •

When Isaac Napoleon, who works at the Mutzing Health Center’s TB clinic, “saw that
TB and AIDS are cousins,” he joined the Tingim Laip Project.

Umi, a village of 600, is located along the
Highlands Highway leading to Goroka and
Mount Hagen, Papua New Guinea’s major cof-
fee and tea production areas, and is their only
access to the port of Lae, about 100 kilometers
to the southeast. Because of the heavy truck
traffic on the road and truckers’ culture of
giving “free rides”—that is, rides to women in
exchange for sex—Umi’s small roadside mar-
ket is a well-known HIV “hotspot.” Another
hotspot, Yang Creek, is also nearby.
The Coupon System
The site committee in Umi has developed
a coupon system to refer youth and others
to the Mutzing Health Center outpatient
department, a short walk from the market. The
coupons provide bearers with free counseling
and testing services for a number of health issues and are later collected by the
committee, which tracks the response rate on its computer. The coupons were
introduced through what site committee coordinator Ben Martin, who received
Chapter seven
Creating Demand for Services
in Umi Market
umi market Successes
A small village, Umi, sees
heavy truck traffic due to its
location along the Highlands
Highway, making Umi Market
an HIV “hotspot.”
The Umi Market Tingim Laip site
committee introduced a coupon
system to refer people to the
health center nearby, which offers
free counseling and testing. The
coupon system has increased
interest in and attitudes toward
condoms, demonstrated by the
fact that youth, police, and oth-
ers now ask for them.
HIV counseling and testing are
promoted through the commit-
tee’s civil society organization
representative, who assists
youth in starting small business,
and through the local TB clinic.
Church, police, and other
stakeholders also contribute to
outreach efforts.

Tingim Laip training in behavior change communication and peer education,
calls a “sports intervention,” a three-week volleyball tournament held each year.
“The sports intervention brought impact,” Ben says, “and was a good way to
impart information.” Before each game, committee members and other partner
representatives talk to each of the 12 clubs about different aspects of HIV, other
sexually transmitted infections, tuberculosis (TB), and prevention. The clubs,
whose members come from all around the area and not just Umi, are then offered
the coupons as well as condoms, and are encouraged to drop by the committee’s
resource center, built on land and with materials donated by Ben, anytime.
Since the coupon system began in 2006, the committee notes that interest in and
positive attitudes toward condoms have risen dramatically. People, mainly youth,
come openly to the resource center to ask for condoms. Police and other partners
are asking for condoms as well. This increase in demand represents a major rever-
sal of attitude for a once condom-averse hotspot.
Engaging the Small-Business Sector
The committee’s civil society representative, Jonathan Zarampua, leads
Community Consulting Services (CCS), which assists youth in starting small
businesses. In this area, typical business startups include growing cocoa, vanilla,
or peanuts, and raising poultry. Jonathan says that when youth seek his help, CCS
offers advice on licensing and other bureaucratic procedures and helps draft any
needed letters. He decided to participate in the Tingim Laip program because
“when youth came in, they saw it as a beginning,” and he realized it would “also be
a good beginning to talk about HIV.” Ben says that the CCS contribution has been
Since the coupon system began in 2006, the committee
notes that interest in and positive attitudes toward
condoms have risen dramatically.

successful. “Youth had previously roamed about, but CCS is helping them settle
down and get involved in activities other than drugs.”
“TB and AIDS Are Cousins”
Isaac Napolean works at the Mutzing Health Center’s TB clinic. When he “saw
that TB and AIDS are cousins,” he joined Tingim Laip. TB treatment requires
patients to follow a six-month treatment regimen. When the treatment is
stopped early—for example, if patients start to feel better and stop taking their
medicine—the TB develops resistance to the antibiotics and becomes much
more difficult and expensive to treat.
To prevent this from occurring, Jonathan’s clinic uses the directly observed treat-
ment, short course (DOTS) method, which means the patient must be directly
observed taking the medicine by a clinician or adherence support worker. When
Ben Martin, Nelson Silas, and Jonathan Zarampua, celebrate the completion of the first
peer education tools developed by a Tingim Laip Project site committee.

patients do not show up for their medicine for more than two days, Jonathan or
the support worker must try to locate them. Most of Jonathan’s referrals are youth
from the Tingim Laip Project. Of the nine referred so far in 2008, all were cured,
taking 100 percent of their course. His patients’ HIV status is not known, but
he expects that testing all TB patients for HIV will begin soon. Ben says Tingim
Laip’s work with the TB clinic presents an opportunity to encourage TB patients
to seek counseling and testing and treatment for other infections. “Before,” he
says, “the OD [outpatient department] just waited for people to come.” Now
Tingim Laip creates demand for clinical services.
View of the mountains near Umi Market, along the Highlands Highway.

Contributions of Church, Police, and MOthers
Nelson Silas, the committee’s church representative, is a member of the Seventh-
day Adventist Church, which has signed a memorandum of understanding with
the Tingim Laip Project and invited all the partners to make presentations to the
church leadership. In November 2008, the Tingim Laip Project participated in a
one-week Bible Camp, offering the church leadership training on basic facts about
HIV, peer education, and counseling.
The Tingim Laip site committee has also done outreach work with the police on
child abuse and neglect problems. The committee conducted information cam-
paigns on the signs of child abuse and neglect, and police representatives came to
in-home trainings for mothers and community leaders to explain, among other
things, children’s rights and the legal consequences of child neglect and abuse.
Localizing the Response
Ben seems eager to add an item to the agenda—he wants to show off some of the
tools he’s developed with the support of the site committee: two manuals, a peer
profile tool and a peer educator’s guide for use in small-group and one-on-one
interventions. Ben and the committee adapted Family Health International
training materials to the situation in Umi, because, Ben says, “we’re talking with
different classes of people: families, individuals, and groups.” The tools were
developed with Umi community members in mind. Ben proudly notes that they
are the first in the country to be aimed at a specific community.
Tingim Laip’s continued success in creating demand for clinical services to
diagnose and treat sexually transmitted infections will depend on just such
community-inspired and highly targeted HIV tools and interventions. •

A fisherman in Wagang (Sipaia) Village.

Chapter eight
Sustaining Innovation and
Self-Reliance in Wagang
(Sipaia) Village
Wagang (Sipaia), though just minutes away
from Lae, Papua New Guinea’s second-largest
city, is an isolated, idyllic fishing village of a
thousand or so. Its black-sand beach is lined
with coconut palms, hand-hewn canoes, neatly
stacked driftwood, and tidy wood and rattan
houses. One fisherman is in view, casting his line
off the rusty bulkhead of a ruined Japanese
warship that has been heaved ashore. (Villagers
say the name Sipaia, Pidgin for “Ship on fire!,”
refers to the naval battles that occurred here dur-
ing World War II.) The others are out on their
fishing boats or working at Lae Ports, and the
children are in school.
Despite the tranquil scene, Wagang has some
serious problems, and not just with HIV, but it
addresses all of them with meticulous organiza-
tion and attention to detail. On the way to the
village, for instance, a group of men and boys are repairing and grading the deeply
rutted and muddy road, using only shovels. The village volunteers its labor to
maintain its only access road, because government services are not as dependable
WAGANG SUCCESSES
The site committee in Wagang,
a small fishing village, has
sought support from the busi-
ness community; when local
businesspeople saw what the
committee was doing, they
donated their own funds as
well as sought funds from
their employers.
The village has taken a
methodical, systematic
approach to setting up and
funding youth sports clubs as
sustained points of entry for
HIV education and prevention
messages. Sports interventions
include talks before and after
games, and team captains
distribute referral coupons
to players.
Interventions have decreased
the amount of drug and
alcohol use among youth, and
have spurred changes among
adults as well, with men spend-
ing more time at home.

as the rains that beat up the roads daily and are responsible for Lae’s reputation as
the “city of potholes.”
Consulting Widely to Build Broad Support
This high level of organization is illustrative of Wagang’s self-reliance and helps
explain its successes in implementing the Tingim Laip Project initiative. Another
example: Wagang was not even selected as a Tingim Laip site, but villagers
who worked at Lae Ports, which had a site committee, immediately saw the
potential. The Wagang site thus began as a Lae Ports subsite and benefited from
technical support and training that the Tingim Laip Project provided to that
group. Wagang’s initiative and perseverance paid off, and its site committee was
established in 2005, led by Dalla Yaling, site coordinator, and Tobias Wangu,
chairman of the advisory committee.
After a consultative process that included the local councilor, village leadership,
and local youth, the site committee decided to hold an annual sports tournament.
They agreed it would be an attractive venue for youth and an effective means of
providing information and behavior change interventions, referrals to the local
health centers, and access to condoms. Almost 450 youth now participate in the
basketball, volleyball, touch rugby, and dart tournaments, which occur over three
months early each year. The youth are organized into six clubs, each captained
by a boy and a girl chosen by the youth themselves. Each village clan—the
Wakambu, Balum, and Ong—is responsible for two clubs. The clubs are named
“BCC,” “STI,” “VCT,” “PLWHA,” “IEC,” and “Condom,” and each organizes 7 to
12 sports teams.
Ensuring Sustainable Funding
The Tingim Laip Project’s activity grants funding is not always predictable,
so Wagang found a way to sustain its activities by using its own resources and
seeking support from the private sector. Funding was unstable at first, but the
tournament has now been successfully held for four years and is going strong.
The first cash donation came from the village councilor, then each team paid a

startup fee, and each player a nominal registration fee. The Morobe Provincial
AIDS Committee also provided startup funding, and the Tingim Laip Project
has supported the tournament with activity grants.
Having established support from within, the committee sought support from
the business community. Members approached local businesses and asked them
to provide funding. When local businesspeople who worked for large firms saw
what was being done, they decided to donate their own funds as well as seek
funds from their employers. In return for their support, businesses received
letters of appreciation from the site committee and Tingim Laip management,
an invitation to a presentation at the end of the tournament, bilums (handbags)
of appreciation made by local women, and the opportunity to display their logos
on team uniforms.
Sustained and Creative Youth Interventions
The methodical and systematic approach taken by the village to set up and fund
the sports clubs has helped ensure they will have a sustained point of entry to
The basketball court in Sipaia, where the annual sports tournament is held, is in the
center of the village in a common space.

impart HIV education and prevention messages and other health messages, as
well as to provide youth with an attractive alternative to nightclubs and experi-
mentation with alcohol, drugs, and early sex.
The health interventions are conducted in several ways. Talks are given before and
after games and during the breaks. Afterward, discussions focus on such topics as
sexually transmitted infections, use of condoms, and Tingim Laip Project’s “four
pillars,” or goals (see “The Tingim Laip Project at a Glance” on the front cover
flap). Outside of the tournaments, each team organizes its own activities, such as
a “coffee night,” where, according to Tobias, teams are given a program to discuss.
Talks may focus on such topics as the different types of sexually transmitted
infections, symptoms, and complications, and the participants may receive and
discuss educational materials.
Committee member and youth representative Mala Tapi says that team captains
also distribute coupons to the players. The coupons entitle bearers to free “volun-
tary counseling test, HIV rapid test & STI treatment” and promise confidentiality.
These coupons are distributed and their use tracked by the site committee. The
coupons reduce anxiety about visiting the health clinics for counseling and testing and
diagnosis of sexually transmitted infections.

Players (or anyone else) may bring a coupon to the clinic, where they are given
priority access with no questions asked. The health center returns the coupons to
the site committee’s monitoring and evaluation officer, Eric Mai, who keeps track
of all the numbers. So far, 15 males and 10 females have presented coupons at the
health center—about a 6 percent response rate.
The site committee reports that the changes in village youth are clear. Doreen
Mambu, a Sunday-school teacher, says that the youth used to drink a lot, but now,
“they don’t hang around drunk, and the sports program attracts them.” Recently,
says Tobias, the committee set up a counseling committee to talk to youth, not
only about HIV but also about issues such as alcohol and drugs. And, according
to Mala, changes have occurred among adults as well: “On paydays, the men are
coming home, and wives don’t have to go looking for them.”
Thinking about the Future
These successes have the committee making plans to add new programs. They are
considering various income-generating activities, such as raising poultry, baking,
screen printing, and sewing to help sustain the tournament and allow the com-
mittee to move away from Tingim Laip support. They note that some mothers are
already benefiting from the tournament by selling snacks and food items at the
games that they’ve prepared themselves. The site committee also plans to begin
repairing and renovating the resource center that was built on donated land a few
years ago but has fallen into disrepair.
The Wagang (Sipaia) community has proven itself self-reliant (raising more than
80 percent of its budget year after year) and innovative (organizing itself, forming
a strong partnership with the private sector, and designing coupons and tracking
their use). These successes bode well for Wagang’s effort to sustain its locally
driven response to HIV. •

Wari Kuks and her young relative, near the field by the Madang airport where the
Tingim Laip Project site committee organizes volleyball tournaments for youth.

Madang is a small city whose pristine
seafront and magnificent coral reefs attract
tourists from all over the world. It is also the
site of the RD Tuna Canneries, which produce
the Diana brand of canned tuna products.
And Madang is a major producer of betel nut,
which is transported throughout the country
by both land and water routes. All three
industries attract many hundreds of full- and
part-time sex workers, mostly women, who
negotiate sex at various “hotspots” throughout
the city.
The Madang sex workers are highly mobile—
they come from settlements around the city,
do not always have permanent homes, and
enter and leave the business with frequency.
Estimating the total number of sex workers
is difficult, but Otto Jenjet, chairman of
Madang’s Redscar Tingim Laip site commit-
tee, estimates that his committee works with
about 300 at any one time.
Chapter nine
Promoting “Nogat Condom,
Nogat Kuap” in Madang
MADANG SUCCESSES
Madang’s three industries—
tourism, canned tuna, and betel
nut—attract many sex workers,
who are highly mobile.
The site committee in Redscar
has had condom dispensers
installed throughout the city
and conducts “mobile condom
distribution” at night. At the RD
community Tingim Laip Project
site, the committee distributes
17,000 condoms per month, and
uses referral coupons for counsel-
ing and testing and STI checkup
and treatment. The committee
also has held a sporting-event
intervention at the cannery.
Interventions have resulted in
reduced drug and alcohol con-
sumption, more discussion of sex
and STIs, and reduced numbers
of STIs. A local catchphrase
women use is “nogat condom,
nogat kuap” (no condom, no
sex)—though violence has
occurred against women who
insist on condom use.

The Tingim Laip site committee takes its name, Redscar, from a bus stop that is
also the site of shops and a popular nightclub. Sex workers gather to negotiate sex
with clients who frequent the shops and the club, and with the betel nut vendors
who are in transit to other parts of the country. The sex work is also facilitated by
a network of guest houses that charge very low rates, some even making rooms
available by the hour.
Developing a Strong Condom Culture
The Redscar site committee members understood that sex workers were more
vulnerable to transmitting or acquiring HIV than other members of the popula-
tion, and they knew the sex workers’ clients were equally vulnerable. Their first
step, therefore, was to promote safer sex practices. Current and former sex work-
ers, such as site committee members Martina Alloi and Wari Kuks, began holding
monthly meetings with some of these sex workers, demonstrating how to use a
condom and then checking to see if learning had taken place by having “speed
tests” to see who could get one on quickly and correctly. The women encouraged
“the girls” to bring a friend to the next meeting. According to Martina, “we would
sometimes end up with over 30 girls on any one night.”
Joseph Mocke, the Tingim Laip project officer in Madang, says the committee
has installed 17 condom dispensers in the Redscar area, and more in other parts
of the city, including the airport. Sex workers, clients, and others now always have
easy access to protection. More of the distinctively labeled yellow dispensers are
to be placed in other Madang hotspots. In addition to stocking the dispensers,
The committee has installed 17 condom dispensers in
the Redscar area, and more in other parts of the city,
including the airport. Sex workers, clients, and others
now always have easy access to protection.

the committee does “mobile condom distribution” at night, driving around the
city and handing out condoms in person. Through these efforts, the committee is
distributing an average of 17,000 condoms per month.
But are the condoms being used? Martina says she is sure they are—from her own
experience as a sex worker. “I was one of them,” she says, adding that the women
would borrow condoms from each other. “If they asked me for condoms, I knew
it was because they were using them.” Another sign the condoms are being used
is that clients complain that the women insist on it. The catchphrase the women
often repeat is “nogat condom, nogat kuap” (no condom, no sex). However, in
some instances, there have been reports of violence from clients against women
who “go tough” on wearing condoms. But Otto says that condom distribution will
continue forever as far as he is concerned, “as new girls come onto the scene and
older girls go out of demand.”
The Redscar night club and bus stop from which one of the Tingim Laip sites takes
its name.

One troubling development the committee is learning to grapple with is very
young girls, ages 12 to 15, entering the sex work business. “At first we thought
they were children,” Wari says, “and the clients just took them and they didn’t
know where to get condoms. So we brought them some and told them, ‘Use a
condom like we do.’” Martina and Wari think the increase in the number of young
sex workers has to do with the girls’ situations at home. They theorize that there
may be too many children for the parents to care for, or their parents don’t treat
them well. Wari says, “They say, ‘I want money, so I do this.’ I tell them the price is
too high, but if you have to, use these [condoms].”
Otto Jenjet, chairman of the Redscar site committee.

Introducing Referral Coupons
One effective tool the committee has developed is the use of referral coupons for
counseling and testing, as well as STI checkup and treatment. Sex workers and
other community members find the coupons useful to “break the ice and open up
free communications” between counselors and clients. Site committee member
Maryanne Guam says women sometimes go alone for the counseling and testing,
but she will often accompany them to the clinics, where the committee has made
sure that Redscar clients will always be welcomed, and with no judgment. At
monthly meetings, Maryanne discusses referral experiences with the women.
“The ones who have a positive experience come back and tell their friends, and
sometimes their clients,” Maryanne says. She reports that the numbers of sexually
transmitted infections being reported by the clinics had been increasing, but that
numbers have been going down since the committee began distributing coupons.
Sporting Intervention at the Cannery
The Diana Tuna cannery employs a large, mainly female workforce. Social map-
ping of the area indicated that frequent unprotected sexual activity was taking
place among the employees and between employees and sex workers who work
or live nearby.
The entrance to the Diana Tuna canning factory.

The RD Tuna Community site committee decided that a sporting event would
be a quick way to bring the community together in one place for an intervention.
The site organized 24 touch rugby teams for males, and 17 volleyball teams for
females. According to Blum Manase, the site committee’s behavior change com-
municator, “the sports activities were for communities around the factory, includ-
ing employees.” When employees attended events, they would go back to the
factory and talk about what they had learned. The committee has also taken train-
ing activities into the factory (although condom distribution is not permitted).
During the sporting activity, the committee carried out awareness activities, dis-
tributed condoms and demonstrated their use, and gave out information and edu-
cational materials. A positive side effect of the sporting activity was that it created
mini-markets for mothers to sell food and other small items. The activity brought
parents and children closer together, Blum says, and talking about sex within
Madang’s beaches and coral reefs attract many tourists.

families, “especially for mothers and fathers,” was an important breakthrough that
helped them realize the importance of talking to their children, not just about sex,
but about other family matters as well.
Site committee members say that other results of the intervention included
“more order at home and reduced drug and alcohol consumption.” According
to Martina, “if children had questions they would bring them to the parent, who
would then bring them to the site committee.” She adds that talking about sex in
public is against local custom, so the sports intervention helped people approach
difficult issues. Another result of the activity was a drop in sexually transmitted
infections at the local clinic as people started using condoms. Joseph says that
because of this success, other Tingim Laip committees are seeking to expand
sporting activities for youth.
Welcoming Other Vulnerable Groups
The Redscar site committee has reached out to a new group recently formed by
men who have sex with men. The “Medix Sisters” has more than 20 members and
is operating as part of the Redscar site. Two members have identified themselves
publicly as men who have sex with men—a brave move in Papua New Guinea—
and with the assistance of the Tingim Laip Project have taken part in training and
other activities for the past two years. They are now initiating income-generation
activities (screen printing) and holding monthly meetings to discuss prevention
ideas and the risks of unprotected sex.
Tingim Laip’s work in Madang has shown again that impressive results can be
achieved when interventions are tailored to a particular setting, such as where
vulnerability (high-risk sex work) and opportunity (high-risk settings such as
factories, bus stops, and nightclubs) intersect. •

Rose Mauyet, Tingim Laip project officer in Wewak, strolls along the beach with a site
committee member.

Chapter ten
Raising Awareness in Wewak
through Conversation, Play,
and Food
Robert Awai is 27, but looks much
younger. He recently married, has a newborn
at home, and is only intermittently employed.
He knows from experience that a lot of youth
in Wewak, a seaside fishing and tourist town,
are involved in high-risk sexual activities,
as he was. “I was one of them,” he confides,
“but my training changed me so much.” The
life-changing training Robert is referring to is
the basic HIV and AIDS awareness training
organized through Tingim Laip.
Engaging Discouraged Youth
Some of the problems youth face, Robert says,
include heavy use of alcohol and drugs, leaving
school early, and “doing nothing.” “We target
these hopeless ones,” he says. When he began
working with the Tingim Laip Project, he
was the only volunteer focusing on youth. Now the youth volunteers number as
many as 12. They deliver condoms to their peers and at hotels, and act as “human
dispensers,” handing them out as opportunities arise.
WEWAK SUCCESSES
In Wewak, home to multiple hot-
spots, committee members have
found three effective methods of
reaching sex workers: one-on-one
counseling; games organized at
night markets and screenings of
HIV-themed videos; and visiting
families at dinnertime to talk and
bring informational materials
and condoms.
The site committee also uses risk-
assessment cards developed by
FHI to spark dialog about sexual
practices and STIs.
Wewak is not served by clinics
for diagnosis and treatment of
STIs, and TL activities have been
met with some hostility. But the
committee, including youth vol-
unteers, is distributing more than
1,000 condoms per day and sees
a condom culture developing.
People are also seeking counsel-
ing and testing for HIV and
diagnosis and treatment of STIs.

Melchior Pupu, a youth peer educator, says he approaches other youth with a few
coins to buy some betel nut or a cigarette. Melchior—who has never smoked,
drunk, engaged in high-risk sexual behavior, or even used betel nut—sees himself
as a youth role model. But he doesn’t launch straight into the topics of HIV and
sex. He might “go around it” by talking about the community, telling stories, and
then moving on to personal issues. “And then the topic just comes up,” he says.
Melchior thinks that many problems faced by Wewak youth could be lessened if
there were more options for them to advance their education and find meaningful
activities, including employment opportunities. “If you could take care of your
needs, you wouldn’t go out and do those things,” he says.
Wewak’s “hotspots” seem to be everywhere…and anywhere: settlements around
town, at landmarks such as the Mobil service station on the beach, and along the
Dagua road that heads out of town. Public sex is common on the beaches and
back roads—and is a problem not easily addressed by the police, some of whom
are known to participate. Some guest houses on the beaches are also hotspots.
Near the compound of Timothy Wanie.

Glenda
Glenda met Melchior Pupu at the
Windjammer, a Wewak beach hotel,
nightclub, and hotspot. Melchior
is a Tingim Laip committee youth
representative who volunteered at the
Windjammer, handing out condoms
on dance nights. One night, Melchior
decided to put on a skit for customers,
pretending to hire a sex worker to have unprotected sex. He wanted
it to be as realistic as possible, and Glenda, a sex worker at the time,
was willing to help out. Thus began her career as a Tingim Laip
Project behavior-change agent.
Glenda began sex work quite young. After she finished school she
couldn’t find work. She got married and started going to hotels,
motels, and nightclubs. This went on until 2004, when she attended
the basic HIV and AIDS training awareness training. She and other
sex workers were introduced to Tingim Laip, and afterward she and
some of the others asked if they could join. Then they grew, “step
by step,” conducting outreach, handing out information and risk
cards, and organizing behavior change interventions. In 2006, she
left sex work altogether. “I know that what I was doing was putting
myself in danger,” she says. She is now a youth representative and
makes a living selling home-cooked food and betel nuts. Glenda
helps organize dart competitions, distributes condoms to motels
and hotels, and organizes video showings to small groups. She
tells people that “what I did is no good. Try this and you’ll see the
difference.” Glenda is proud that she has referred 23 women for

Though they are unmarked, and look like ordinary thatched-roof dwellings, they
are bustling at night. The small dirt road leading to them is crowded with cars,
whose occupants negotiate sex with the women who work there. Another hotspot
is not even on land. Every afternoon at 4 o’clock sharp, a group of sex workers
paddle out a few hundred yards to the fishing boats to visit the fishermen around
closing time. The price per sexual encounter is one fish.
Engaging Women through Multiple Methods
In working with female sex workers to promote knowledge of safe-sex practices,
the committee has found three methods to be most effective. First is one-to-one
counseling, which Rose Mauyet, the Tingim Laip project officer in Wewak, says
is very effective. “I say, ‘OK, let’s go together to get treatment [for the sexually
transmitted infection].’ I talk about how the longer it stays, the worse the effect,
and it opens you to HIV.” But the stigma of having a sexually transmitted infection
and being a sex worker is so strong that it takes much coaxing to get them to
Proof that a condom culture is developing at a famous Wewak hotspot.

Lisa
Lisa’s parents divorced when she was
very young. Her mother worked in a
bank, and rather than leaving her alone
at home, she sent Lisa to live with her
aunt, who treated Lisa “like a slave.”
By the time Lisa made it to grade 6,
she had lost interest in school and
felt “lazy and sleepy.” In 2003, she
dropped out of school, but she had been going to nightclubs with
her schoolmates for three years already. The way Lisa sees it, girls
have more material needs than boys, “so I just went for whatever
the boy offered.” Sometime in 2003, soon after moving to Wewak,
she didn’t feel well. “Whether it was malaria or whatever, I felt it.”
Another aunt took her to the hospital, where she tested positive for
HIV. When she heard the news, Lisa thought, “‘My life is useless.’ My
family accepted me, but I didn’t. I thought I’d have no friends.” Then
Lisa met Glenda and Rose Mauyet, the Tingim Laip project officer
in Wewak, and they asked her, “Are you willing to come out [as HIV-
positive]?” She was, and started making outreach visits to people at
the nearby prison camp, conducting peer education sessions, and
giving personal testimonials in many forums. By coming out, she feels
“unburdened,” and as a member of the Tingim Laip family, Lisa says,
“I’m normal!”
seek treatment (even though, as Rose points out, everyone is well aware of who
they are).
A second method is to organize dart games at the night markets and show a
popular HIV-themed video series such as O Papa God. The Tingim Laip Project
provides food prizes for the dart competitions. Before the games and after the

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