ICASA 2011 Tegbar Achamyeleh Save Your Generation Ethiopia Feasible Communication Methods for HIV Prevention Addis Ababa Taxi Community HIV/AIDS Prevention Intervention Programme ICASA 2011 Tegbar Achamyeleh Save Your Generation Ethiopia

BACKGROUND Numerous evidences show that large proportion of new HIV infections occur in young people (14- 35); According to BSS 2002,One or more misconceptions about HIV/ AIDS exist among 76.5% of Ethiopian youth, 89.6% youth Addis Ababa; 82.2% are out of school youth in Addis, *BSS 2002, round one, pages 113-115 (BSS Indicators for Uniformed Services, Transport Workers, Factory workers and Rural populations)

BACKGROUND Majority of taxi community members in Addis are out of school, in the age range 15-35 BSS 2002 also revealed that among Taxi Community members, 81.4% were sexually active. 60.6% had one or more misconceptions 31.8% had multiple sexual partners *Taxi Community is operationally defend as taxi drivers, their assistants and Informal Inspectors.

BACKGROUND 81.8% of taxi drivers and assistants chew chat and take alcohols regularly 61.7% had at least one stigmatizing attitude towards PLWHIV Only 7.1 % had ever tested for HIV Only 4-5% were willing to care for relative who is PLHIV

NEED FOR INTERVENTION Based on a Formative Assessment conducted by fhi and AAHAPCO, it was found out that Taxi community in Addis Ababa have: Very low risk perception Misconceptions on modes of transmission & methods of prevention Ignore the importance of HCT, unaware of existence services & immense fear of stigma & discrimination

NEED FOR INTERVENTION Accept peer information than that of health educators Use & Abuse drugs and substances Potential customers of CSW Most were in MCP network They have never been targeted by any HIV/AIDS Intervention Programme

INCEPTION Project Title : Addis Ababa Taxi community HIV Prevention Intervention Outreach Project January 2004 SYGE, FHI, AHAPCO, Objectives : Increase awareness on HIV/AIDS Increasing Self Risk Perception Increase the need for HIV service Utilization Promoting safer sex *January 2004-2009, PEPFAR- IMPACT Project *2008-2011, The Royal Embassy of the Netherlands

Strategies: INCEPTION Interpersonal Communication using Peer Leadership Approach Community Capacity Enhancement Life Skills Strategic Steps Step 1: stakeholder identification Step 2: consensus building workshop with stakeholders Dissemination of assessment findings and discussion. All stakeholders agreed that initiating an HIV prevention program among taxi society members was important and promised to support implementation Step 3: planning to initiate the HIV prevention program in 20 pilot sites, and later – based upon lessons learned – expand to the entire city Step 4: identification of 20 pilot sites with appropriate project stakeholders Strategy design Step 5: design & implementation of a targeted formative assessment & mapping of social networks among the taxi population: to provide key information for the design of the peer leadership strategy Targeted formative assessment & mapping of social networks identified The existing social networks, mobility, working and leisure time, influential persons, their sources of information, specific HIV intervention needs, selection criteria for peer leaders Street dramas are important in triggering Group discussions Step 6: strategy design workshop & agreement on core issues: 1. Identification of focal persons inspectors 2. Four step cascade training to implement the Peer Leadership Program core trainers, peer leadership trainers, peer leaders, peer beneficiaries 3. Selection process for each step in the cascade Who, how, when M&E Step 7: Identification of focal persons Focal persons were selected among Inspectors Step 8: Curriculum design Based on the targeted formative assessment & mapping findings Step 9: Training manual adaptation and preparation Adaptation of existing resource materials & manuals to tailor to the objectives identified in the curriculum design Step 10: Conduct pilot training Pre-testing of the manual & refinement Step 11: Training of core trainers 20 core trainers from 20 sites Step 12: Selection of peer leader trainers From all taxi society members using the criteria set Step 13: Training of peer leader trainers 98 peer leader trainers were trained by the 20 CT Step 14: Social group identification & selection of peer leaders 553 social groups identified and 1 peer leader selected per social group Step 15: Training of peer leaders 553 peer leaders were trained Step 16: Implementation of the peer leadership program Learning through group discussion, reinforcement activities (street drama, forum drama, hidden drama in minibuses, IEC material distribution, AB promotion, condom promotion and distribution, referral services, monitoring and supervision) Step 17: Review of the pilot program Achievements, challenges, strengths, weaknesses

INCEPTION Strategies Supportive/ Reinforcing Edutainment Forum Drama, Street show Tailored IEC/ BCC Materials Sechento News Letters, Posters, Leaflets Network and Partnerships

OUT COME Comprehensive knowledge on HIV   Majority of the taxi community members have knowledge on HIV prevention and don’t have misconception on HIV as a cumulative effect good proportion of the community has comprehensive knowledge on HIV.

OUT COME Sexual behaviors   The proportion of taxi community members who stick to one regular partner had increased as compared to the baseline and multiple sexual partnership among partners who have regular partner dropped significantly

OUT COME Condom use   High level of condom use with commercial sex workers and casual partners was reported

OUT COME Outcome of program   The taxi community members who were targeted by HIV prevention peer leadership programming showed statistically significant level of change on comprehensive HIV knowledge, condom use with casual partners and use of HIV related services like VCT which may be attributed to their exposure to the peer education intervention

SUCCESS Increased Awareness on HIV/ AIDS & STIs Decreased Risky Sexual Behaviors Safe Sex Consistent Condom Use

SUCCESS Improved Service Seeking behavior VCT, Treatment linkages

SUCCESS Decreased Stigma and Discrimination towards PLHIV ; self help groups mobilization

SUCCESS Compassionate Network and Partnership

SUCCESS Promises to change in Life Styles

SUCCESS ‘A recent skit reinforced me that I should keep myself safe and have safe sexual behavior. At the top of the list, even though I have casual sex and I have condoms, is to be faithful to my partner’’. A taxi driver Driving HIV away Steve Teravella Family Health International

CONCLUSION SYGE has been engaged in HIV/AIDS Intervention program among the taxi community members since 2004 to contribute to the national effort of reducing new infections of the epidemic and stigma and discrimination. Yet there is a lot to be done.

RECOMMENDATION The peer Leadership cascade implementation shall be strengthened to reach those unreached and those newly joined member of the Taxi Community. The Programme shall be replicated to other regions and towns of the country in a comprehensive manner( Integrated RH Intervention) for all types of Transport workers in/across cities (Track Drivers, Bus Drivers, Bagage Drivers).

አመሰግናለሁ!! Thank You for Your Attention!