Group 1: HIV PREVENTION Facilitators: Ms Mai Harper Dr Stephen Kusasira

PREVENTION –Gaps, best practices, emerging situations -Overall focus on evidence based prevention practices and gaps therein. -The group recognizes the great role prevention has played and continues to play in the fight against. However there is a gap between knowledge and practice

Prevention Best practices Political will Multi-sectoral approach Involvement of the PHAs [GIPA]

PREVENTION –Gaps, best practices, emerging situations GAPS:- A. Inadequate funding on Prevention activities compared to treatment. Need to refocus. B. Ineffective communication 1.Less community involvement in prevention strategies. There is dependence on generic IEC materials from MOH- They cant work. 2.No uniform comprehensive communication strategy. There is need to harmonize the information.

Prevention cont 3. Use of local ‘arts’ –drama, songs in local languages to communicate needs emphasis. 4. Need to integrate the whole component of ABC as one. The artificial division should be dispensed of in action and not only in word. 5. Need to have messages that target the whole family. 6. Prevention messages have been static – don’t keep in pace with changing epidemic challenges eg no messages to combat complacency 7. Should have evidence based messages i.e. best practices for different groups, geographical region Therefore there’s need to do pre and post intervention research. Need to set up a technical committee to periodically review intervention strategies

Prevention cont Prevention for positives is not adequately addressed. Messages don’t target this group. Treatment not being appropriately promoted as a preventive tool. Limited involvement of Faith based organizations at grass roots Glaring Lack of life skills development in preventive strategies.

Prevention cont SECONDARY PREVENTION Practical Strategies to involve Male involvement in PMTCT should be developed Target hindrances to hospital deliveries PMTCT plus not emphasized. Aggressive follow up necessary Incorporation of family planning in preventive activities Need to improve the infrastructure & human resource in health units to strengthen the secondary prevention e.g VCT & PMTCT

Prevention cont Practical, locally developed infant feeding options eg local foods should be developed HBCT and VCT should be rolled out and must be cost free to the users. Reactivate campaign on testing before marriage

Prevention cont Emerging issues More knowledge/messages about circumcision, microbicides & vaccines coz these are the emerging strategies of prevention. Advance information needed if they are to be used in future. Alcohol and drug abuse -Law enforcement on alcohol abuse- time, place -Specific target to bars, lodges -messages about substance abuse -Support recreation activities especially for the youth Inappropriate media exposure [eg pornography] – ?Strengthen laws Are we seeing emergence of homosexuality in schools? Need for programs to address it before it gets out of hand.

Prevention Cont Program management Sustainability – outside donor support. Involvement of private sector for sustainability of the prevention strategies Mapping of services undertaken by UAC need to be disseminated to the end users through focal persons. Need to update UAC web site.

Prevention cont Establishment of community based management information systems

Conclusion – Strategic priorities/approaches 1.Comprehensive communication strategy – Appropriately contextualized, and standardized for the different audiences 2.Use of evidence based interventions 3.Pursuance of new strategic approaches focusing on family, community, workplace and GIPA/MIPA. 4.Emphasize and continue with the best practices that have worked.

Conclusion – Strategic priorities/approaches 5. Review of funding for prevention 6. Sustainability concerns