Summary

Whilst prevalence of HIV/AIDS in Madagascar is lower than other African states, most probably on account of the island’s isolation, prevalence of sexually transmitted infections (STIs) such as gonorrhoea and syphilis is among the highest in the world.  This highlights the potential for spread of HIV/AIDS and prevalence has risen in recent years.  The epidemic is being caused by unprotected heterosexual contact.  A number of socioeconomic factors are increasing the likelihood of high-risk sexual encounters including poverty, lack of education, the marginalised status of women, traditional customs supportive of casual sex especially for men, and limited sexual health services.  The risk is particularly acute for communities living in ‘high-risk’ zones such as tourist destinations, ports and mining or construction sites. 

National and regional committees for the fight against HIV/AIDS (CNLS) have been established and a national strategy has been devised.  Government studies indicate that young people aged 15-24 years old is the age group with highest number of confirmed infections.  Azafady has been given responsibility by the Anosy Regional Committee to run educational activities targeting young people in the Fort Dauphin urban commune.  This is vital, given the town’s increasing popularity as a tourist destination and influx of migrant labour due to a new mining development.

Azafady has worked with young people in Fort Dauphin to identify and test a variety of communication channels, strategies and settings to identify effective ways in which information on HIV/AIDS & STIs can reach the maximum number of young people.  The results led to the implementation of a pilot Behaviour Change Communication project in 2006 where young people were empowered to act as peer educators and to lead a variety of communication strategies including community events, home visits and focus groups to educate and motivate other young people.  The National Lottery is funding expansion of this pilot work to meet the needs of young people across the urban commune.

Project Aims

• To contribute to the Madagascar Action Plan Commitment 5 (Health) Challenge 3, 'to win the fight against HIV/AIDS', the main components of which at community level are behaviour change communication strategies and promotion of prevention and treatment services.

• To contribute to the CNLS Action Plan’s goal to maintain rate of prevalence of HIV/AIDS below a level of 1% and reduce prevalence of STIs in the Fort Dauphin urban commune.

Purpose

To improve access to information on HIV/AIDS/STIs and means of primary prevention and treatment amongst 13-24 year olds in the Fort Dauphin urban commune through education and reinforcement of communication.

Objectives

1. Increased knowledge about HIV/AIDS & STIs, modes of transmission and prevention among young people 13-24 years old, their parents and opinion leaders.

2. Increased perception of personal risk among young people 13-24 years old and motivation to adopt practices for prevention and treatment of STIs.

3. A more supportive environment and reduction of stigma for young people with respect to HIV/AIDS & STIs.

Principal activities

Training and capacity building
Members of youth associations in Fort Dauphin will be trained in the modes of transmission and prevention of HIV/AIDS & STIs and in communication techniques, and will develop communication tools.  They will be empowered to act as ‘peer educators’ within their community, a source of information, advice, mentoring and encouragement for young people and the link between the community and the project team. 

Information, education and communication
The project will use a number of communication channels and strategies - schools workshops, local radio, community sporting and cultural events, focus groups and house visits – so that the messages will be accessible to even young people who are difficult to reach through mainstream channels, including out-of-school youth and young married women.  Activities will educate young people and their parents on HIV/AIDS & STIs and stimulate self-risk assessment and discussion on the risks between young people and in the home.

Improving access to products and services
Through links to products and service providers, the project will promote voluntary testing and counselling, accessible male and female condoms, lubricants and treatment drugs.  Empowering young people to take control of their sexual health and sustain behaviour change.