Community-level Interventions against HIV/AIDS

"In writing this paper I have deliberately avoided dwelling on the epidemiology of HIV/AIDS, its impact on women, families, communities and on development, as I believe these issues will be well highlighted in other papers and presentations. I have chosen rather to focus on some salient issues pertaining to Community Level Health Interventions Against HIV/AIDS from a Gender Perspective, and from my own experience and personal perspectives.

I have also deliberately focused primarily on Community – level interventions within the African context for two reasons, one of which is objective and the other quite subjective.

On the subjective side, as an African and a HIV/AIDS prevention activist, I found it difficult to approach the subject with detachment. The subject of HIV/AIDS, women and the community and its overall impact in our sub - continent raises some of the most fundamental and deep-seated questions about human values which are not so easy to ignore. What is more, from my work, I am also naturally more familiar with community and women's realities in Africa.

On an objective note I have focused on the African experience for three reasons. The first is that Sub- Saharan Africa is the worst - hit region in the world accounting for 70% of global infections. According to the latest UNAIDS report on global HIV/AIDS epidemic (June 2000), in sub-Saharan Africa HIV is "now deadlier than war itself: In 1998, 200,000 Africans died in war but more than 2 million died of AIDS". In 16 countries of the sub-region, more than one-tenth of the population aged 15 – 49 is infected. Even Uganda, which is celebrated as having successfully reversed the progressive trend of HIV infection still has an estimated prevalence rate of 8%!

Secondly, the fact that health care systems are practically overwhelmed and that terminally ill people in this region are nursed at home and in the community implies that African women have an especially heavy burden as women, as poor people and as traditional caregivers. Thirdly, quite a few bold community-level initiatives have emerged in the region over the past decade in response to the devastating effects of the AIDS epidemic.

To cite a few examples of such community level initiatives: there is the Cindi project in Lusaka in Zambia, launched by catholic women in collaboration with other religious women's organisations and other community people, to provide care for orphans and for people living with HIV/AIDS. These women work to ensure that orphans have shelter, food, medicare, clothes and that they go to school, or learn skills.

We have the Wamata and the Kiwakkuki projects in Tanzania which are also involved in care and support of people living with HIV, counseling and home-based care, as well as preventive education including promoting sexuality education for young persons and tackling socio-cultural issues pertaining to HIV/AIDS. There is the community-based counseling project of the Ugandan AIDS Control Programme which uses Voluntary Community Counseling Aides to provide HIV/AIDS education and counseling to families and communities and to engage them in dialogue on how to adopt healthier sexual behaviour.

We have the Zinatha programme in Zimbabwe which, in collaboration with the ministry of health, has mobilised traditional healers for preventive education, care and support, the adoption of safe medical practices and treatment of opportunistic infections; there is the Indeni HIV/AIDS workplace intervention in Zambia which provides preventive education, and support for treatment of opportunistic infections for workers."

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