Skills Building Workshop Themes for the 8th ICAAP

Care and Support While access to medicines is extremely important, the needs of people with HIV/AIDS extend far beyond drugs and health care. HIV/AIDS care strategies therefore need to be comprehensive. Social security for PLWHA is considered as part of the right to a life with dignity in the face of HIV. Incorporating rights to treatment, food and nutrition, livelihood, employment and education, to fulfill the social, psychological, nutritional and economical needs of PLWHA. Care and support must also address stigma and discrimination faced by infected and affected people. It requires social support to help HIV-positive people, their families and their communities cope with the economic and social consequences of sickness and death due to AIDS. Prevention as part of care and support should be promoted. Home based care of infected people should be encouraged rather than institutionalized care. HIV should be an integral part of the primary health care system, ensuring quality treatment without stigma and discrimination. Micro credit, also known as micro-finance, is an effective poverty-alleviation instrument and a mechanism to support will support PLWHA and their families. Advocacy and Leadership Advocacy is a process of communication which is different from the mere dissemination of information and education (IEC). Advocacy goes beyond this and first seeks support, commitment and recognition from policy and decision-makers and the general public about the problem. Advocacy provides solutions and support in tackling issues. Advocacy is important in HIV prevention because it can enable things to be done which a single organization could not do on its own; partnerships are key and create support for an HIV/AIDS prevention programme in a number of ways. Advocacy work should include creating awareness of the magnitude and seriousness of the problem, diminishing discriminatory practices and removing policy and other barriers to prevention and care activities, and campaigning for effective and sustainable action. It should aim to influence the highest authorities in the country to provide leadership, political support and commitment. Advocating for national and international policies that enhance the right to universal access to free, comprehensive and sustainable care and support. Promote advocacy for the ethical use of drug trials and practices in Sri Lanka. Budget tracking and keeping states accountable to their commitment to HIV/AIDS initiatives. Human rights of PLWHA are protected through state practices and policies. Involving people with HIV/AIDS in policy design, planning and the implementation of AIDS-related work is itself an important aspect of advocacy. Community Participation Increasing importance of community-based participation in prevention, care and treatment of HIV/AIDS is recognised. A range of outreach activities across the country will draw communities into the Conference and bring the Conference to communities. Experiences of countries with a vibrant and varied grass-roots NGO movement could be shared. This is an opportunity for communities living with HIV/AIDS to learn and share their experiences, recognising the increasingly important role of community in prevention, care and treatment. It can include workshops and sessions to encourage dialogue and explore new community-based approaches and strategies to further the goal of Access for All. The Stepping stones’ training package is a participatory tool practiced by ActionAid International, aiming at behavioural change for prevention and control of STI/HIV/AIDS. It was developed to address the vulnerability of women and young people when it comes to decision making about sexual behaviour. It is based on the following principles, the best prevention strategies are those developed by community members themselves; Peer groups need their own time and space to identify and explore their own needs; Behaviour change will be more effective and sustained when all members of the community are involved. Gender and HIV/AIDS Gender roles and relations powerfully influence the course and impact of the HIV/AIDS epidemic. Gender-related factors shape the extent to which men, women, boys and girls are vulnerable to HIV infection, the ways in which AIDS affects them, and the kinds of responses that are feasible in different communities and societies. Gender-based inequalities overlap with other social, cultural, economic and political inequalities—and affect women and men of all ages. Experience shows that controlling the epidemic depends in large measure on communities’ and families’ abilities to confront the gender-driven behaviour that increases the chances of infection for girls and boys, men and women. Social risk factors such as illiteracy, lack of awareness, violence against women together with the powerlessness of women in a patriarchal society makes women more vulnerable to HIV. Biologically it is twice as easy for women to contract HIV from men and the physiology of women increases their risk to HIV (e.g.: menstruation, intercourse). Pregnancy associated conditions such as hemorrhage increase the need for blood transfusions in women. According to UNAIDS, 40% of PLWHA in the world are women. Innovative activities targeting boys and girls are needed to promote more equitable and mutually respectful attitudes and behaviour, especially in sexual relationships. Also needed are targeted anti-poverty programmes that extend credit and other forms of support to both women and men in need, as well as measures that address the special needs of widows and child-headed households. Substance Abuse Substance abuse is the use of a drug or other substance for a non-medical use, with the aim of producing some type of 'mind-altering' effect in the user. This includes both the use of illegally produced substances, and the abuse of legal drugs, in a use for which the substance was not intended. Often this involves use of the substance in excessive quantities. Drug use is associated with a variety of negative consequences, including increased risk of serious drug use later in life, school failure, and poor judgment which may put teens at risk for accidents, violence, unplanned and unsafe sex, and suicide. People using shared/contaminated needles and syringes or exchange sex for drugs are in the high risk category for AIDS. Currently shared/contaminated needles used by drug users accounts for approximately 5 -10% of adult infections. Difficulties in preventing drug addiction augment HIV prevention interventions with this group. Alcohol increases the possibility of engaging in high risk behaviour. Drug use and alcohol use are linked to poverty, unemployment and lack of awareness on health issues. Adolescence Nearly 12 million youth around the world live with HIV/AIDS, of who 62% are females. Youth are also especially vulnerable to the infection due to powerlessness, illiteracy, poverty and lack of information on reproductive and sexual health and rights. Youth are also more prone to sexual and physical exploitation, increasing their risk to HIV. Unemployment in youth drives them to unsafe lifestyle practices increasing their susceptibility to HIV. Worldwide every 15 seconds a child becomes orphaned by AIDS. HIV/AIDS in Disasters Disasters such as the tsunami and war, results in a sudden increase in displaced people, especially women and children. Women’s health and safety in post-disaster situations is often not prioritized, increasing their vulnerability to HIV. Positive people’s medical needs are often neglected in post disaster scenarios and they are relocated without proper consideration of their access to medical care and support. The breakdown of social and health infrastructure in disasters is seldom replaced – the people who were accessing these services often left with no replacement services and medical care. Women and children living in camps are exposed to violence, unsafe environments and face lack of food security. During war situations, women’s and girls’ bodies are used as weapons of war. Primary Prevention Primary prevention will include the following: • Guidelines for HIV testing • Access to condoms • Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV • Incorporating HIV Prevention into the Medical Care of Persons Living with HIV • Primary and Secondary HIV Prevention - opportunities for and obstacles to HIV prevention activities in clinical settings • HIV Transmission - Addressing bodily fluids proven to spread HIV, behaviors associated with a risk for HIV infection, and frequently asked questions about HIV transmission • HIV Prevention Approaches and Strategies - Behavior change counseling, models of behavior change, motivational interviewing, safer sex interventions, and practical advice on condoms • Taking Patients' Sexual and Substance Use Histories, and HIV risk associated with sexual activities • Challenges of HIV prevention - provider frustration and "prevention burnout • HIV prevention among IDUs