YOUTH PREVENTION AND EDUCATION PROGRAM AGAINST HIV/AIDS

Summary:

This project is directed to communities in all the vulnerable and frontier zones of the Dominican Republic and the Republic of Haiti (the two countries that share the island of Hispaniola), and has as its objective to educate and bring to the public´s awareness the dangers of HIV/AIDS, its transmission, treatment, and preventative measures.

Communication Strategies:

The main strategy of this program consists in training educators, "multipliers," about HIV/AIDs and aspects related to AIDS, involving diverse social and cultural-ethnic groups. These educators multiply what they have learned by teaching other members of the community, and these in turn teach others, in an increasing spiral, hence the term "multipliers."

We use the non-profit Centro Guanín, Inc. as the vehicle to educate the populace and to work directly with young men and women, boys and girls. To begin the project and to prepare the 3-5 day educational workshops, we will contract local medical groups, neighborhood committees, cultural clubs, and educators from various social sectors who will work together with Centro Guanín, Inc. and the communities, children and young men and women, whom we will seek out using all manner of media to ensure that they will receive information about HIV/AIDS.

We will organize sports teams and form theatrical groups, medical conferences and workshops, together with educational-cultural and sports activities to get out the message. We will educate groups of young men and women to be the messengers to continue the work of bringing information about the prevention of HIV/AIDS to other youths, until we can put a halt to the disease´s escalation. This program is focused on finding and mobilizing local resources to create empathy and consciousness of the HIV/AIDS problem. We will use sports programs to train children, adolescents, and other persons who can form partnerships with those of similar interests.

The multipliers will disseminate the message that whoever does not take protective measures against HIV/AIDS can contract and spread the disease. Part of their work is also to inform the community about actions through which HIV/AIDs is not transmitted, such as not by sharing a cup with an infected person or by using the same toilet. In this way, both apathy and the myths that cause fear and motivate discrimination against those with HIV/AIDS can be eliminated. We will be developing educational materials, with the collaboration of the community, based on real and specific information about HIV/AIDS, such as how it is contracted, its dangers, how it can be treated, and especially how it can be prevented. Once members of the community are actively involved, the project, originally financed through resources provided by INTERREG, will achieve sustainability, even if the initial funds run out.

1. Strategic Content

There are a number of pre-requisites to reduce poverty and reach sustained growth in the Dominican Republic (D.R.). Among these is the need to continue supporting social development. We propose that this HIV/AIDS project is explicitly related to this need as one of the various instruments to increase the poor population´s access to the benefits of social development and economic growth.

2. Principal problems of the sector

The HIV/AIDS epidemic. The rate of HIV prevalence in the adult population is estimated at 2-3%, but only a fraction of HIV/AIDS cases are reported. It has been suggested that HIV/AIDS in the D.R. is in transition-it is changing from a concentrated epidemic to an expanding epidemic. The General Control of Sexually Transmitted Infections and AIDS agency (DIGECITSS) of the Secretary for the State of Public Health and Social Assistance (SESPAS) estimates that in the D.R. approximately 120,000 persons are currently living with the HIV virus, which is approximately nine times the total of reported cases that have been reported, and that more than 16,000 people here have died as a consequence of AIDS. In 1998 alone, SESPAS received 900 reports of death by AIDS, making this disease the principal cause of death from infectious diseases.

Other studies conducted among the general population indicate that AIDS is the principal cause of death among women of reproductive age. In the D.R., the principal method transmission of the HIV virus (70% of the cases) is through sexual activities, principally heterosexual relations. The majority (81%) of cases of AIDS in the D.R. occur among people in the prime of their reproductive and economic lives, which is to say, between ages 15 and 44. The percentage of men and women with HIV/AIDS has varied and recently has increased considerably among young women. It is estimated that 4,000 pregnant women who go for prenatal checkups are infected with HIV and can give birth to 1,300 infected children, in the absence of a program to reduce vertical transmission. It is also estimated that of 2.5% of the sexually active population, between 2% and 9% of the country´s sexual workers and 11% of the men who have sexual relations with other men are infected with HIV/AIDS. Furthermore, 6% of those who go for checkups for sexually transmitted diseases (STDs) are infected with HIV/AIDS.

Despite the efforts that have been carried out in the D.R. to control the HIV/AIDS epidemic, conditions still exist for its rapid expansion. These conditions are represented in the high rates of infection of STDs; high rates of birth among adolescents and young women; an active migration to and from the country; an ever increasing number of sexual workers; hidden homosexual and bisexual preferences; and the stigmatization of HIV/AIDS that does not allow it to be treated openly.

The above situations are combined with the existence of a large migratory population in the D.R. that is difficult to reach. More than 2 million tourists visit the country each year, and it is estimated that around 500,000 Haitians live legally and illegally in the D.R., the majority of them young men, who migrate here to work in construction and agriculture. Projections for the country indicate that if the current tendency continues, the prevalence of HIV/AIDS could reach 5% of the adult population or more before the end of this year (2009). Studies conducted in other parts of the world indicate that when the epidemic reaches those levels, the expansion of HIV/AIDS becomes much more rapid and the economic growth of the country will be reduced by more than 1% per year.

Widespread interventions versus limited interventions: The following areas of intervention have been selected as high priority for the D.R.:

These interventions are not the only possible activities to carry out programs of HIV/AIDS prevention and control.

Theme: HIV/AIDS

Key Points

Communities in the most vulnerable zones of the Dominican Republic have the highest incidence of HIV/AIDS infections in the country. This situation has been produced, among other reasons, by labor migration and also by sexual interchanges in tourist regions. In recent decades, men and women have migrated to the D.R. as well as from city to city in search of work, or to tourist destinations within the country, as well as to other countries. Upon their return to their own communities, many members of these migrant groups test positive for HIV/AIDS.

1. Objective for the project´s development

The main objective to of this Project, which is still in development, is to stop the expansion of the HIV/AIDS epidemic through broadening the programs and activities aimed at high risk groups in the D.R.; to broaden the knowledge base and HIV/AIDS among the Dominican population in general; and to strengthen the country´s institutional capacity to insure the effectiveness and sustainability of the project.

2. Key indicators for the project´s execution

The key indicators that will insure the project´s ongoing success include:

Children, Adolescents, and Young Men and Women

Effective Sexual Education Program

Sports against HIV/AIDS

Alliances

3. Benefits to the target population

The Dominican Republic´s population in general will benefit indirectly from reduced incidences of HIV/AIDS and other STD infections. Nevertheless, the direct beneficiaries of the project in terms of reduction of exposure to the risk of becoming infected with HIV/AIDS and other STDs, .improved access to detection, treatment, and prevention, plus improved medical attention and less stigma/discrimination against them, are the migratory workers, who are the major targets of this project. They include:

The project will deal with sensitive social topics that concern HIV/AIDS and other STDs, thus could attract powerful opposition, individuals and groups that will attempt to prevent assistance to and empowerment of those who are vulnerable to HIV/AIDS and other STDs. Among the opposition could be such groups as the PLWHA and those who oppose helping socially marginalized people such as drug addicts, men who have sex with other men, and prisoners-all of whom, along with their families, suffer continual stigmatization and discrimination.

It is hoped that the program will have a very positive impact, and will assist and empower the people and institutions who participate, such that we can effectively treat and eventually stop the HIV/AIDS epidemic in the Dominican Republic. The project, under the coordination of the Centro Guanín, Inc, will provide permanent follow-up to the education and prevention of HIV/AIDS and other STDs, as well as to the social impact of the project, and will attempt to quell any social problems that may arise during the project´s implementation and program definition projection.