ESST - Maastricht University - March 2004

What kinds of technologies does a

development agency/organisation
apply under specific social conditions
to prevent and treat HIV/AIDS?
One has to create a context for
the technology to work
condoms

Antiretroviral treatment

Health education

ESST - Maastricht University - March 2004

Pr evention, tr eatment and
care of HIV infected people
includes inter ventions such
as
 Biomedical
 Nutritional
 Psychosocial
 Behavioural

ESST - Maastricht University - March 2004

 All interventions (technologies) must
be guided by local socio-economic
conditions and epidemiological
conditions
 One technology may
be successful in one
particular setting…..

 ….and a failure in
another

ESST - Maastricht University - March 2004

Social conditions

 Poverty
 Political situation
 Culture as a barrier or a resource for
HIV/AIDS prevention and treatment
 Individual behaviour
 Increased knowledge on HIV/AIDS does not
reduce high risk behaviour

ESST - Maastricht University - March 2004

W hich technologies?

 Condom distribution
 Test centres
 Treatment of opportunistic diseases
 Diagnosis and treatment of STD
 Antiretroviral treatment
 Distribution of clean needles and syringes
 Mass media campaigns
 Blood safety

ESST - Maastricht University - March 2004

Additionall y…

 Development of national programs

 Health education and counselling
 Social welfare
 Poverty alliviation
 Reduce the impact of sexual ineqality
 Stigmatization of PLWHA

ESST - Maastricht University - March 2004

 Important!!!
 Investigate where new infections are
occurring!!!

ESST - Maastricht University - March 2004

 Patterns of transmission of HIV varies
between countries and within
countries
 Commercial sex workers
 Homosexual relationships
 Heterosexual
relationships
 Injecting drug users
 Blood transfers
 Mother-to-child
transmissions

ESST - Maastricht University - March 2004

 Which development
agency/organisation?
 1. Norwegian Church Aid
 2. Haydom Lutheran Hospital,
Tanzania
 Norwegian Church Aid
 Experience with HIV/AIDS since the late 1980s

 NCAs policy:
 The poor will be the main focus
 Gender sensitivity
 Activities must reflect the cultural situation
 Promote human rights

ESST - Maastricht University - March 2004

 What will NCA do?

 Testing for HIV

 Education and information in relation
to sexuality (incl. condom promotion)
 Access to medicines and treatment
 Advocacy and lobbying for the rights
of HIV infected people

ESST - Maastricht University - March 2004

Haydom Lutheran Hospital,
Tanzania

ESST - Maastricht University - March 2004

 Haydom Lutheran Hospital,
Tanzania
 Risk, Vulnerability, Impact

 HIV/AIDS policy
 Increase awareness
 Reduce transmission
 Reduce the impact of the disease

 The program is supported by NORAD with

13 millions NOK.

ESST - Maastricht University - March 2004

 How?
 The target groups will have a deciding role in the implementation
of the strategies

 The official Tanzanian policy ABC (Abstinence, Be faithful,

Condom) in a culturally adapted context
 Traditional culture vs modern culture
 Treatment of diseases
 Social welfare and poverty alliviation
 A pilot project with antiretroviral treatment for pregnant women
 Campaigns
 Counselling activities
 Multisectoral cooperation

ESST - Maastricht University - March 2004

ESST - Maastricht University - March 2004
 CONDOM
► Condom use is often associated with
higher education

ESST - Maastricht University - March 2004

The increasing distribution/use
of condoms will have little
impact on the transmission of
HIV, if condoms are not used in
sexual high risk partnerships

ESST - Maastricht University - March 2004

 Lower the costs of condom
use
► Costs
are not only the price of a
condom but also

► The humiliation of obtaining one

► The humiliation of using one
► The experience of reduced sexual
pleasure

ESST - Maastricht University - March 2004

 ABC
 Abstinence
 Be faithful
 Condom

 Does it work in all cultural contexts?

ESST - Maastricht University - March 2004

 Haydom Lutheran Hospital in
Tanzania applies ABC in its HIV/AIDS
policy

 Field work from 4 ethnic groups in

Botswana shows a cultural resistance
towards the use of condom (and
hand gloves when caring for the
sick).

ESST - Maastricht University - March 2004

 Many groups regard and
respect their culture highly,

and expect the solution of

HIV/AIDS to come from within
the culture
 Method

Literature
interviews
research

analysis

ESST - Maastricht University - March 2004

 Time table
 End of March – interview appointments
 April – do research and prepare thesis
outline
 May – do research, prepaire for
interviews, do and analyse interviews
 June – interviews and writing
 July etc. writing

ESST - Maastricht University - March 2004