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HIV/GYD in Cameroon What YOU can do!
Lots to cover:
In this presentation, over 4 hours, we will:
– Introduce the HIV/GYD Committee – Discuss Gender and Youth initiatives – Discuss HIV:
transmission prevention stigma myths/culture
– Present successful project ideas – Present resources – Hear from someone living with HIV in Cameroon
Objectives: Gender and Youth Development
Begin to understand the ramifications of gender inequality in Cameroon Understand the ―why’s‖ of youth and gender specific development Identify activities of interest to the PCV and their community
Grasp the basics of HIV transmission and prevention Understand how myths/culture/traditions impact HIV transmission and prevention Give PCTs a human face to HIV in Cameroon Be familiar with issues that People living with HIV and/or AIDS (PLWHA), their families and friends face
Who we are:
The HIV and Gender and Youth Development Committee coordinates country-wide Peace Corps HIV and AIDS activities by providing regional resources and programmatic support, as well as guides the overall direction of Peace Corps Cameroon's HIV/AIDS and Gender/Youth Development initiatives.
What that means for you:
We are here for YOU!!
– Need ideas? – Need project resources? – Have random questions?
Call on us! The HIV/GYD Committee is represented by most provinces and ALL programs! We are never far!
What is ―Gender and Youth Development‖??
The issues of women, men, girls and boys MUST be accounted for in development!
– in – in – in – in community assessment project planning project implementation project evaluation
It’s NOT just about
What is ―Gender‖?
And how is it different than ―sex‖?
– People are born female or male (their SEX) but learn to be girls and boys who grow into women or men (their GENDER). They are taught what the appropriate behaviors, attitudes, roles and activities are for them and who they should relate to others. This LEARNED behavior is what makes up gender identity and gender roles.
Keep in mind….
Cameroon is a multi-ethnical and multi-cultural country. With hundreds of ethnicities and languages and most religions represented, it is difficult to point at "the Cameroonian" in a gender profile. One aspect is quite common in Cameroon: the importance given to local traditions widely affects Cameroonian women's situation, as traditions never give as much protection as modern equality laws.
One of the Millennium Development Goals is to:
Promote gender equality and empower women
Target: Eliminate gender disparity in all levels of education no later than 2015
Educating girls is the single most effective policy to
– – – – raise overall economic productivity, lower infant and maternal mortality, educate the next generation, improve nutrition and promote health.
Girls with at least six years of school education are more likely to be able to protect themselves from HIV/AIDS and other diseases.
– immunize their children 50 per cent more often than mothers who are not educated, and their children have a 40 per cent higher survival rate. – are more than twice as likely to send their own children to school as are mothers with no education.
What can YOU do to promote girls education?
Work with women’s groups on income generating projects with the caveat that they MUST send their children to school in order to benefit Work with individual students on income generating projects Set goals with students and parents—stress the importance of education to achieving those goals Meet with the fathers and the community leaders—get them on board
Violence against women and girls:
Critical issues in Cameroon: Female genital mutilation Breast ironing Rape Domestic violence Trafficking
The 1981 Civil Code allows a husband to oppose his wife's right to work in a separate profession if the protest is made in the interest of the household and the family. Polygyny is permitted by law and tradition, but polyandry is not. In cases of divorce, the husband's wishes determine the custody of children over the age of 6. While a man may be convicted of adultery only if the sexual act takes place in his home, a female may be convicted without respect to venue. Despite the law that fixes a minimum age of 15 years for a bride (18 for the groom!), many girls are married off by their families by the age of 12. The extent to which a woman may inherit from her husband normally is governed by traditional law not state law. Forced and early marriage for girls and women Spousal abuse is not a legal ground for divorce.
Tips and Guidance…
Incorporate men! Money—women typically use money that they make to support the family! Income generating and savings schemes can do wonders. Start slow! Work with your counterpart! Don’t go it alone!
Men as Partners Sports for Life Choose a Future for Girls and Boys Literacy classes Vocational trainings (sewing, basket making, crafts, soy/tofu, soap, etc) Round-table discussions at Women’s Day and other holidays
HIV: The Basics
The Immune System T Cells (CD4 Cells) = Part of body’s immune system
The average person has between 800 & 1500 CD4 cells per cubic millimetre of blood
The immune system helps fight diseases
What is AIDS?
Acquired = something contracted, not genetically inherited. Immune = the capacity to resist infections. Deficiency = when the immune system is unable to fight disease. Syndrome = a group of health issues that make up a disease.
What is HIV?
Human = the virus only affects humans. Immunodeficiency = because the immune system, which normally protects a person from disease, becomes weak. Virus = HIV is a small organism, a virus, that infects living cells and makes copies of itself.
How is HIV Contracted?
1. Through these FOUR bodily fluids
VAGINAL SECRETION S BREAST MILK
2. Through these acts:
INFECTED MOTHER TO HER CHILD DURING: 1. PREGNANCY 2. BIRTH 3. BREAST FEEDING
UNPROTECTED INTERCOURSE (vaginal, anal, oral) WITH SOMEONE WHO IS INFECTED
HIV-contaminated needles and/or syringes (for example, sharing needles for recreational drug injection with someone who is HIV+ but also from reusing needles/syringes in unhygienic medical settings).
Prevalent Myths about Transmission:
You cannot become infected with HIV from…. kissing. sitting on a toilet seat or sharing a latrine 3. coughing or sneezing 4. sharing cutlery 5. drinking out of the same glass 6. holding hands 7. hugging 8. mosquito bites!
HIV and the Immune System
When HIV enters the body it must enter a cell to live and reproduce. The HIV virus attacks CD4 cells, eventually killing them
Enters CD4 Cells
The newly produced HIV then moves into new CD4 cells and infects them. The body’s immune system tries to replace the lost CD4 cells, but over time it is unable to keep these levels up.
Briefly: Technical info…
As the amount of HIV in the body increases the amount of CD4 cells in the body decreases
Amount in Body
When the CD4 count becomes low the body is less able to fight off any disease.
HIV? Or AIDS?
CD4 count is an indicator:
1500 to 800 CD4 - Average healthy person
Below 500 CD4 - HIV+ person at risk from Opportunistic Infections
For an AIDS diagnosis to be given 3 factors must be in place: 1. An HIV diagnosis 2. CD4 count BELOW 200 3. Presence of an opportunistic infection
As the CD4 count of the HIV infected person drops their immune system becomes less effective. They are more vulnerable to other infections which would be effectively kept under control with a healthy immune system. These infections are known as opportunistic infections, as they take the opportunity to take advantage of the weak immune system. It is gradually these infections rather than the HIV that will kill the infected person. Some of the most common opportunistic infections are:
– PCP: a rare type of pneumonia. – CMV: a type of herpes that can cause blindness, brain and lung problems. – Cancers: as the immune system is unable to keep the growth of cells under control. – TB
During Pregnancy During childbirth During breastfeeding
Percentage of health facilities providing ANC services that also provide HIV testing and counseling services: 43.7%% Estimated number of pregnant women receiving PMTCT services: 7,516 (22% coverage) Prevalence among infants born to HIV+ mothers when tested at 15 months: 19.1%
People with other STIs are up to 10 times more at risk as many of the STI will result in cuts and open sores giving the HIV more chance to enter the body.
Can HIV be Prevented?
Abstinence is the only foolproof means of prevention.
– Abstain from sex – Abstain from sharing needles
But…There is RISK REDUCTION!
HIV risk can be reduced based on the following factors:
– – – – – Knowledge of HIV. Sense of personal susceptibility. Skills for behavior change. Sense of personal efficacy. Community, legal, and social structures that support HIV risk reduction.
What can be done…
Practice and teach universal precautions. This means avoiding direct contact with blood and other body fluids that contain visible blood, semen, and vaginal secretions. In health care settings, advocate the use of protective barriers such as gowns, masks, and protective eyewear. Educate yourself about HIV and AIDS. Then teach others about HIV and AIDS Normalize the illness. Seek to reduce and eliminate any stigma that is attached to the disease so that people feel comfortable learning about and discussing HIV and AIDS, and involve People Living with HIV and/or AIDS (PLWHAs) in prevention and care efforts.
Test for and seek medical treatment for Sexually Transmitted Infections (STIs). Get tested for HIV. Testing allows people to know their status, which can increase the likelihood that they will not transmit the virus to anyone else. Test before marriage and test before entering into a sexual relationship. Test during pregnancy. Ask your partner(s) their status about HIV and STIs. Communicate. Communicate. Communicate. Respect your partner’s status (HIV positive or negative).
Acquire and impart skills for avoiding infection by HIV. This includes building self-confidence, independence, and self-esteem. Practice and advocate safe behavior, which may include abstinence, use of condoms and other barriers (gloves and dental dams, for example), postponing sexual intercourse until marriage, not sharing sex toys, avoiding peer pressure, and abstaining from alcohol or drug use, which may facilitate risky behavior. Trade higher risk activities for low risk sexual activities
Help to fund the global vaccine and microbicide campaigns. Empower women and girls! If HIV positive, follow your doctor’s advice about medication and health care. When you are healthy, you are less likely to transmit the virus to others. If both you and your partner are HIV+, continue to use condoms correctly and consistently to prevent transmission of different strains of HIV (some might be drug resistant!)
Do not inject illicit drugs. You can get HIV through needles, syringes, and other works if they are contaminated with HIV+ blood. Drug use may result in riskier sex.
– If you do inject drugs, do the following: Use only clean needles, syringes, and other works. Never share needles, syringes, or other works. Be careful not to expose yourself to another person's blood. Get tested for HIV at least once a year. Consider getting counseling and treatment for your drug use. Get vaccinated against hepatitis A and B viruses.
HIV: The situation in Cameroon
Over a half a million people are infected Overall adult prevalence is 5.1%
– Females aged 15-49= 6.8% – Males aged 15-24= 1.2% – Females aged 15-24= 4.3%
The proper and consistent use of latex or polyurethane (a type of plastic) condoms when engaging in sexual intercourse-vaginal, anal, or oral--can greatly reduce a person’s risk of acquiring or transmitting sexually transmitted diseases, including HIV infection.
Women and HIV
WOMEN ARE AT A GREATER SUSCEPTABILITY: Females are 3 times more easily infected compared to males as the vagina is more susceptible to lesions allowing the virus to pass into the body, and semen can remain in the body for up to three days. Social status affects HIV rates among certain groups
WHY!?? Social Reasons:
Male dominated sexual practices and attitudes:
– Women generally have limited ability to negotiate safe sex or refuse unwanted sex. – They often cannot request, let alone insist on using a condom or any form of protection. If they refuse unprotected sex or request condom use, they often risk abuse, as it is causes suspicion of infidelity. – Due to unequal power relationships between men and women, women may not be able to determine whether, and with whom, they have sex, or may be unable to discuss matters of contraception with their partners.
Why?!? Biological Reasons:
– Little or no knowledge of their reproductive system and sexual health – Women tend to ignore serious symptoms like vaginal discharge or genital swelling in their own body parts and even in their partners. – They are not able to make connections between sexually transmitted infections and HIV and generally not able to assess its severity. – The female genitalia are much more vulnerable than male genitalia. The lining of the vagina is particularly vulnerable to infection, and its large surface area increases the possibility of infection by semen, the most virulent carrier of the virus. Because the vaginal lining and cervical area in young girls are not fully developed, they are extremely vulnerable to rips and tears during intercourse, which can speed access of the virus into the bloodstream. – Women and girls are two to four times more susceptible to HIV infection during unprotected sex than men – Male-to-female transmission during unprotected sex is twice as likely to occur as female-to-male.
Cultural practices and early marriage:
– Forced and early marriage among girls on attaining puberty increases their vulnerability to sexual problems. – Women are not encouraged to discuss about sexuality or sexual practices and feel hesitant to discuss about their problems with their partners, peers and even medical practitioners.
– Lack of economic independence or economic resources among women reduces their equal status and rights within their families. – Women and girls often depend on husbands or other male family members for financial security, and so, may be reluctant to introduce sensitive topics, such as the use of condoms, for fear of being ostracized. – In some societies widowed women may not have inheritance rights, and may be forced to trade sex for goods or services or may be forced to marry her husband’s brother. – Many women are subjected to domestic violence and sexual abuse, increasing their vulnerability to HIV. – Because women may lack access to educational services, they may also be unfamiliar with the concept of ―safe sex.‖
Youth and HIV:
WHY ARE YOUTH AT GREATER RISK?? Experimentation Risk taking Feeling of invincibility Lack of self esteem Peer pressure Lack of information/education Political reasons Gender issues Young people are more infectious
109 sites to access ART (anti-retro therapy) BUT only 17% of eligible children (aged 014) are receiving ART 25% of eligible adults are receiving ART
HIV as a Development Issue
Destruction of social capital
– Knowledge base of society – Production sectors: agriculture, industry
Weakening of institutions
– - Civil service, judiciary, armed forces, education, health – - Inhibition of private sector growth
Wider, deeper poverty
HIV and the Household:
HIV and Healthcare:
HIV and Food:
Poverty and Inequality New HIV infections
Faster progression HIV to AIDS Malnutrition Risky survival activities
What can volunteers do?
It is important to encourage the community to talk about the epidemic:
– – – – – – – – – – – Start talking to your host-family and friends Make individual contacts Identify allies in the community Find ways of talking about delicate topics. Choose the right people to deliver messages. Listen closely to the opinions and concerns of the people you speak to. Identify what people do not know and respond to their need for information. Hold group or community meetings Invite outside AIDS support groups to make presentations and discuss their work. Involve infected people in the process from the start. Set up a location that people can come to for more information.
Life Skills Men as Partners Teach English-Fight AIDS Peer Education Curriculums Sports for Life
A run or a walk to raise awareness Piggy-back on other village activities (ie: vaccine campaigns) Have an anonymous question box at a high school Sponsor a testing event Art contest with prevention messages Train peer educators Work with PLWHA
Testimonials of PLWHA are a great way to fight stigma and get your community talking! STEP 1: Find someone!
– Contact their Provincial Hospital – Provincial Coordinator of CNLS – GTZ – APCD
Step 2: Prepare the guest speaker
– Let them know about your group – What is the purpose for their talk – What are the logistics (travel, food, lodging, etc) – Find out their fees – Find out their schedule
Step 3: Prepare the Group
– explain that it’s not an easy thing to come and talk to a group about HIV – stress that the speaker has come voluntarily in order to share their experiences with HIV, and to help the audience
(1) prevent infection in themselves and their broader community, and (2) increase understanding and tolerance of and support for PLWHA in their community.
– The facilitator should prepare the audience to behave respectfully and with compassion during the session. – Before the speaker arrives, ask the audience if they have any concerns or questions they want to raise before the session.
During the session:
– Assure that the speaker is comfortable – Assure that the important topics are being covered
Their experiences with testing, counseling, treatment, stigma, etc.
After the testimonial: Questions to ask the audience to stimulate discussion:
– What message did you take away from the testimonial? – Did the testimonial strike you as hopeful or fatalistic, or both? Was it realistic? – Did anything the speaker say surprise you? If so, why? – What are things you plan to do to support people living with HIV and/or AIDS in your community? – With what issues does the speaker struggle most as a result of his/her infection?
Need Help? Have Questions? Need Advice?
– email@example.com – also on the Peace Corps volunteer website! – Check with your regional committee representative!
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