Francisco M. Guerra Jr.U.S. Peace Corps VolunteerHIV/AIDS Project, Zambia

May 2005 – July 2007

Part of My Story• My experience and work as a PCV: coming soon • Challenges I faced: language, limited resources,

frustration with education and government related issues, lack of inputs, lack of time, lack of information.

• What I wished I knew before venturing to Zambia: info about HIV/AIDS (initiatives, programs, country specific statistics, etc.), info about “development” theory and projects, history of international involvement in all areas of life.

• Impact on my life, perspective, and future plans.

Thoughts…• What are international careers in health like?

– Varied:• Time: Fully committed to a few days visit.• Focus: Medical practice, education in all sectors,

diversity of NGO targets.

• How do people get their foot in the door?– Networking, GO/NGO projects, school linked

activities, and self initiative.

• What is an average day like?– Where, what, for whom is… average…?

HIV/AIDSGLOBAL ESTIMATES FOR ADULTS

AND CHILDREN, 2006

Data from UNAIDS/WHO AIDS Epidemic Update: December 2006

ADULTS AND CHILDREN ESTIMATED TO BE LIVING WITH HIV IN 2006

ESTIMATED ADULT AND CHILD DEATHS FROM AIDS DURING 2006

• “Sub-Saharan Africa bears brunt of global epidemic. Two thirds (63%) of all adults and children with HIV globally live in sub-Saharan Africa.”

• “In sub-Saharan Africa, for every ten adult men living with HIV, there are about 14 adult women who are infected with the virus. Across all age groups, 59% of people living with HIV in sub-Saharan Africa in 2006 were women.”

• “Across sub-Saharan Africa, women are more likely than men to be infected with HIV, and they are more likely to be the ones caring for people infected with HIV.”

• “A little less than one quarter (23%) of the estimated 4.6 million [4–5.4 million] people in need of antiretroviral therapy (in sub-Saharan Africa) are receiving it.”

• “At current levels of HIV prevalence, young persons in Zambia face a 50% life-time risk of dying of AIDS, in the absence of treatment.”

Zambia Stats• “In rural areas, HIV prevalence increased

marginally from 11% to 12% in 1994–2004.”• “Older pregnant women (30–39 years) in

urban areas, HIV prevalence rose considerably (from 24% to 30%) in 1994–2004.”

• “Young pregnant women in some urban sites, HIV prevalence has remained high (at 28%–30% during 1994–2004), while in some rural sites, infection levels almost doubled in the same period (e.g. 7% to 14% in Kalabao).”

Data from UNAIDS/WHO AIDS Epidemic Update: December 2006 & Ministry of Health Zambia, 2005

Time to feel UNCOMFORTABLE

DANGER!!!

Fear Based Messages…

HIV/AIDS and Morality• “The tendency to link HIV and morality might

be related to the fact that affliction is often perceived as an outward manifestation of a moral transgression. “

• “In some Asian cultures, these perceptions might be couched in terms of karma.”

• “In a number of African societies, specific illnesses or sets of symptoms are associated with having broken one or more social prohibitions.”

…Morality continued.

• “Elsewhere, including the Judeo-Christian traditions of North America and Europe, it is not uncommon for people to believe that illness is a punishment for one’s sins.”

• “Whatever its roots, the tendency to associate illness with moral impropriety is a central contributing factor to HIV and AIDS-related stigma. “

Thoughts to think about:

Did you feel slightly embarrassed when I asked whether you had been tested for a cold or the

flu?

Did you feel embarrassed when I asked about having been tested for HIV?

If you felt differently, Why?

HIV/AIDS Related Stigma• “This stigma is exacerbated by the seriousness

of the illness, its mysterious nature, and its association with behaviors that are either illegal or socially sensitive (e.g., sex, prostitution, and drug use). Also relevant is the perception that HIV infection is the product of personal choice: that one chooses to engage in “bad” behaviors that put one at risk and so it is “one’s own fault” if HIV infection ensues.”Data/text from “Common at It’s Core: HIV Related Stigma Across Contexts” by International Center for Research on Women.

Behavior Change• “Unlike some infectious diseases, transmission

of HIV is mediated directly by human behavior, so changing behaviors that enable HIV transmission is the ultimate goal or outcome required for HIV prevention. “

• “Sexual behavior, which remains the primary target of HIV prevention efforts worldwide, is widely diverse and deeply embedded in individual desires, social and cultural relationships, and environmental and economic processes. “

From the UNAIDS website: www.unaids.org (under Behavior Change)

Work as a Peace Corps Volunteer (PCV)

1. Helping the people of interested countries in meeting their need for trained men and women.

2. Helping promote a better understanding of Americans on the part of the peoples served.

3. Helping promote a better understanding of other peoples on the part of Americans.

Work as a PCV – HIV/AIDS Extension Worker

• The overall project purpose is to enhance community-based development, coordination, and implementation of HIV/AIDS prevention, care, and socioeconomic support in rural areas of Zambia.

• Examples:– HIV/AIDS workshops

with NHCs, Women’s groups, Farmers’ groups, PLWHA Support Group

– Life Skills Lessons and HIV/AIDS sensitization at 8 government schools with students and teachers

World AIDS Day 2006

World AIDS Day 2006

Mukungule RHC

Putting all of this into context…