This report covers the FHI AIDS Control and Prevention (AIDSCAP) Project (1991-1997). Volume 2 contains brief summaries of each FHI/AIDSCAP country program or activity.
Table of Contents
Volume 2
Introduction
Africa
Major Countries
- Cameroon
- Ethiopia
- Kenya
- Nigeria
- Rwanda
- Senegal
- South Africa
- Tanzania
- Zimbabwe
Associate Countries
- Côte d'Ivoire
- Lesotho
- Mali
- Mozambique
- Niger
- West Africa
- Zambia
Asia
Major Countries
- India
- Indonesia
- Nepal
- Thailand
Associate Countries
- Bangladesh
- Egypt
- Mongolia
- Morocco
- Philippine
- Sri Lanka
Areas of Affinity (See Below)
- Indian Subcontinent
- Indonesia/Philippines
- South Pacific Island Nations
- Thai/Cambodia/ Vietnam
- Thai/Lao PDR/Burma
Latin America/ Caribbean
Major Countries
- Brazil
- Dominican Republic
- Haiti
- Honduras
- Jamaica
Associate Countries
- Bolivia
- Colombia
- Costa Rica
- Ecuador
- El Salvador
- Guatemala
- Nicaragua
- Peru
- Regional Activities
Volume 1
ASIA, Areas of Affinity: Indian Subcontinent
Epidemiology
Due to the region's large population base, the magnitude of the HIV/AIDS epidemic in South and Southeast Asia may be enormous. The number of persons living with HIV in this region increased from 1.5 million in 1993 to more than 5 million in 1997. In 1993, 312 AIDS cases in India and 18 cases in Nepal had been reported to the World Health Organization. By 1996, the number of reported cases had risen to nearly 3,000 in India and to 87 in Nepal. Currently, officials estimate that more than 2 million people in India are living with HIV. The number of persons living with HIV in Nepal is believed to be greater than 5,000.
In 1994, available seroprevalence data indicated that HIV prevalence among truck drivers in Bihar state was approximately 7 percent and increasing. These drivers were identified as a group that could play a significant role in the spread of HIV because of their mobility between countries, their tendency to seek commercial sex while away from home for extended periods of time, and a 25 percent sexually transmitted infection (STI) prevalence greater than among truck drivers in parts of India.
Country Overview
Although the Indian subcontinent area of affinity (AOA) included India, Bangladesh, Nepal, Pakistan, and Sri Lanka, the activities implemented under AIDSCAP primarily involved a cross- border intervention between India and Nepal. India, the world's second most populous nation, has a population of 953 million, with almost 75 percent living in rural areas. India has recently experienced high rates of urbanization, leading to urban concentrations such as Bombay (15 million), Calcutta (12 million), and Delhi (9.9 million). Although India contains a large number of ethnic and linguistic groups, approximately 80 percent of the population are Hindu. The largest religious minority, Muslim, constitutes slightly more than 10 percent of the population. Approximately two-thirds of the labor force are involved in agriculture.
Nepal, one of the world's most isolated and least developed countries, has a rapidly growing population of approximately 21 million. Most of the population is very young; 42 percent of the population are younger than 15 years of age. Nearly 86 percent of the population live in rural areas, and 90 percent of the nation's work force are agriculturists. The urban population is concentrated in the capital city Kathmandu. Two ethnic groups, the Nepalese and the Bihari, make up 70 percent of the population; remaining ethnic groups constitute less than 5 percent each. About 90 percent of the population are Hindu.
In addition to sharing cultural and social similarities, India and Nepal have close economic ties and share major truck routes that are used by large numbers of transportation workers. Traffic at one border town alone can reach 1,400 trucks daily. AIDSCAP, with support from USAID's Asia/Near East Bureau, initiated a 22-month clinic-based AOA project in India's northern Bihar state to increase the capacity of both Indian and Nepali health care providers to prevent STI/HIV transmission among truck drivers and their assistants and sexual partners, as well as customs officials, owners of local shops, and tea/food/drink houses frequented by truckers. The Raxaul, India to Birgunj, Nepal border crossing, which was the primary implementation site, handles 90 percent of the commercial traffic between India and Nepal.
Accomplishments
After conducting a behavioral assessment of the target populations, AIDSCAP implemented a comprehensive, clinic-based STI/HIV/AIDS prevention project, the Bhoruka AIDS Project, that increased local clinicians' capacity to manage STIs, promoted the reduction of sexual risk taking among members of target populations, and developed a sustainable condom distribution system. In addition, AIDSCAP-sponsored workshops and advocacy meetings that sensitized local and national policymakers to the need for cross-border approaches to STI/HIV/AIDS prevention and bolstered support for the project. As a result, the project served as a model for future cross-border STI/HIV/AIDS prevention projects in the region.
Behavioral Research
In collaboration with local partners, AIDSCAP conducted a rapid assessment of the HIV/AIDS situation on trucking routes between Nepal, India, and Bangladesh. The assessment's key findings were that: (1) a large majority of trucks stop at major road junctions to eat, rest, or repair vehicles; (2) few local STI/HIV/AIDS education or prevention services exist; (3) truckers often preferred to seek treatment for STIs from unlicensed doctors or to self-treat; (4) condoms are not easily accessible; (5) almost all truck drivers work alone or with an apprentice; (6) single and married truckers engage in commercial sex along routes; (7) apprentices don't generally engage in commercial sex but may occasionally serve as sexual partners for truck drivers; and (8) commercial sex occurs in a variety of venues, including small, family-run brothels, large establishments, with hitchhikers along truck routes, and in pubs and bars.
Behavior Change Communication
Based on information obtained from the assessment, AIDSCAP developed a series of behavior change communication (BCC) activities to provide truck drivers with the knowledge and skills to protect themselves from STI/HIV/AIDS. Eighteen trained resource persons conducted both clinic- and community-based educational activities reaching over 9,100 men and women. To assist resource persons in their work, 9,339 STI/HIV/AIDS prevention education materials were produced and distributed to members of target populations.
Condom Promotion and Distribution
Distribution and sales outlets were established at the Bhoruka clinic in Raxaul, the border checkpoint, bars, and commercial sex establishments in Raxaul and Birgunj. Over 50,000 condoms were distributed or sold to target populations. By 1997, the project successfully weaned target populations from receiving free-of-charge condoms to buying condoms sold through a Nepal condom social marketing project.
Strengthening STI Services
With AIDSCAP technical assistance, the Bhoruka STI clinic was established in Raxaul. Clinic staff now provide effective STI case management through the use of the syndromic approach as well as STI/HIV/AIDS counseling to clinic attendees. Over the life of the project, the clinic averaged three new male STI patients per day. Moreover, initiation of an outreach program where female health care providers visited commercial sex workers at their workplaces increased sex workers' use of the clinic's STI services.
Policy Development
Through a series of workshops and seminars, local, national, and international policymakers were sensitized to the importance of STI/HIV/AIDS prevention and the need for cross-border collaboration. As a result of this effort, two advisory boards, consisting of government officials, community-based leaders, and trucking industry representatives from India, Nepal, and Bangladesh, were established to advocate and oversee future HIV/AIDS prevention activities along international borders.
Capacity Building
As a result of AIDSCAP efforts, the necessary clinic infrastructure, networks with other organizations, and material and human resources were put in place to stop the spread of STI/HIV in cross-border areas previously known for their inadequate STI services. The Bhoruka AIDS Project served as a model for the entire Indian subcontinent. Other international donors, such as the Joint United Nations Programme on HIV/AIDS and the U.K. Department for International Development, expressed interest in AIDSCAP's cross-border work and funded national expansion of project activities, thereby ensuring their continuation.
Implementing Partner
- Bhoruka Research Center for Hematology and Blood Transfusion
ASIA, Areas of Affinity: Indonesia/Philippines
Epidemiology
The Philippines and Indonesia are countries with low rates of HIV infection. When epidemiologists from the Philippine Department of Health conducted HIV surveillance in six sites in 1996 and 1997, they found unexpectedly low HIV prevalence, even among injecting drug users and commercial sex workers (CSWs) charging low fees. Since the first publicly acknowledged case of AIDS in Indonesia was reported in Bali in 1987, 517 AIDS cases have been reported from 17 of the 27 provinces.
Country Overview
The Philippines and Indonesia are both archipelago nations with large, culturally heterogeneous populations. Both countries have major regional commercial shipping centers, thriving tourism and commercial sex industries, and large migrant worker populations. To the extent that the sexual networks of Filipino seafarers overlap with Indonesian networks, an epidemiologic bridge has been established among the two countries and their neighbors.
Through AIDSCAP, USAID supported behavioral research and interventions targeting transient populations, such as fishermen and CSWs in ports and border areas in Indonesia and the Philippines. In addition, multiple pilot interventions were implemented in Indonesia with diverse populations: CSWs in Riau province near Singapore and Batam; street children in Jakarta; sexually active youth in Bali; newspaper reporters and editors in Jakarta and Surabaya; and Islamic institutions for advocacy and research to define HIV/AIDS interventions for youth.
Accomplishments
From 1993 to 1996, the Asia/Near East Bureau supported AIDSCAP to conduct a needs assessment and to develop projects targeting mobile populations traveling between Indonesia and the Philippines. The results of formative research on the risk behaviors of fishermen and their sexual partners were used to develop a project that reached 1,500 fishermen through peer education. Activities were also targeted to reach the CSWs who serve the fishermen.
When an assessment of the shipping industry in the Indonesian port city of Merauke identified Thai fishermen as a link in the spread of HIV/AIDS, an intervention was developed and piloted to provide an example for AIDS committees and nongovernmental organizations (NGOs) in other Indonesian cities facing the problem of reaching foreign fishermen in international ports. Most of the fishermen said that the inability to negotiate in their own language and the unavailability of condoms increased their risk for HIV infection. The Thai fishing companies responded by agreeing to provide the Thai seafarers a bonus for completing a term of employment in good health, thus providing a short-term incentive for condom use.
In an attempt to obtain a more complete understanding of the context for HIV transmission and the resources available for prevention, AIDSCAP supported a rapid ethnographic assessment in five Indonesian cities in 1995. The assessment indicated that rapid development of transportation and industry in border and port cities in Indonesia had a major impact on the growth of the sex industry. This, in turn, seemed to contribute to the high prevalence of sexually transmitted infections (STIs). In all sites, the provincial teams selected adolescents and CSWs for targeted HIV/AIDS prevention messages.
The Outreach Peer Intervention Model was developed in 1996 to decrease the spread of STI/HIV/AIDS among CSWs and their clients in Teluju, which is located in the Riau province of Sumatra. The development of the business growth triangle comprised of Singapore, Johor (Malaysia), and Riau (Indonesia) facilitates cross-border movement and provides potential pathways for HIV transmission. Riau province hosts several economic projects that employ large numbers of migrant workers, who have subsequently attracted a large population of CSWs. These CSWs were targeted with peer education, which was reinforced by community awareness campaigns, competitions between brothels for cleanliness, and improved access to condoms and behavior change communication (BCC) materials. According to an evaluation survey, condom use increased, but the decision to use a condom remained with the client.
AIDSCAP also supported projects targeting the youth of Indonesia through the two largest Islamic institutions in the country. In 1995, research was conducted with senior policymakers in Nahdlatul, Muhammadiyah, and with schoolteachers and students in Islamic schools to determine the most effective types of communication interventions to reach youth. Based on the finding that parents and adolescents lacked the communication skills to discuss reproductive and sexual issues, reproductive health modules were designed and used in Islamic religious and social institutions.
In Jakarta, where the number of street children ranges from 5,000 to 20,000, a pilot activity was designed to reduce sexual risk taking among youth. Based on research findings, outreach educators were trained, BCC materials were developed, and technical assistance was provided to NGOs who work with street children. Additional BCC materials for youth -- a film, comic book, and puppet theater -- were developed through the HIV/AIDS Arts and Media Project.
In Bali, a pilot intervention with sexually active youth aged 15 to 25, was implemented in three sites from 1996 to 1997. Through male and female peer outreach workers and volunteer peer educators, more than 2,856 youth were reached with STI/HIV/AIDS risk-reduction messages and more than 15,000 condoms were distributed. Pre- and post-knowledge, attitudes, beliefs, and practices surveys found that 71.6 percent of survey participants reported that they always or almost always used condoms, compared with a baseline of 22 percent.
The Media Center, established with support from the Ford Foundation, implemented a one-week training in June 1995 for journalists and editors in writing responsibly and informatively about HIV/AIDS. Twenty journalists from Jakarta and Surabaya attended the workshop. Samples of their articles published after the workshop indicated increased sensitivity in reporting on the issues of HIV/AIDS and increased coverage of the topic.
Implementing Partners
- Center for Health Research, University of Indonesia (CHR-UI)
- Center for Multidisciplinary Studies and Health and Developments (CEMSHAD)
- Private Agencies Collaborating Together (PACT)/Indonesia
- Program for Appropriate Technology in Health (PATH)/Indonesia
- Project Concern International (PCI)
- Yayasan Citra Usadha Indonesia (YCUI)
- The Media Center
ASIA, Areas of Affinity: South Pacific Island Nations
Epidemiology
The first case of HIV infection in Papua New Guinea (PNG) was identified in 1987. By 1993, the reported number of persons living with HIV rose to 153 (including 57 persons living with AIDS), and estimates of the prevalence rate among the general population ranged from 0.25 to 0.75 percent. The male to female ratio among seropositive persons was 1:1, and heterosexual contact was considered the primary transmission mode. Syphilis prevalence among the general population was estimated to be 3 percent in 1993, and incidence of this STI has increased four-fold since 1971. The high mobility of transportation workers within PNG and among other nations of the South Pacific could play a critical role in the spread of the epidemic throughout the Pacific Rim.
Country Overview
Papua New Guinea is the largest and perhaps most complex of the Pacific island nations. In 1990, its primarily rural population was estimated at 3.9 million. Over 860 language groups are represented on the island. The country's economy is based primarily on mining, logging, and agricultural exports. Scarcity of local employment drives many villagers to PNG's two port cities, Port Moresby and Lae. Public and private medical services are generally inaccessible to PNG's rural population.
In 1993, AIDSCAP, in collaboration with the PNG Institute of Medical Research (IMR), assessed the country's STI/HIV/AIDS situation and reviewed the response of the Department of Health, international donor agencies, and nongovernmental organizations (NGOs) to the epidemic. Results of the assessment indicated that the epidemic was probably more advanced than initially expected and that interventions targeting specific groups, such as commercial sex workers (CSWs) and workers in the transport industry and fisheries, were needed. To this end, the $100,000, 1-year AIDSCAP program supported research on these groups' risk behaviors and, based on this research, designed comprehensive STI/HIV/AIDS interventions targeting these groups.
Accomplishments
With AIDSCAP support, the IMR successfully conducted ethnographic research that laid the groundwork for future HIV/AIDS prevention interventions. Moreover, AIDSCAP assisted in the development of educational materials designed for use with three at-risk populations.
Behavioral Research
The IMR conducted a 6-week rapid ethnographic assessment of six target populations: long-distance truck drivers, truck driver assistants, truck stop workers, public motor vehicle drivers, sailors, and dockside workers. The study obtained information about these populations' social networks and sexual behavior and the receptivity of the transportation industry to HIV/AIDS prevention programs. Results of this research confirmed the epidemiologic significance of these groups and provided information about their behaviors that was critical to the development of effective AIDS prevention activities. Study findings were presented at a series of three workshops attended by government officials, international donor organizations, NGOs, and worker and management representatives from the transportation industry.
Based on the ethnographic assessment, the IMR concluded that: (1) most men and women interviewed, including both managers and workers, needed more information about HIV/AIDS prevention; (2) sailors and truck drivers were frequent buyers of sex; (3) sailors frequently shared sexual partners among themselves; (4) because they receive only brief periods of shore leave, shipboard outreach was the most effective approach to educating sailors; (5) drivers were rarely at their bases for extended periods, indicating that roadside intercepts or trucker association meetings were the best sites for interventions; and (6) condom use was low, particularly among older truckers and sailors.
Program Design
Based on the results of the ethnographic research, AIDSCAP and the IMR designed a $3-million, comprehensive STI/HIV/AIDS prevention program targeting CSWs, truckers, and maritime workers. The IMR submitted a proposal for this program to the Australian International Development Assistance Bureau, which subsequently funded the program.
Behavior Change Communication
In collaboration with local artists, AIDSCAP developed three STI/HIV/AIDS prevention cartoon storybooks and accompanying laminated flip charts for use with CSWs, sailors, and truckers. The storybooks use easily understandable terminology and speak directly to the target groups.
Implementing Partner
- Papua New Guinea Institute of Medical Research
ASIA, Areas of Affinity: Thai/Cambodia/Vietnam
Epidemiology
The first round of HIV sentinel surveillance (HSS), supported by AIDSCAP and completed in 1995, found that the average rate of HIV infection in target groups was among the highest in Asia. The second round in 1996 confirmed increases in HIV rates among commercial sex workers (CSWs) from 38 to 47 percent in the same nine provinces that participated in the 1995 HSS. HIV prevalence remained stable at approximately 8 percent for police and military personnel and at 2.6 percent among pregnant women. An additional nine provinces included in the 1996 HSS reported lower levels of HIV. This difference is more than likely because the nine provinces surveyed in the 1995 HSS have border crossings with Thailand and Vietnam.
Country Overview
Most of AIDSCAP's assistance in the Thailand/Cambodia/Vietnam area of affinity (AOA) was programmed to Cambodia because of the restrictions on USAID funding to Vietnam and Thailand and at the recommendation of USAID's Mission in Cambodia and its Regional Support Mission in Thailand. Both countries had no USAID presence for some or all of the duration of AIDSCAP.
As of 1997, Cambodia had 21 international border crossings with its three neighbors -- Thailand, Laos, and Vietnam. Research funded by the Asia/Near East Bureau established that sexual networks connect Thai men with female Cambodian and Vietnamese commercial sex workers (CSWs), who in turn have extensive contact with local Cambodian men. Cambodia is a good example of how the AOA principle can explain the spread of an epidemic across borders. AIDSCAP research described the phenomenon of a high-risk environment existing near large border crossings and explained how domestic epidemics are ignited and perpetuated.
Through AIDSCAP, USAID supported a rapid assessment of two Cambodian/Thai border crossings to document the STI/HIV risk environment in 1994. In late 1995, a USAID/Cambodia assessment led to national program research and policy advocacy in the areas of STI/HIV prevalence surveys, HIV counseling and testing guidelines, behavioral surveillance, and capacity building.
Accomplishments
The accomplishments of AIDSCAP projects in Cambodia include revised national guidelines for the management of STIs and for HIV counseling and testing practices; wider global recognition of the severity of the HIV/AIDS epidemic in Cambodia; and increases in foreign assistance for HIV/AIDS prevention in Cambodia.
AIDSCAP support of the HSS allowed for expansion to all Cambodian provinces by 1997, thus documenting the pervasive spread of HIV in much less time than was needed for a comparable epidemic in Thailand. With AIDSCAP support, the methodology of the 1996 and 1997 rounds of the HSS was improved by addressing the problems of coercion and anonymity, refining the range of sentinel groups, and training personnel to maintain surveillance and data collection.
The results of AIDSCAP's STI prevalence and etiology survey led to the revision of Cambodia's national guidelines for the management of STIs. As a result of the University of Washington's finding of antibiotic-resistant Neisseria gonorrhoeae, the MOH and its STI advisory panel changed the recommended treatment for gonorrhea.
In order to preempt a possible witch-hunt mentality toward persons living with HIV, AIDSCAP hired a Thai consultant to work with the National AIDS Program on HIV counseling and testing. In addition to holding multiple advocacy meetings with government staff and training them in appropriate HIV testing and counseling, AIDSCAP assisted in the development and dissemination of national guidelines that can be used as a model for other countries in the region.
AIDSCAP focused on strengthening existing health care structures and building the capacity of health care personnel to enable them to develop their own research and educational activities. Technical assistance was provided in developing research protocols, analyzing data, and facilitating workshops. A behavioral surveillance survey has established the baseline for future evaluation of behavior change in response to the increasing level of prevention activity in Cambodia.
Implementing Partners
- Family Planning International Assistance
- National AIDS Program (NAP) of the Ministry of Health
- Population Services International (PSI)
- The Institute for Population and Social Research (IPSR), Mahidol University, Thailand
- University of Washington
ASIA, Areas of Affinity: Thai/Lao PDR/Burma
Epidemiology
The HIV/AIDS epidemic in Lao People's Democratic Republic (Lao PDR) is at a relatively early stage compared with those of many other countries. In 1989, the first case of HIV infection was identified, and in 1991, the first AIDS case was detected in Bokeo province adjacent to Chiang Rai, a province with one of the highest HIV prevalence levels in Thailand. As of 1993, only 38 persons had been identified as HIV-positive. Between January and June 1997, 4,743 samples were tested (including samples from blood donors) from all over the country and 47 were HIV-positive. Of those 47 HIV-positive persons, 18 had developed AIDS.
Despite the low levels of detected infection, the proximity of northern Lao PDR to one of the highest prevalence areas of the region (northern Thailand and Burma) creates an environment conducive to the transmission of HIV into Lao sexual networks. Every Lao province borders on another country, and travel is easy and frequent between Thailand, China, Vietnam, and Lao PDR.
The National Committee for the Control of AIDS (NCCA) oversees all HIV/AIDS programs. Lao PDR has no systematic reporting for HIV and no program to control sexually transmitted infections (STIs).
Country Overview
The common borders of Thailand, Lao PDR, and Burma, and the frequent movement of populations in this infamous "golden triangle" drug trade region, provided the rationale for its area of affinity (AOA) designation. The political differences of these countries, however, pose challenges to AOA implementation. Thailand is a free market, capitalist democracy; Lao PDR has a communist government that only opened its borders to the outside world at the start of this decade; and Burma has a repressive dictatorship. Although the countries share some common language, hilltribe and ethnic populations, and the predominance of Buddhism, their cultures are also distinct and different.
AIDSCAP's initial scope of work noted the high rates of HIV infection in parts of Burma and northern Thailand and the absence of data in Lao PDR. As a result, AIDSCAP conducted an assessment in Lao PDR in 1994 along the Thai-Lao border and made recommendations for future interventions that included behavior change communication (BCC), STI prevention and care, and condom programming. An 18-month delay in approval of the assessment by the Lao government was an unanticipated reality of communist bureaucracy. Because of limitations in funding and at the recommendation of the USAID Regional Support Mission, AIDSCAP limited its pilot interventions to BCC activities along the Lao-Thai border. Ongoing fighting made interventions along the Burmese-Thai border impossible.
Accomplishments
As a communist country, Lao PDR has no indigenous nongovernmental organizations (NGOs). Therefore, AIDSCAP managed and implemented its activities through the international NGO, CARE, in direct consultation with the government. AIDSCAP supported three subprojects through CARE: the original Lao-Thai border assessment; further qualitative research with target populations to design interventions; and a BCC intervention at three key border crossing areas. In addition, AIDSCAP supported a workshop for journalists and an HIV and STI sentinel surveillance design workshop, and sponsored the attendance of numerous representatives of governmental organizations at regional conferences and workshops.
Behavior Change Communication
A 3-month formative research activity, involving focus group discussions with migrants, traders, border police, restaurant and bar owners, waitresses, and commercial sex workers provided the baseline data for the design of communication materials and intervention activities. The three border sites identified for interventions included Vientiane municipality, Bokeo province, and Champasak province.
Following approval of the assessment plan by the NCCA, AIDSCAP initiated a 22-month BCC activity in the three border sites. BCC messages and materials were tailored to the specific target populations in each site. A key implementation feature was the involvement and participation of government committees at each stage of the project, from pretesting BCC materials to participating in special events. The project working teams in each province included representatives from the Provincial Committee for the Control of AIDS (PCCA), the Lao Women's the Health Education Division of the Ministry of Health, the Lao Youth Union, representatives of ethnic minorities and the private sector, and CARE/Lao staff. Project activities included the development of BCC materials (e.g., stickers, pamphlets, posters, billboards, calendars), radio spots, and a radio soap opera series, special events, and distribution of materials at Lao festivals. At the end of the project, the target population, particularly women, reported increased knowledge about STI/HIV/AIDS.
STI/HIV Surveillance
Because of budget constraints and at the recommendation of the Regional Support Mission, AIDSCAP did not implement any direct STI interventions in Lao PDR. However, at the invitation of the NCCA in May 1997, the project sponsored a roundtable discussion at the Institute of Hygiene and Epidemiology in Vientiane on setting up an STD reporting system and HIV sentinel surveillance. At the seminar, 18 local representatives and five resource persons from Thailand and AIDSCAP identified specific sites for collecting HIV and STI data and developed an implementation plan.
Media Workshop
At the request of the NCCA, AIDSCAP supported a media workshop for local journalists designed to improve the quality and increase the frequency of HIV/AIDS coverage in Lao PDR. The HIV/AIDS Workshop for Media Personnel in Lao took place in August 1996 with 15 participants. Experts on HIV/AIDS and senior journalists from both Thailand and Lao served as resource persons for the workshops.
Capacity Building
NCCA and PCCA staff who participated in the CARE interventions reported significant increases in skills and in knowledge of how to plan, manage, and implement an STI/HIV/AIDS prevention project. In addition, AIDSCAP supported the attendance of NCCA staff at a number of international conferences and regional workshops and seminars to share their own experiences and learn from neighboring countries. Given the past isolation of the Lao PDR, these activities were particularly meaningful.
Implementing Partner
- CARE/Lao
