FHI - IV. Support Areas Part 4

Providing Access to the Translation of the Guidelines for Comprehensive Sexuality Education Developed by SIECUS, USA

Implementing Agency: Grupo de Trabalho e Pesquisa em Orientação Sexual (GTPOS)

Year: 1996

Budget: 5,000.00 USD (AIDSCAP)

Geographic Area: São Paulo

Background

GTPOS is a non-governmental organization founded in 1987 with the mission to empower professionals working in the areas of education and health to run projects on sexuality and AIDS prevention.

In the face of the urgent need to develop prevention and educational guidelines on sexuality, GTPOS in conjunction with two other NGOs (ECOS and ABIA), produced a guide on sexuality to serve as a key instrument in the education of teachers. Since its publication a total of 16,000 were sold. GTPOS receives numerous requests of donations from all over Brazil and to respond to this need, AIDSP/USAID supported the distribution of the guidelines in the State of São Paulo.

Objectives

To distribute 400 free copies of the Guia de Orientação Sexual - Diretrizes e Metodologia, to 400 educators and/or professionals that are already working on HIV/AIDS prevention programs in São Paulo.
To provide well-designed and well-written technical material on sexuality to professionals working in HIV/AIDS prevention.
To prioritize cities in the state of São Paulo with high incidence of HIV infection such as São Paulo, Santos, São Vicente, São Bernardo do Campo, Ribeirão Preto and São José do Rio Preto.
To collaborate with the State Council for Women to identify women's organizations working on the prevention of HIV/AIDS and STIs to be part of the GTPOS mailing list to receive the guidelines.

Accomplishments

Organized the mailing list after consulting with the State Council for Women in São Paulo and AIDSCAP/Brazil. Included also institutions from the northeast Bahia, Ceará and Pernambuco, which are USAID target areas for reproductive health.
Distributed 400 copies of the Manual Guia de Orientação Sexual to women's groups and organizations by prioritizing the geographic regions with highest incidences of HIV in the state of São Paulo.
With the technical assistance of AIDSCAP/Brazil, designed a simple two-page questionnaire with 14 questions to evaluate the use of the manual by 400 selected recipients. AIDSCAP/Brazil also provided technical assistance for analysis of data.
Out of 400 distributed questionnaires, 120 answered the evaluation with the following findings: 40 percent of the recipients work with women; 22 percent work in education; 21 percent are linked to public health and 17 percent are NGOs working with AIDS and sexuality. Forty-seven percent of the respondents were coordinators or directors of institutions; 87 percent had university level education; 13 percent first- or second-grade; 84 percent were women and 16 percent men. The average ages of respondents were at or older than 30 years of age. Fifty-five percent of respondents did not know of the guide, 45 percent had some contact with the material and 15 percent had already read or used the material before receiving it through AIDSCAP. Thirty percent had superficial contact in that they had heard about or seen it.
After receiving the manual, 24 percent did not read it due to lack of time. However 76 percent of the respondents read the manual and 51 percent planned activities with their colleagues after reading it. A total of 66 percent of the respondents reported that the guide will help them to reflect and plan an educational activity in the area of sexuality and HIV/AIDS prevention.

Process Indicator Summary

Category Total

Materials distributed 400

Training of Teachers from Secondary Schools in São Paulo

Implementing Agency: IBEAC - Brazilian Institute for Study and Community Support

Year: 1996

Budget: 5,000 USD (AIDSCAP)

Geographic Area: São Paulo

Background

IBEAC is a non-governmental, non-profit organization established in 1981. It is considered public interest by federal, state and municipal laws. IBEAC's main mission is to stimulate and support civilian society in solving social problems within the community. It aims to improve the political consciousness of the population and to develop the true exercise of citizenship. The Councils Of Education (COE) of fifteen communities conduct IBEAC programs. The main concern of the communities' COE is to implement programs to teach people between 14 and 30 years old to read and write.

IBEAC involves in this process 681 teachers and 85 pedagogical advisors which are supported by the Ministry of Education. In view of the current AIDS situation in Brazil, IBEAC submitted a proposal to AIDSCAP to train two teachers/coordinators from each of the fifteen community councils to act as trainers for the other 85 coordinators, who in turn will pass the theoretical and practical training to 681 teachers working in the classrooms.

Objectives

Increase AIDS awareness among 30 selected community educators in São Paulo City.
Train 30 selected community educators on HIV/AIDS/STI and related matters to act as trainers of 85 community coordinators and 681 teachers.
Educate 17,000 students on HIV/AIDS prevention through trained teachers.

Accomplishments

Trained 30 women who are pedagogic coordinators at the community education level to act as trainers on HIV/AIDS STI prevention.
Distributed 330 guidelines on eleven different types of HIV/AIDS/STI prevention to 30 pedagogic coordinators as educational support materials.
Produced 17,000 leaflets on HIV/AIDS prevention to distribute to IBEAC target population (students between 14-30 years of age) learning how to read and write.
Trained representatives from 12 different target geographic areas: Arujá, Cotia, Embu, Itapeva, Jandira, Jundiaí, Lorena, Osasco, Campo Limpo, Santo Amaro, Barueri, Itapevi (most areas belong to the great São Paulo city and are poor neighborhoods).
Established a pre- and post-test to evaluate the training.

Lessons Learned/Recommendations

Existing infrastructures such as community-based systems that are already organized, committed and have good access to at-risk individuals are an important avenue for the development of HIV/AIDS prevention programs at relatively low cost.

Working with a well-established and respected NGO in the area of education allows integrating HIV/AIDS/STI prevention more easily in the community.

Process Indicator Summary

Category Total

Teachers trained 30

Guidelines on HIV/AIDS prevention distributed 330

Leaflets produced and distributed 17,000

Fortunetellers as Romantic Advisors and Their Potential for AIDS Prevention

Implementing Agency: Culture Concepts Institute and Medicine (CCIM)

Year: 1996

Budget: 5,000 USD (AIDSCAP)

Geographic Area: Ceará

Background

The Culture Concepts Institute and Medicine (CCIM) is a Brazilian NGO dedicated to conduct community-based research on the interface of medicine and culture in Fortaleza, Ceará. CCIM has built upon the international experience and reputation of a nucleus of researchers in social medicine who have investigated the socio-cultural context of illness in the Northeast Brazil over the past 20 years. The rapid increases of HIV/AIDS among low-income women have motivated the researchers from CCIM to seek new approaches and strategies for HIV/AIDS prevention taking into consideration the existing culture.

In Fortaleza, Ceará, CCIM has identified the fortuneteller as a key player in solving problems of love and romance for couples of all socio-economic classes and lifestyles. Busy housewives normally isolated from sources of official medical care go to fortunetellers hoping to solve problems. During the consultations, clients "open the game," presenting a clinical history of their private interpersonal relationships without apparent shame or discretion to the fortuneteller, who has the power, it is believed, to foretell and advise for the future. Thus, CCM conducted a four-month ethnographic study to explore the potential role of the fortuneteller in HIV/AIDS prevention.

Objectives

To prevent the transmission of HIV among couples by conducting an ethnographic (anthropological) descriptive study on the role of the popular, amorous advisor, the fortuneteller, and her/his clients.

Accomplishments

Seven experienced professionals worked together to establish research logistics for a week-long period.
Conducted 20 in-depth ethnographic interviews with persons from four distinct socio-economic strata (impoverished slum dwellers, lower class workers, middle class and wealthy urbanites) who have consulted the fortuneteller regarding amorous/sexual problems in the past 6 months.
Identified and interviewed 20 fortunetellers in the city of Fortaleza. Interviews explored their role, beliefs, practices and cures.
Transcribed, coded, processed and analyzed 40 interviews using the computer program "The Ethnographic."
Created pre-test social marketing strategies based upon research findings for the inclusion of fortunetellers in AIDS prevention efforts, including distribution and promotion of condoms.
Project team had created the "Cards Of Love" for HIV/AIDS prevention.

Lessons Learned/Recommendations

Fortunetellers and card readers are considered by many Brazilians as experts in love. People seek them to gain information about the future and believe what the cards reveal. Some people believe that card readers "read the thoughts and worries that a person has." At this moment, with the rapid increase of HIV/AIDS in Brazil among heterosexual couples, new strategies of HIV/AIDS prevention should be explored. Study results highly suggested that fortunetellers should be trained to deliver HIV/AIDS prevention advice, condoms.

Process Indicator Summary

Category Total

Fortunetellers interviewed 20

Persons interviewed that went to Fortunetellers 20

Materials produced 6

Male Goat

Implementing Agency: Culture Concepts and Medicine Institute (CCM)

Year: 1996

Budget: 5,000.00 USD (AIDSCAP)

Geographic Area: Fortaleza, Northeast

Background

The implementation of culturally-appropriate intervention health programs is one of the missions of CCM, an NGO based in Fortaleza-Ceará, that is dedicated to conducting community-based research to serve as the basis for interventions. In 1996 CCM, with the technical support of AIDSCAP/Brazil and funds from USAID, performed qualitative research among women to better access their views, aspirations, expectations, sexual beliefs and behaviors.

Objectives

To conduct an ethnographic (anthropological) descriptive study to access women's sentiments and sexuality.
To create an informal, face-to-face educational intervention for women adapted to the cultural context of northeast Brazil and to these women's day-to-day reality based upon these findings.

Accomplishments

Formed a multidisciplinary team composed of 3 researchers, 1 transcriber, 2 university research assistants, 1 popular artist, and 2 community researchers.
Trained multi-disciplinary team and discussed research protocol.
Conducted 40 in-depth interviews with 40 men and women with steady partners from 4 distinct socio-economic levels (high society, upper middle/middle class, lower class and urban slum dwellers) in Fortaleza. The interviews were conducted at the interviewee's home, workplace or a comfortable private setting.
Following an ethnographic interview, guide information was collected assigning a number to the cultural norms of sexuality -- attitudes, costumes and behaviors -- which shape and influence the intimate relationship of heterosexual couples in northeast Brazil. The information collected included demographic data, popular language and terminology, notions of marriage, fidelity and infidelity, extra-marital affairs, gender- and sex-linked roles and obligations, ethnotypologies of men and women, sexual relationships and sexual behaviors.
Interviews were conducted with 24 married persons with fixed partners over the past 5 years (12 males and 12 females who had tested HIV-negative. An identical sample (24) of HIV-positive married men and women were identified and interviewed.
All interviews were transcribed, typing directly into the ethnographic program. Interviews were read and a list of codes created. Interviews were then re-read and coded one by one. Codes were entered into the computer and processed.
Analyzed data based upon findings created 12 IEC prototypes to be used in future interventions for the prevention of HIV among heterosexual couples in the northeast.

Lessons Learned/Recommendations

Based upon IEC prototypes, posters, cards, leaflets etc., can be developed for the prevention of HIV among heterosexual couples.

Ethnographic (anthropological) descriptive studies provide rich background information for the proper design and implementation of HIV/AIDS prevention programs.

The in-depth link between research and intervention in the design and implementation of AIDSCAP HIV/AIDS/ STIs prevention programs is key for quality programs and should be considered for future programs.

KAPB Research Among Adolescents to Evaluate Condom Use During the Winter Festival in Campos do Jordão, São Paulo

Implementing Agency: M/W Marketing Social and the State Department of Health in São Paulo

Year: 1996

Budget: Not available

Geographic Area: São Paulo

Background

The Winter Festival in Campos do Jordão attracts each year an average of 210,000 people from São Paulo and other Brazilian states. Most people who go to Campos do Jordão are young and belong to middle- or upper-social class. During winter festival young people have an opportunity to meet and date each other informally and sexual relationships can take place with partners that they just met. Quite frequently on occasions like this, prevention is not considered. In addition, the use of alcohol among adolescents is very prevalent in Brazil so the State Department of Health in conjunction with the private group M/W Social Marketing developed a KABP survey with the main objective to evaluate condom use. This study was supported by USAID through DKT/AIDSCAP Brazil Program with important counterpart contributions from the State Department of Health.

Objectives

Identify the main characteristics of the young population who participate at Winter Festival in Campos do Jordão in order to design HIV/AIDS future interventions for this target group during the festival.
Verify the frequency of condom use among adolescents participating in the Winter Festival.
Identify reasons and motivation for condom use.
Identify behavioral differences in condom use according to gender, age, education and residency (from Campos do Jordão and tourists).

Accomplishments

A structured questionnaire with 18 questions was developed, pre-tested and professionals were trained as interviewers.
A total of 282 adolescents (50.7 percent male and 48.2 percent female) answered the questionnaire. Out of 282, 63 percent were between 18 to 21 years old, 35.8 percent were between 14 to 17 years old and 1 percent was between 10 to 13 years old. Most participants had either finished high school or were at university. Out of 282, 64.8 percent were from other cities and 35.2 percent were from Campos do Jordão.
Out of 282, 57.1 percent had never used condoms.
The studied showed a low perception of risk related to oral sex. The reasons reported were lack of detailed information and incomplete media coverage.
Among the major reasons for not using a condom was "I don't need it." Low perception of risk, lack of practice with condoms and lack of detailed information for proper use were other reasons for not using condoms.
The number of adolescents from Campos do Jordão reporting never using a condom was significantly higher than the response of adolescents from São Paulo and other cities.

Lessons Learned/Recommendations

It is clear that adolescents need a more participatory education to teach proper condom use.

Barriers for not using condoms should be addressed based upon quantitative and qualitative research.

Programs need to be designed based on assessment of local needs and culture. Baseline data should be collected on a systematic basis for adequate intervention design.

Process Indicator Summary

Category Total

People educated 600

Condoms distributed 600

IEC materials distributed 600

Amplifying the Communication Spaces on HIV/AIDS Prevention Among Women

Implementing Agency: Nós Mulheres

Year: 1996

Budget: 5,000 USD (AIDSCAP)

41,991 (counterpart contribution)

Geographic Area: Rio de Janeiro

Background

The group Nós Mulheres is a non-profit organization in Rio de Janeiro, which has been acting in the areas of women's health since 1984, implementing educational activities among health care providers, community leaders and women. In 1996 "Nós Mulheres," in collaboration with AIDSCAP/Brazil, developed an intervention during a four-month period in 11 health services to increase access to existing educational materials produced for women, in a special 6-video kit containing, as follows:

Julieta e Romeu (ECOS/1995);
Mancha de Batom (SES-SP/1995)
Vênus de Fogo (PIM/ISER/1991);
Uma Vezinha só (ECOS/1995);
O dia da cura (ABIA/IBASE/1993);
Sem camisinha não dá (CECIP/1992);

The kit was reproduced and distributed to the 11 selected Health Centers as part of the Rapid Response program.

Objectives

Amplify the access of BCC materials at women's health services.
Provide a kit of 6 videos on AIDS and women to health services in Rio de Janeiro.

Accomplishments

Reflection workshops were conducted with health care providers from women's health services to include video sessions as support for the discussion of HIV/AIDS prevention among women.
The kit of 6 videos was distributed to 11 different health services in conjunction with condoms and other IEC materials.
Professionals were recruited and trained to use HIV/AIDS prevention videos for women during the development of daily activities at 11 health centers.
The project obtained funds from USAID and the MacArthur Foundation to implement HIV/AIDS prevention activities for women.
A total of 1,104 women participated in project activities, among those 279 were health care providers.
A total of 378 men, 32 of whom were health care providers, were reached through project activities.
A total of 7,066 educational materials were distributed to target population at the centers.
A total of 11 video kits with 6 different videos were distributed to health centers. A total of 1,066 people participated at video sessions and debates.
Special events were conducted during World AIDS Day.

Lessons Learned/Recommendations

The videos were used according to the specific service of each health center. For example, one health center composed a group of men to discuss the video session with special emphasis on condom use.

The kit was well accepted among women attending the anti-natal services or seeking contraception methods. Project coordinators evaluated that the use of videos contributed to the reflection process.

The activities were conducted during summertime (vacation period) in Rio de Janeiro. Project team evaluated that more women could be reached if project activities would remain beyond funding.

Process Indicator Summary

Category Total

Females educated 1,104

Males educated 378

Condoms distributed 3,643

IEC materials distributed 7,066

HIV/AIDS Intervention at the Waiting Room Clinics in Rio de Janeiro

Implementing Agency: Grupo Pela Vidda - Rio de Janeiro

Year: 1996

Budget: 5,000 USD (AIDSCAP)

3,030 USD (counterpart contribution)

Geographic Area: Rio de Janeiro

Background

Pela Vidda group located in Rio de Janeiro city is a community-based non-governmental, non-profit organization dedicated to the advocacy for the rights of people with HIV and AIDS, AIDS awareness and prevention.

In 1996, through the Rapid Response program, Pela Vidda developed an intervention for men and women on HIV/STI at 3 waiting rooms at a gynecology department, an internal medicine and a tuberculosis outpatient care unit. During the intervention, information counseling was provided with IEC materials.

Objectives

Increase HIV/STI awareness among women and men attending health care centers in Rio de Janeiro through the development of safer-sex workshops at waiting rooms.
Taking gender issues into consideration, discuss with men and women HIV/AIDS prevention.

Accomplishments

Reached 410 people (261 female and 149 male) in the waiting rooms providing at-site HIV/AIDS/STI information.
Produced 40.000 leaflets -- 22,000 for men and 18,000 for women -- for distribution beyond the life of the project.
Conducted safer-sex workshops with 410 people at clinic waiting rooms.
Evaluated activities through a questionnaire for participants.

Lessons Learned/Recommendations

Although the level of general information on HIV/AIDS transmission and prevention is high, there is a need for more detailed information.

There is an urgent need of HIV/AIDS prevention programs for men which will consider their specific needs and cultural mores.

Process Indicator Summary

Category Total

Females educated 261

Males educated 149

IEC materials produced 40,000*

*Note: IEC materials will be distributed beyond the life of project.

The Community Response to HIV/AIDS: an Experience in Slum Areas in Rio de Janeiro

Implementing Agency: Ação Comunitária Pró-Favela (ACPF)

Year: 1996

Budget: 5,000 USD (AIDSCAP)

3,600 USD (counterpart contribution)

Geographic Area: Rio de Janeiro

Background

The expansion of the HIV/AIDS epidemic in the late eighties and early nineties is characterized by a growing number of infected women, demanding a reassessment of the current prevention policies and programs, as well as the implementation of specific interventions to target women. In this context the Ação Comunitária Pró-Favela (ACPF) a philanthropic non-profit organization with the support of the AIDSCAP Rapid Response Fund promoted a training course on HIV/AIDS/STI for 32 community educators from 3 slums in the city of Rio de Janeiro. IEC materials were reproduced and distributed in door-to-door educational activities.

Objectives

To update and train community educators to integrate reproductive health and HIV/AIDS/STI prevention activities in their daily work at 3 slums in Rio de Janeiro.
To reproduce and distribute IEC materials for the prevention of HIV/AIDS/STIs to women living at slums in Rio de Janeiro.
To promote safer-sex behavior and condom use among women living in slum areas in Rio de Janeiro.

Accomplishments

Planned, organized and conducted an updated training course for 32 community educators to integrate HIV/AIDS/STI into the reproductive health agenda.
Reproduced and distributed 10.000 copies of IEC materials for HIV/AIDS/STI prevention (5,000 folders and 5,000 booklets).
Educated 8,207 women and 1,790 men during door-to-door work by trained community educators.
Promoted and distributed 77,372 free condoms during project activities.

Lessons Learned/Recommendations

HIV/AIDS prevention programs should be built upon existing organized groups with credibility and access to the target population. The training of community educators who know the violent and complex environment of slums in Rio de Janeiro is an important strategy in reaching and educating vulnerable, low-income women.

Process Indicator Summary

Category Total

People trained 32

People educated 9,997

IEC materials reproduced and distributed 10,000

Condoms distributed 77,372

Safer Sex Education Community Journey

Implementing Agency: Adolescent Health Program (PROSAD) and Viva Mulher

Year: 1996

Budget: 5,000 USD (AIDSCAP)

3,150 USD (counterpart contribution)

Geographic Area: Fortaleza

Background

PROSAD and Viva Mulher are institutions in Fortaleza, Ceará, located in the Northeast of Brazil, involved with the assistance of adolescents and women in terms of physical, psychological, developmental and social well being. The PROSAD/Viva Mulher program aims to improve the health situation of women and adolescents in 10 low-income neighborhoods in Fortaleza-Ceará. Over time, USAID/Brazil has supported "Viva Mulher" as part of their reproductive health programs in the Northeast. In response to the increase of heterosexual transmission of HIV in the region, USAID/AIDSCAP initiated pilot activities through the small grant program to integrate efforts on HIV/AIDS programs into reproductive health targeting female adolescents and women. To achieve this, PROSAD and Viva Mulher conducted a multi-faceted educational intervention which was evaluated through the administration by a structured questionnaire and focus group discussion.

Objectives

To increase the capacity of youth, women and men to communicate about different aspects of safer-sex practices and AIDS prevention.
To reach low-income youth through participatory methodologies and approaches to the prevention of HIV/AIDS/STI and unwanted pregnancy.

Accomplishments

Conducted preparatory meetings with the participation of PROSAD, Viva Mulher, and state AIDS control and prevention program.
Identified and trained 24 professionals to act as facilitators and reporters during projects activities.
Conducted activities using role-plays, small group discussions, and safer-sex workshops for 442 participants to whom were distributed 718 copies of IEC materials and 144 condoms.
Promoted contraceptive use to avoid unwanted pregnancy.
Applied questionnaires and conducted focus group discussions as part of the evaluation process.

Lessons Learned/Recommendations

There is a need to conduct HIV/AIDS prevention for adolescents and women in low- HIV prevalence regions were epidemiological data is showing an increase of HIV transmission among heterosexuals.

Epidemiological study of HIV and STI as well as behavioral studies of the target population are a important needs in the region to better assess the epidemic situation.

Process Indicator Summary

Category Total

People trained 24

People educated 42

IEC materials distributed 718

Condoms distributed 144

Evaluation of Maze Use on HIV/AIDS Prevention

Implementing Agency: SOS Adolescents

Year: 1996

Budget: 5,000 USD (AIDSCAP)

6,207 USD (counterpart contribution)

Geographic Area: São Paulo

Background

The number of HIV infected women is increasing rapidly and the male and female ratio in Campinas is 1:3. SOS Adolescents, a NGO established in 1992 in the city of Campinas, the second largest city in the state of São Paulo, has the mission to develop programs for adolescents. In an effort to control the rapid increase of HIV/AIDS among adolescents, SOS Adolescent created a Maze to target women with the collaboration of AIDSCAP. The Maze strategy as an educational tool has the objective to attract the attention of adolescents and women. In addition, several other public and private institutions as well as NGOs were interested in the Maze's model. Through the small grant program SOS was able to evaluate the methodology with the technical assistance of AIDSCAP/Brazil.

Objectives

To conduct a quantitative and qualitative evaluation of the Maze as an educational device.
To prepare a Manual, describing the methodology used in the Maze.
To disseminate information about the Maze use in HIV/AIDS prevention.
To acquire a patent on the "Maze as an Educational Device."

Accomplishments

The Maze was constructed to develop activities and be evaluated from November 28-30, 1996.
Developed a standard questionnaire to evaluate the use of the Maze as a educational device.
Before and after walking through the Maze 1,624 subjects answered questionnaires.
Focus group guidelines were developed and two focus group discussions with adolescents were conducted to evaluate the Maze use as a educational device.
A manual for Maze use was developed and 500 copies were distributed.
The qualitative data show that adolescents acquired substantial new information on HIV/AIDS prevention through the Maze strategy. For example: "I had information, but I didn't know about the proper use of condoms and lubricants at all…"
The experience to be inside of the Mazes was considered good by 91 percent of the participants. The stories inside Mazes were considered real by 98 percent. The Maze was considered proper for women by 98 percent of the adolescents interviewed and considered adequate for men by 99 percent.
The Maze was disseminated in the major newspaper in the country "Folha de São Paulo" (548,280 issues per day).

Lessons Learned/Recommendations

Creative and innovative strategies can be used or adapted to different target groups and to different regions/countries. The Maze is an innovative way to approach HIV/AIDS using participatory and interactive methodologies.

Process Indicator Summary

Category Total

People educated 2,534

Female adolescents interviewed 823

Male adolescents interviewed 791

Special events 03

Manuals produced and distributed 500

Articles in the media 1 article in Folha de São Paulo that sells 548,280 newspapers per day

The Use of Maze as an Educational Device

Implementing Agency: SOS Adolescent

Year: 1996

Budget: 5,000 USD (AIDSCAP)

Geographic Area: Campinas and São Paulo

Background

Although adolescents are well informed on HIV/AIDS prevention in the city of Campinas there is a need to go a step further -- from information to the adoption of prevention practices. This need motivated SOS adolescents to produce and test a prototype of an educational interactive material: a maze with information about HIV/AIDS/STI specially targeted to women and female adolescents. This project was funded under the Rapid Response Fund and provided one of the most innovative tools of HIV/AIDS prevention. This model can be adapted to different settings and cultures playing on natural human feelings: curiosity, interest and adventure.

Objectives

To produce and test a prototype of an educational interactive material, the maze as an educational device to HIV/AIDS prevention.
To construct and install the maze in high schools in Campinas.
To promote through maze the personal responsibility for the options made.
To promote safer sexual behaviors.

Accomplishments

Planned and constructed an installation in a maze format, built with a light structure with colorful "walls." The construction of the maze required the technical assistance of an architect and a professional specialized in tent production.
Developed the information and scenarios inside the maze based upon the most common questions and problems faced by adolescents based on SOS files and counselors' experience. In addition, it had the technical assistance of a health education professional. Construction of educational materials required the experience of a professional from art and communication area.
Trained 28 professionals to use the maze.
Presented the maze to 938 adolescents (468 female and 470 male).
Distributed 2,856 free condoms and 1,820 IEC materials; 50,000 media spots promoted the maze.
Provided counseling and safer sex education for all participants.

Lessons Learned/Recommendations

The use of maze as an educational device is an extremely creative, innovative way of providing HIV/AIDS prevention. The maze uses the concept of having positive, risk-preventing options and can be constructed with different materials and in different countries, depending upon the materials used. For example, making the drawings about HIV/AIDS prevention on bamboo and bananas is inexpensive and involving people in the activity makes it fun..

The maze can be used for HIV/AIDS/STI, reproductive health or any other educational activity. It will depend on the scenarios and information incorporated inside.

A maze constructed with more sophisticated, permanent materials remains inexpensive and is a mobile tool.

Process Indicator Summary

Category Total

People trained 28

People educated 938

IEC materials distributed 1,820

Condoms distributed 2,856

Spots in the media 50,000

VI Congresso Brasileiro DST/AIDS

Implementing Agency: Brazilian Union Against Sexually Transmitted Diseases (BUASTI)

Year: 1996

Budget: 5,000 USD - AIDSCAP

Geographic Area: National

Background

The Brazilian Union against Sexually Transmitted Diseases is a non-profit organization that is more than 20 years old. During this time it has organized seminars, conferences, workshops in the area of sexually transmitted diseases, including the VI Congresso Brasileiro DST/AIDS. Numerous epidemiological and biologic studies show that STIs, both ulcerative and non-ulcerative, enhance HIV transmission. Studies also show that treating STI reduces the transmissions of HIV. Thus, AIDSCAP-supported activities are necessary to improve the management of STIs in Brazil. As part of the strategy to improve the management of STI in Brazil AIDSCAP supported the VI Brazilian Conference on STI and AIDS in Porto Alegre, Rio Grande do Sul, Brazil, through the NGO small-grant program. The conference was held in Porto Alegre with representatives from WHO, PAHO, CDC, Institute Pasteur, Institute Fournier, MOH and professionals from Brazil, Argentina, Uruguay and Chile.

Objectives

To update HCPs from Brazil, Argentina, Uruguay and Chile on the scientific knowledge on HIV/AIDS/ STIs and its interaction and synergism.
To integrate actions in the area of STI/HIV/AIDS between MOH, WHO, PAHO, CDC and the local scientific community.
To promote technical scientific exchange among health care providers from Brazil, Argentina, Uruguay and Chile.

Accomplishments

The VI Brazilian Congress on STI/AIDS was held from October 9-12, 1996 in Porto Alegre, Rio Grande do Sul, Brazil, with the participation of 1,200 professionals. One hundred and thirty teachers (20 were from other countries) collaborated with the scientific program.
The meeting had MOH representatives from Argentina, Uruguay and Chile. Furthermore the Conference had the support from The Brazilian Society for Gynecology and Obstetrics, the Brazilian Society of Dermatology, Pediatrics, Infectious Diseases and Proctology.
A total of 6,000 conference newspapers, 1,500 abstract books and 3,000 posters were distributed.
A total of 40,000 calls for abstracts were distributed in Brazil and other countries.
A total of 125 abstracts were presented and 3 satellites meetings were conducted prior to the conference.
Highlighted events: Dr. Luc Montagnier from Institute Pasteur presented "The Present Situation And Future Perspectives Of HIV Dissemination;" Dr. Weinner GrossKurth from the United Kingdom presented in plenary session "The Treatment Of STIs And The Control Of HIV: The Example Of Tanzania."
Several issues such as prevention of HIV, counseling, management of STIs, syndromic approach, STI among adolescents and children, contraception and HIV/STI, and the epidemiology of AIDS and STIs were extensively discussed.
Meetings were conducted during the conference between WHO, PAHO, CDC, MOH, and the Union Against Sexually Transmitted Diseases to discuss collaboration and procedures.
AIDSCAP supported the participation of professionals from the Northeast, the poorest region of Brazil.

Lessons Learned/Recommendations

Collaboration between national and international agencies, inter-regional countries and Brazilian societies were keys for the success of this conference.

Massive participation of professionals from different states and specialists was very important.

The change from STI etiologic, laboratory driven approach to syndromic approach is a long process. Brazilian professionals have shown a strong resistance to accepting the Syndromic Management of STI.

Future projects should build upon AIDSCAP experience on STIs to improve STI management in Brazil. The expertise in proper STI management from USAID-funded projects is a comparative advantage and needs to be considered in future programs.

Process Indicator Summary

Category Total

Participants 1,330
(650 female / 550 male)

Technical materials distributed 50,000

Abstracts presented 125

V^th Brazilian Congress on STI and the II^nd Symposium on Genital Ulcers and AIDS

Implementing Agency: Brazilian Union Against Sexually Transmitted Diseases

Year: 1996

Budget: 3,000.00 USD - AIDSCAP

Background

The Brazilian Union Against Sexually Transmitted Diseases, a non-profit organization, held a three-day Brazilian Congress on STIs and a Symposium On Genital Ulcers And AIDS for medical specialists, dermatologists, urologists, infectologists, gynecologists and HCP. Updated information on epidemiology, diagnosis, treatment and prevention of STI/AIDS was discussed.

There were lectures, conferences and round tables. Some of the topics were: Prevention And Control Of STI; Interaction of STIs and HIV; Sexuality and STIs; Mechanisms Of Bacterial Resistance On STI, Pappilomavirus, Genital Ulcers, Pelvic Inflammatory Diseases; Syndromic Management of STIs; and AIDS And Ethical And Medical Aspects In The Management Of STI.

Objectives

To plan, organize and conduct the V Brazilian Congress on STI and the II Symposium On AIDS And Genital Ulcers.
To share experiences with colleagues.
To improve STI management.
To discuss Syndromic Management.

Accomplishments

Planned, organized and conducted a 3-day national conference on STI/AIDS in Recife, Pernambuco, for 350 participants.
Disseminated the conference for abstracts to 2,000 BUASTI members.
Distributed 4,400 technical materials bulletins, 2,000 on STIs. A total of 800 posters were selected and presented.
Awarded the "Walter Belda" prize for the best scientific work in the following areas: epidemiology, laboratory, clinic and treatment.
Disseminated the event on the media through 10 newspaper articles, magazines, TV and radio interviews.
AIDSCAP/Brazil was part of the organizing committee and the Institute of Tropical Medicine from Belgium presented the Syndromic Management of STI.
The conference had the participation of professionals from MOH, PAHO, AIDSCAP, Universities, Argentina, Spain, USA, France and Uruguay.

Lessons Learned/Recommendations

Considering the relevant resistance to Syndromic Management, all the opportunities should be explored to disseminate the technical and specific aspects of Syndromic Management.

USAID should mobilize top senior specialists in the regions to address Syndromic Management in developing countries, especially the ones with important resistance to a comprehensive approach to STI.

Combined efforts from UNAIDS, USAID, CDC. NIH, Fournier Institute, US and European universities to recommend the Syndromic Management through articles, books, brochures, guidelines (for example CDC) are important actions to promote the STI-prevention agenda worldwide.

Process Indicator Summary

Category Total

Participants 350

IEC materials distributed 9,200

Spots on the media 10

Final Report for theAIDSCAP Program in Brazil: Subproject Highlights

Final Report for the
AIDSCAP Program in Brazil: Subproject Highlights