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Final Report for the AIDSCAP
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Table of Contents I. Country Program Description
III. Non-Subproject Highlights Tourist Industry - COVICOSIDA
Background COVICOSIDA is a non-profit organization, created in 1988 by community members concerned with the spread of HIV/AIDS. COVICOSIDA targeted hotel employees who worked in the tourist industry of the Puerto Plata region. Two subagreements were carried out with COVICOSIDA to implement these interventions, one a continuation of the other. The Puerto Plata region encompasses a population of 230,000 people. It has a thriving tourism industry receiving some 500,000 tourists per year. Following the growth in tourism, a growth in the commercial sex industry has been evidenced as the Dominican Republic was promoted overseas as a "sex paradise." COVICOSIDA conducted a KABP study of hotel employees to assess HIV infection risk. Of those interviewed, 15.2 percent reported having had a history of STI, and 78.6 percent exhibited high risk behaviors. Most of these employees lived in zones with high levels of commercial sex work. Only 25 percent had knowledge of STI/HIV/AIDS transmission and prevention measures. The purpose of the first project (FCO#53452) was to reduce high risk behaviors among hotel employees (i.e. activities, housekeepers, waiters, maintenance and security personnel) in 13 hotels located in the Playa Dorada tourist complex. The second stage of the project (FCO#63447) built upon the work done before. It focused on the development of a marketing strategy, which established guidelines for a fee for service program to secure sustainability beyond the life of the AIDSCAP project. Objectives The main objectives of the educational intervention were to 1) increase knowledge and prevention behavior among hotel staff ; 2) increase condom use among the target population ; and 3) reduce the number of the hotel staff's non-regular partners. Accomplishments COVICOSIDA recruited, trained and updated a total of 35 workers (16 women and 19 men) in order to maintain a network of Health Messengers and Volunteers. These workers were trained in both the project design and HIV/AIDS prevention techniques. Project educators also learned about condom logistics and condom social marketing. With this sound training, the COVICOSIDA team developed innovative approaches to educating its target audience. For instance, provocative theater was used to reach hotel employees. Spontaneous discussions were generated on HIV/AIDS prevention and project educators would answer questions and hand out educational materials and condoms. Other employees were contacted during their breaks or at hotel sponsored meetings. COVICOSIDA's educators and health messengers reached 9,822 employees and hotel managers (4,417 women and 5,405 men). Educational materials were specifically adapted to the target audience and included posters, fliers, flipcharts and STI pamphlets. Over the LOP 9,171 educational materials were distributed. COVICOSIDA complemented its behavior change communication activities with a condom social marketing plan. An inter-institutional agreement with public clinics in the region to ensure provision of STI services to the target population was signed. With AIDSCAP/DR's technical and financial support, COVICOSIDA developed a marketing strategy for the program. The main thrust of the strategy was to persuade hotel management to assume the financial responsibility for the HIV/AIDS prevention services. This was one of the steps needed to ensure project continuity beyond the life of the AIDSCAP project. A marketing piece including information on the program, HIV/AIDS and the socioeconomic impact of HIV/AIDS on the tourism sector was also developed in support of the marketing strategy. Constraints Although COVICOSIDA exceeded its expected outputs for the project, it reported some constraints to implementation. Reaching the hotel mid- and high-level managers was difficult. This caused delays in planned activities while the NGO tried to win the managers' support. Other delays occurred due to internal labor difficulties and to disruptions caused by the presidential campaign of 1996. Also, budget limitations restricted the number of educators to three, when there was need for five to facilitate implementation. COVICOSIDA also found that given the high staff turnover in the hotel industry, project indicators which required increases or improvements greater than 20 percent were unrealistic and unattainable due to the inability to conduct follow-up activities with the same employees. Findings and Recommendations COVICOSIDA found that it was critical to leverage support of hotel management in order to get time allocated for educational activities. Attempts to meet with general managers failed. A viable alternative which COVICOSIDA strongly endorses is to approach human resource managers. These were invited to attend workshops on how HIV/AIDS affects the workplace. Contacts were also established with the Hotel Owners Association. All this contributed to increased managerial involvement during the second phase of the project. Taking advantage of weekly hotel departmental meetings to plan interventions, distribute materials and condoms were part of COVICOSIDA's strategy. Monthly "employee of the month" celebrations also proved to be excellent opportunities to educate. COVICOSIDA offered several recommendations for future interventions. First, government officials should be involved when marketing projects. Their status could help gain access to corporate managers and secure funding for activities. More research should be done to identify the barriers that prevent women from accepting safer sex measures. A condom distribution network should be maintained which includes a network of hotel employees, since they have extensive contact with foreign tourists. COVICOSIDA strongly recommends maintaining continuous educational interventions to avoid loosing trained personnel due to high turnover.
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