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Population (2001): PROJECT TITLE: Behaviour change communication for HIV/AIDS prevention among young people

36 million

IMPLEMENTING BODY: Chama Cha Uzazi Na Malezi Bora, National Family Association of Tanzania (UMATI)

Urban population (2000):

AIM: To reduce the incidence of HIV infection among young people aged 10–25 in Mwanza City


Literacy level (1997): 73%

The HIV/AIDS prevalence rate in Tanzania is high and trends indicate that despite a great deal of effort it is still rising steadily. The highest growth rate is among young people. In 2002, UNAIDS estimated that more than 15 per cent of Tanzanians aged 15–49 were HIV positive. Given huge gender inequality in the country, far more women than men are infected. In response to the growing crisis, health workers turned their attention to developing youth-centred projects in Tanzania. The IPPF Member Association in Tanzania implemented a youth-focused project which emphasized the importance of behavioural change communication for young people in 2002. The initiative aims:

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GNI per capita (1999): US$260

Life expectancy (1995–2000): 51 years

Infant mortality (1995–2000): 81 per 1,000 live births

Adult HIV prevalence (end 2001): 7.8%

to reduce the incidence of HIV infection among young people aged 10–25 to influence the behaviour of youth in Mwanza City through communicating the risks of multiple sexual partners

Social and cultural practices and beliefs affect young people’s vulnerability to HIV/AIDS. In Mwanza City, for example, it is reported that children become sexually active very early. The practice of having multiple sexual partners is socially accepted; older men seek out young girls and many subscribe to the belief that sex with a virgin will cure them of HIV/AIDS. Customs governing widows' inheritance also makes young people vulnerable.

Youth (15–24) HIV prevalence: 6.7%

Community participation and collaboration resulted in the

GETTING THE FACTS STRAIGHT Accurate data is essential if HIV/AIDS initiatives are going to be effective. Understanding youth behaviour – and the things that influence them – is critical if HIV/AIDS projects are to prove relevant and appropriate. Research done by the Mwanza City project found that 40 per cent of youth were not using condoms. It also revealed that girls feared unplanned pregnancy more than HIV/AIDS, which was seen as a more distant threat. Young people said they first had sex at around eight or nine years old and that the level of

HIV/AIDS knowledge and awareness of parents was limited.

increased awareness of the broader community. The active participation of youth, the local community, religious leaders and NGOs based in the city was, according to the project

STRENGTHENING YOUTH-FRIENDLY FACILITIES The Mwanza City project based at the family planning clinic hoped to work with youth to increase health-seeking behaviour, reduce the number of sexual partners and increase the correct use of condoms. The project strengthened youth-friendly services by building the

evaluation, a "distinct strength" of the project.

THE INTERNATIONAL PLANNED PARENTHOOD FEDERATION (IPPF) is a global network of Member Associations in 148 countries and the world's foremost voluntary, non-governmental provider and advocate of sexual and reproductive health and rights. IPPF envisages a world in which every woman, man and young person has access to the information and services they need; in which sexuality is recognized both as a natural and precious aspect of life and as a fundamental human right; a world in which choices are fully respected and where stigma and discrimination have no place. 1

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"A major benefit of the programme is that, although it targeted youth at risk, it also included the whole society so everybody could benefit." Parent in focus group, Temeke Youth Centre.

"To reduce vulnerability to HIV/AIDS, individuals and communities need three things: the basic

capacity of 12 service providers from health facilities across Mwanza City and developed the capacity of key collaborators in the community to support and deliver information, education and services. Twenty teachers in 11 schools across the city were also trained to provide information on an ongoing basis. A range of key activities was implemented during the project.

facts to understand the urgency of the epidemic, access to appropriate services and an environment supportive of changing and/or maintaining safe behaviour." Judith Dorrell, evaluator,

DEVELOPING RELATIONSHIPS AND COMMUNITY SUPPORT Community participation and collaboration resulted in the increased awareness of the broader community. The active participation of youth, the local community, religious leaders and NGOs based in the city was, according to the project evaluation, a "distinct strength" of the project.

POSITIVE OUTCOMES REPORTED Although more follow-up is needed, early anecdotal reports suggest that the project led to positive outcomes, including a reduction of teenage pregnancy.

Mwanza City, 2003.

"The AIDS epidemic forces societies to come to terms with the


perceived ideals of traditional cultures and the harsh realities of practices that are discordant with those ideals. Behaviour change communication plays a vital role in this process and can set the tone for a compassionate and responsible response."

COMMUNITY PARTICIPATION It is vital to sensitize the community and to work with key groups like religious leaders. CAPACITY BUILDING The specific HIV/AIDS training needs and competencies of the staff should not be overlooked, particularly in order to strengthen integration linkages. Sufficient time needs to be allocated to training and to sensitization processes. STRENGTH THROUGH PARTNERSHIPS Networks and partnerships resulted in opportunities to work closely with other NGOs working in HIV/AIDS, so benefiting from their expertise and knowledge. TREATMENT OPTIONS Advocacy for VCT would be much more successful if treatment and support was available following a positive diagnosis.

Judith Dorrell, evaluator, Mwanza City, 2003.

JAPAN TRUST FUND FOR HIV/AIDS (JTF) is IPPF's first fund established exclusively to support the HIV/AIDS prevention programmes of its Member Associations. This is funded entirely by the Government of Japan and is a key instrument in IPPF's response to HIV/AIDS. The objective of the JTF is to enhance the institutional capacity and managerial skills of IPPF and its Member Associations in Africa and Asia to carry out effective and innovative prevention and care programmes for STI/HIV/AIDS. Since the establishment of the JTF in October 2000, 32 Member Associations in Africa and Asia have received support from the fund to implement a total of 64 projects. 2