How effective are activities aimed at helping individuals and communities stricken by HIV/AIDS? How can their experience shape the policies of governments, donors and other helping agencies? This was the focus of recent collaborative research by the Aids Consortium, a group of 13 non-governmental organisations (NGOs) based in the UK and 19 community level organisations in Africa, Asia and South America. Their report suggests ways to improve HIV/AIDS prevention and care. They hinge on participation by whole communities in the dual process of accepting and coping.

The poorest countries and communities tend to be the worst affected by the AIDS epidemic, the more so if their troubles are set against a background of deprivation stemming from Structural Adjustment Programmes. Intended to boost national solvency by curbing public spending and direct official provision of social services, these policy packages can disrupt education, health and employment. Reducing discrimination is a key task for all agencies trying to improve the quality of life of people stricken by HIV/AIDS. Also essential is accurate information and help for those infected by the disease to fend for themselves and their families. Enabling people with HIV/AIDS to carry on working is crucially important.

Peer group pressure, counselling and family involvement can all help influence sexual behaviour and so reduce risks of disease transmission. But professional behaviour on the part of health workers or sex workers, is easier to measure and influence than private conduct. Even in areas most gravely affected by HIV/AIDS, behavioural change is limited and may be further constrained by cultural traditions. Some of the main conclusions drawn by Consortium researchers were that:

• dealing with HIV/AIDS cannot be regarded in isolation from other aspects of people's lives
• community participation is vital to the effectiveness of care and prevention programmes
• networking and referral to specialist agencies can help NGOs be more focused and effective
• local culture commands respect but risk- increasing practices should not be viewed as unchangeable
• combined service programmes, embracing both care and prevention, achieve better results
• NGOs achieve more where there is political support for their work and for people with HIV/AIDS
• community-based groups are well able to evaluate and articulate their own experiences and needs.

The report's recommendations for action by NGOs operating at community level were that they should:

• pitch programme planning beyond initial awareness-raising, to embrace all aspects of HIV/AIDS
• insist that local groups participate in planning and ranking the aims and activities of campaigns
• increase networking at local and country levels to improve co-operation and communications flow
• be sensitive to cultural differences, but aware that HIV/AIDS can change cultures and practices.

The researchers also urged UK-based agencies and support partners to:

• seek opportunities and technologies to assist local partners with research, monitoring and evaluation
• prioritise training in research (especially data analysis) and monitoring
• encourage development of local and national networking and referral systems.

For policymakers and donors, the study report's message was that:

• as HIV/AIDS affects all sectors, official responses should reward networking and cross-sector action
• self-evaluation is more auspicious for sustainable change than external or donor-led evaluations
• prevention programmes should be linked to anti-discrimination and community caring work
• funding policies should encourage co-operation rather than competition between helping agencies
• communities should be encouraged to voice their own experiences and needs and should be listened to.

Source(s):
`Effective HIV/AIDS Activities: NGO work in developing countries`. AIDS Consortium, London (1996)

Funded by: DFID and AIDS Consortium members (1993-1996)

id21 Research Highlight: 1998-August-24

Further Information:
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Contact the contributor: ukaidscon@gn.apc.org

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Other related links:
BMA Foundation for AIDS

Access to HIV treatments in developing countries >