Successful HIV prevention is about social change. For advances in HIV medicine and health care systems to benefit those affected by HIV, there must first be an awareness of the disease and a shift in the social acceptability of the disease and those living with it. 'Breaking the Silence' will focus its dissemination of HIV information through the engagement of different forms of media and the arts in a strategic effort to reach as many people in Andhra Pradesh, Karnataka and Maharashtra State as possible.
S.A.F.E. is an organization that uses theatre, combined with community activities and education, to deliver life-saving information about HIV/AIDS to the most under-served populations in Kenya. Keep a Child Alive has previously supported S.A.F.E.'s invaluable work in Kenya, and this commitment marks the joint effort of both organizations to expand our work into India.
S.A.F.E. has developed an effective and cost efficient public health education model that provides information and skills in a way that is sensitive to the needs of specific groups and cultures, and is applicable to real life decision making. The model extends the education beyond the individual to engage communities, organizations and institutions in positively shaping public opinion and action related to HIV.
In each state, S.A.F.E. will create a theatre company and develop the education training for key groups, including health care providers, policy makers, teachers, community based organizations, and local theatre groups. Then, S.A.F.E. will commence a theatre tour in each state to raise awareness and increase general knowledge about HIV among rural communities, as well as train selected groups to increase their capacity to bring about the social changes necessary to keep HIV contained.
S.A.F.E.'s implementation strategy is embedded within the populations with which they work. By employing local communication traditions, local languages and local staff, they ensure that no population is alienated from the program. Having worked with communities to overcome the factors that inhibit the prevention of HIV and that promote discrimination, S.A.F.E. is able to bridge the gap between populations and health services and to build the social infrastructure required to contain the HIV epidemic.
Keep a Child Alive's awareness expertise lies in identifying who and what speaks best to mass audiences. Therefore, Keep a Child Alive will organize a media campaign around the television cast of 'Friends,' and create public service announcements with these influential actors that encourage people in India to 'be friends with people living with HIV,' engendering openness towards the issue of HIV and those affected by it. Keep a Child Alive will also engage Bollywood stars in this media campaign, utilizing their celebrity magnetism to encourage audiences to pursue testing and treatment for HIV, and join the mission to eradicate stigma in India.
Keep a Child Alive is uniquely placed to galvanize popular public figures to speak out and break the debilitating silence and generate leadership amongst people in a position to influence public opinion. S.A.F.E. is able to capitalize on this social leadership demonstrated by public figures and create the infrastructure required at a community level to bring about the necessary social change to overcome HIV stigma. This momentum on the ground will happen through education, mixed media public awareness campaigns (theatre, radio film - making HIV awareness a part of the fabric of life), and training to increase the capacity of people to sustain such social change.
Through partnerships with civil society organizations and the public and private sectors, Keep a Child Alive anticipates reaching 33 million people over a period of five years. Through S.A.F.E.'s empowerment initiatives, they anticipate reaching more than 10,000 women and girls by training commercial sex workers as health educators and peer counselors and identifying alternative income generating activities to support these women and their daughters. S.A.F.E. anticipates training 1800 local health care workers to ensure that people living with HIV/AIDS are not discriminated against when they receive the care and treatment to which they are entitled. Keep a Child Alive also expects local health services to experience a 200% increase in the number of people accessing HIV testing and treatment services and a 100% increase in enrollment in treatment programs and adherence to treatment. They intend to provide new access to health services to 3 million people in India via S.A.F.E.'s mobile clinics that will operate in conjunction with the theater tours and community outreach program.
India's population is 1.48 billion, and it is home to one in eight of the world's people living with HIV. NACO (National AIDS Control Organisation) in India estimates that only 10-20% of people living with HIV in India is aware of their status. HIV in India is considered a contained epidemic because its highest prevalence rates are among specific high risk groups, including commercial sex workers and injecting drug users, in geographically discrete areas. However, the sheer size of India's population, its population density, and the mobility of its population makes immediate action imperative to prevent a generalized HIV epidemic.
The fierce stigma against HIV in India is having devastating effects on its population. It is commonly perceived as 'another man's problem,' and those infected and affected by the disease face social isolation and abandonment. The high HIV prevalence rates among high risk, socially marginalized groups further compounds the stigma associated with all people affected by HIV. Stigmatization and the fear of discrimination prevents a majority of people from getting tested for HIV, disclosing their HIV status, and receiving treatment and care to live with HIV.
Stigma and discrimination against HIV exists among all demographics and institutions in India. Even the health sector, which is instrumental in forming public opinion about HIV, is itself riddled with misconceptions about the disease, often leading to intense discrimination against HIV positive patients (UNAIDS). This leaves little scope for the general public to be well informed, compassionate and protected.
The silence surrounding HIV in India prevents comprehensive education, perpetuates misconceptions, and enables institutions, communities and individuals to absolve themselves of the responsibility to act. Creating an environment in which HIV is visible and can be discussed without fear of retribution, in which people can access information and are supported to change behavior, is essential to managing HIV in India (UNAIDS).
This commitment's timing is crucial for India. Recent history in Western Europe and North America shows that large scale HIV prevention campaigns can contain the spread of HIV and mitigate the devastating impact of HIV. Prevention programs need to be complemented by the appropriate investment in effective health services, but until people have the knowledge and skills to make positive health decisions, the life-saving HIV treatment and care will remain under-utilized.
HIV must be recognized as a collective problem, a tragedy that transcends socio-economic status, in order to galvanize the political and social will of the general public to overcome the disease. Individuals, organizations and institutions must be equipped with the information and skills to address HIV and understand the social, health, economic and political inequalities that foster its persistence, in a national effort to prevent India from becoming the site of the worst health epidemic in the world. 'Breaking the Silence' will create public awareness about HIV in India through a dynamic arts and media initiative, providing people with the knowledge, skills and momentum they need to take preventative action against HIV in their communities.
SEEKING: financial assistance, implementing partners, media and marketing opportunities. Seeking financial resources to support the operational costs of the prevention campaign covering three states in India for the period of 5 years with the objective of creating a model of best practice in the area of public health education. By engaging the national media (print, audio, TV, film and the Arts), national health and education providers this model can then be replicated and delivered across the country by national partners at a marginal cost.
OFFERING: implementing partnership, best practice information, media and marketing assistance. Depending on the organization/individual seeking partnership, almost all of the above could be offered. Keep a Child Alive can be an implementing partner in India as specialists in treatment and care for people living with HIV/AIDS. They can provide, as a result, Best Practice Information. Furthermore, KCA can provide media and marketing expertise to develop an effective awareness initiative as per their commitment work plan.