The project is to help make impact in the lives of young people so that they can gain trust and dignity through a social development programs that will provide essential HIV prevention and Gender Base Violence activities as well as building their skills in using a participatory medium of communication. The overall goal of this proposal is to design community base programs for young women who are involve in commercial sex work on behaviour that puts them at risks to gain comprehensive knowledge that will promote Consistent condom use, HIV testing , early diagnose and treatment of sexually transmitted infection HIV another health related issues as well as empowering them with life skills programs that will serve as a model for behaviour change concerning their health through community dialogue for self-improvement in making appropriate decision with objectives like Build the capacity of commercial sex workers to negotiate safer sex practices among their peers; To reduce the number of new HIV infections among commercial sex worker population, with a specific focus on young women and girls; To protect the rights of sex workers in the society as well as encourage positive sex worker to access HIV care and treatment services and To develop advocacy materials that will reduce the level of abuse among commercial sex workers as well as addressing behaviour that put communities and populations at risk for HIV.
Introduction:
Since the emergence of the HIV epidemic nearly three decades ago, Liberia, as a member of the global community has experienced her own share of the burdens and effects of the pandemic especially in sub-Sahara Africa. This indicates that in many countries, most-at-risk populations bear a disproportionate burden of HIV epidemic where they are faced with many health risks across different populations which Liberia is no exception, where key populations are usually marginalized from accessing care treatment and support services that involved risk taking behavior as compare to other groups. Therefore, there is a need to design comprehensive framework that will introduce innovative and effective approaches for HIV prevention among key populations reflecting the 2007 population-based Liberia Demographic and Health Survey (LDHS) 2013 which reveals the total of HIV prevalence of 1.9% (2% in women and 1.7% in men.
There is also an increased evidence-based results from the Integrated Biological and Behavioral Surveillance Survey (IBBSS) among most at risk populations to determine the prevalence of HIV and syphilis, including risk behaviors, perceptions and attitudes conducted in 2013. The HIV prevalence was dramatically high among MSM (19.8%) closely followed by FCSW (9.8%), Uniform services personnel (5.0%) and Youth in school which had the lowest HIV prevalence of (1.1%) with no significant difference between male (1.3%) and female (1.0%). Similar trend was observed among OSY with the prevalence being 1.9% and no significant difference between male (2.3%) and female (1.4%). Injecting drug users were predominantly male occupational with the HIV prevalence of 3.9%, whereas Miners recorded prevalence of 3.8%.At the same time, the differences in HIV rates between female and male shows that the infection is strong in younger age groups, where the higher rate of 1.3% and 2.0% was recorded among females ages 15-19 and 20-24 as compared to 0.4% and 0.7% amongst males of the same age group, revealing females ‘higher vulnerability to HIV infection.
This also shows a global picture of UNAIDS 2016 Global AIDS update Index surveys conducted in more than 65 countries that included Sub-Saharan Africa where key population is accounted for more than 20% of new infections making HIV prevalence extremely high. Data has also proven when services are made available within an environment free of stigma and discrimination it reduces the risk of HIV and STI. However, based upon all of these findings the National AIDS Commission (NAC) and the National AIDS Control Program of the Ministry of Health (NACP) requested a third generation of the National Strategic Plan (NSP) 2015-2020 in order to identify key priority HIV and AIDS thematic elements that are evidence-based and results-driven to form the basis of developing the NSP. The NSP 2015-2020 is an expression of the Liberia’s commitment to achieving the universally desirable goal of “Zero New HIV Infections, Zero AIDS-Related Deaths,and Zero Discrimination from the MDG 2012.
It is based upon Liberian context and that the National Strategy Plan (NSP) 2015-2020 have identified priority HIV and AIDS thematic elements that are evidence-based results-driven highlighting the needs of Five high impact priority HIV activities along with selected key social and programmatic enablers to implement high focus activities targeting Behavior Change Interventions, Condom Promotion and Distribution, HIV and AIDS Program for Key Populations Elimination of Mother- to-Child Transmission of HIV, and Treatment, Care, and Support for People Infected and Affected by HIV and AIDS, as well as reviewing critical social programmatic enablers such as Laws, Policies, and Practices; Stigma and Discrimination; Political Commitment, Advocacy, and Resource Availability; Community Participation; Coordination and Management; and Research, Monitoring and Evaluation along with key selected HIV Sectors with crosscutting elements of the National Agenda for Transformation (AfT).
Background
Over two decades ago, HIV was discovered in Liberia. The epidemic has then spread rapidly since its onset. A number of socio-cultural factors and practices in Liberia have greatly influenced the spread of HIV in the country. The Liberian Demographic and Health Survey (LDHS 2007) results showed HIV prevalence rate of 1.9% among the general population aged 15-49 years. Meanwhile, the HIV prevalence is differ according to regions and counties. The prevalence of HIV is higher in urban areas (2.6%) than in rural areas (0.8%). However, the epidemic is highly situated in five (5) regions of our country, which is South Central Region that has the highest HIV prevalence of 2.75% collection for both male and female; while South East have cumulative prevalence of 1.75% and 1.3% respectively. Notwithstanding, the North West and North Central Regions have an HIV prevalence of less than 1%: North West has 0.8% and North Central has 0.7% aggregate prevalence. In terms of counties Montserrado, Margibi, and Bomi counties have the highest prevalence whilst Nimba, Bong, and Lofa Counties have the lowest. Montserrado, Grand Bassa, Margibi, Nimba, Maryland, and Bong Counties have high disease burdens and collectively account for 82% of the HIV burden in the country.
However, the government then committed to carry on full time studies in order for the country to understand the drivers of the HIV and AIDS situation using findings from the 2013 Integrated Bio-Behavioral Surveillance Survey (IBBSS)identifying certain population groupsincluding FSWs, MSM, and People Who Inject Drugs (PWID), previously known asinjecting drug users (PWIDs) as the Key Populations (KPs) driving the epidemic inLiberia. On the other hand, the result also shows the differences with in the HIV prevalence among these key and vulnerable population groups as follows: (MSM 19.8%); FSWs 9.8%; uniform services 5%; people who inject drugs %). Injecting drug users was predominantly male occupational group with the HIV prevalence of 3.9%,transport workers 4.8%; mobile traders 4.5% and miners 3.8%), making these groups to have much higher HIV prevalence relative to the general population of 1.9%. In the same vein, these studies were carried out to enhance the country’s shift programatic activities from evidence-based interventions to know the particular group of individuals responsible for the drive of the national response in directing the program activities for HIV prevention, care, and treatmen services for implementation proposes.
Meanwhile, the National Strategic Plan (NSP) also highlights the needs of Preventing HIV in Key Populations by providing HIV prevention information and services for Key Populations (Women and girls, FSWs, MSM, and PWIDs) as well as stressing condom needs for sexual reproductive health program within the general population including young people with condom compatible lubricants as part of the HIV and AIDS programs including the strengthening of key health and community systems impacting the HIV response on HIV education for in-school youth (ISY); SRH & HIV education for out-of school youth (OSY); stigma and discrimination against PLHIV and KPs that will help mitigate social economic impact on AIDS-affected households; Gender and HIV, and HIV in the workplace, formal and informal sectors of the economy.
In addition to this, the government of Liberia is still making all efforts to develop and implement social protection programs that will protect poor households including key population and those affected by HIV and AIDS in reducing the spread of HIV and AIDS in mitigating its impact by developing advocacy programs that require resources and strategies to address issues affecting these groups with HIV prevention messages and materials based on results from the IBBSS and LDHS 2013 that will promote the continuous usage of both male and female condoms, as well as working with stakeholders, community members to identify key communities that have brothels, hot spots and Ghettos to understand the organiztion advocacy mechanism that will be instituted in linking Drug users, female commercial sex workers, youth in school and out of school youth to services that could empower them in making positive decisions for HIV transmission and sexually transmission infections.
Therefore , securing the rights and empowerment of young women in Liberia is a moral commitment. It is a smart investment that will safeguard the health of young women as a way of ensuring sustainable and inclusive growth across the country. Despite the progress that have being made , young women in Liberia are still vulnerable to HIV and other social economic related issues because females by nature find themselves in a relatively disadvantaged position compared to their male counterparts making them more vulnerable to HIV and AIDS and other related illness because of the widespread cases of sexual and Gender based violence, low skills of empowerment programs for younger women, rape, early forced marriages and the increase of teenage pregnancy, in spite of government and civil society efforts that have noticeably improved HIV and AIDS related situation in the country. This tell us that we need interventions that are very crucial using community Based prevention programs that will focused onFemal sex workers(FSW), including other young women an to meet the three ZERO goal in line with MDGs aimed at improving the quality of health care by 2015 that will promote , condom use, HIV counselling and testing services that will linke Femal sex workers(FSW),including other high risk population to maintain a low HIV prevalence rate within the next six years by half in 2020 through the provision of quality and accessible HIV prevention information and services for key populations.
It is in this light that we have decided to Promote Public and Social Development Programs in Health to initiate activities that will address young women who are engage in Commercial Sex Work (CSW),with awareness and empowerment programs to implement effective community Base interventions as a means of reducing HIV infection and negorating safe sex practice as well as empowering young women in communities through motivational talk and vocational training programs to help them gain self confidence as well as allowing communities to recognize the significance of these groups in addressing HIV and AIDS epidemic and other related social economic issues. Therefore , we need interventions that are very crucial in addressing community Based prevention programs that will focused on female sex workers (FSW) about condom use, encourging them to know their HIV statue and direct them to HIV care and treatment services in order to protect themselves during sexual contacts, engage them in activities that will serve to minimize or halt the stop the exchangeof sexual work for money as well as targeting with HIV and AIDS awareness and sensitization campaigns that will help minimize the impact of HIV and empowerment programs.
Problem Statement
A number of socio-economic factors that push young women into dissparate relationship and behaviour practices that have greatly increased the highest rate of HIV infections amongst young women that have cause them to engage in commercial sex work,as well as taking in Drugs that make them to be at higher risk of HIV. Furthermore, female sex workers and their male clients are one of the most important-risk populations for HIV transmission. In addition to this, transactional sex is a common survival strategy for many young girls between the age of 15-24, where they continue to use this practice as a means of securing livelihood for themselves making them more vulnerable to HIV including their male clients. Such attitude has created social stigma, and discrimination which stop them from making decisions that affect them from acquiring information on HIV care treatment services.
Moreove , The issue of adolescent health is important especially with fertility for both health and social reasons because children born to very young mothers are at increased risk of sickness and death, making teenage mothers more likely to experience adverse pregnancy outcomes to be more constrained in their ability to pursue educational opportunities than young women who delay early childbearing.
The Intergrated Bio-Behavioural Survellance Survey ( IBBSS) 2013 report gives us a clear understanding on the different social characterstics of Most at risk population . This shows that we must pay keen attention to young women who are involved into commercial sex workdue to the high prevelance rate of (9.8%) that is noticeable among them. The prevelance rate indicates that Men who have sex with men (MSM) have the highest rate of infection of (19.8%) despite their age, education, and location. This is followed by female commercial sex worker(FCSW) with (9.8%), injecting drugs users at (3.9%) while transport workers and mobile traders stands at 4.8% and 4.5% respectively. It also shows that long distance transport workers were adolescent aged 15-19.
In addition to this, 4.7% them are legally married and 11.1% are co-habiting with their sexual partners. on the other hand, more then 62% of female commerical sex worker (FCSW) between the ages of 12-24 reflect their youthful age of being a sex worker, while their educational level is around 45.3% and 42.8%. This shows their vulnerability stems from drinking alcohol and taking other drugs on a daily basis. On the other hand, knowlege of HIV prevention among female commerical sex worker is comparatively low.
While, among Injecting Drug Users, 5.3% were aged 15-19 with more than 51.7% acquiring a secondary or higher education, 17.7% reported the use of cocaine , heroin or other related substances. Transport and migrant workers are significant of 5.7 in which long distance transport workers were adolesent aged 15-19 and the percentage of lliteracy constituted 13.4 and 27.5% respectively. In addition to this , a minimum of 88% and maximum of 94% of the targetd populations reported having ever heard of HIV or AIDS , while these proportions are vey similar to those reported in the Liberia Demongraphic Health Survey ( LDHS 2007) and could be seen as high, they remain low as compare to other neighbouring countries.
Moreover, knowledge about the prevention of mother to child transmission during pregency was very low among all of these key groups, but, all target audience had knowledge of voluntary Counselling and Testing (VCT) sites in their communities except for female commerical sex worker (FCSW ) with very low rate at 28.2%, in which they are not knowledgble about the medication of HIV Care treatment and treatment servicses to improv the health of PLWHA.
However, these particular population groups are highly vulnerable to HIV infection because of their behaviour practices. The results also showed low level of knowledge of specific places to access male and female condoms, apart from medical institutions (hospital and pharmacies) In addition to this, It was striking to note that the highest percentage of (13.1%) of misconception that HIV can be cure by having sex with a virgin was recorded among commercial sex work (FCSW) as well as not being informed about treatment care and support services and the linkage to health facilities where they can seek help and get medication sensing its importance in the society today.
It has being concluded to us that HIV prevention may be very focused in health/medical infrastructures and not much at the community level. as well as taking in Drugs that make them to be at higher risk of HIV. Furthermore, female sex workers and their male clients are one of the most important-risk populations for HIV transmission. In addition to this, transactional sex is a common survival strategy for many young girls between the age of 15-24, where they continue to use this practice as a means of securing livelihood for themselves making them more vulnerable to HIV including their male clients. Such attitude has created social stigma, and discrimination which stop them from making decisions that affect them from acquiring information on HIV care treatment services. However,the Intergrated Bio-Behavioural Survellance Survey ( IBBSS) 2013 report gives us a clear understanding on the different social characterstics of Most at risk population.
This is followed by female commercial sex worker(FCSW) with (9.8%), injecting drugs users at (3.9%) while transport workers and mobile traders stands at 4.8% and 4.5% respectively. It also shows that long distance transport workers were adolescent aged 15-19.etc in order that these populations protect themselves during sexual contacts, engage in activities that will serve to minimize or halt the use of of drugs, prostitution and other related substances, and minimize or. Targeting communities with HIV and AIDS awareness and sensitization campaigns will help minimize the impact of HIV and ensure that populations and communities are aware of HIV prevention and empowerment programs. These will further buttress the HIV national response in Liberia with efforts to address causes and effects of HIV and AIDS transemmision in a more effective and sustainable manner.
This shows that we must pay keen attention to young women who are involved into commercial sex work due to the high prevelance that put them at rate (9.8%) that is noticeable among them, it shows that we needs proper intervention in communities targeting commercial sex workersand other young women in areas of kioks, brothels/hotel, night clubs; shops and workplaces targeting communities with HIV and AIDS awareness and sensitization campaigns that will help minimize the impact of HIV and promote condom use and promotion, VCT, PMTCT , Care treatment and support services that will promote behaviour change and life skills program in a more effective and sustainable manner through PROMOTING PUBLIC AND SOCIAL DEVELOPMENT PROGRAMES IN HEALTH (PPSDPH).
Mission Statement
The mission statement of Promoting Public and Social Development Programs in Health (PPSDPH) is to help make impact in the lives of young people so that they can gain trust and dignity through a social development programs that will provide essential HIV prevention and Gender Base Violence activities as well as building their skills in using a participatory medium of communication.
Core Values:
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- Working with communities
- Dignity, respect and sensitivity to people values –
- To be a team player with mutual information sharing
- Building knowledge to open up opportunities
- Fairness and transparency in our implementation process
- Quality services to all of our partners and recipients
- Show respect for our culture heritage
Focus areas:
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- Health
- Promotion of HIV and AIDS awareness activities
- Sexual Exploitation and Abuse, Sexual Gender Base Violence (SGBV) and child protection
- Development of health communication materials
- Hygiene promotion
- Governance and rule of Law
- Event Planning, arranging of meetings and workshops
- Agriculture programs and Livelihood
Goal
The overall goal of this proposal is to design community base programs for young women who are involve in commercial sex work on behavior that puts them at risks to gain comprehensive knowledge that will promote Consistent condom use, HIV testing , early diagnose and treatment of sexually transmitted infection HIV and other health related issues as well as empowering them with life skills programs that will serve as a model for behavior change concerning their health through community dialogue for self-improvement in making appropriate decision.
Objectives:
The objectives of this organization will address these key priority areas :
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- Build the capacity of commercial sex workers to negotiate safer sex practices among their peers
- Foster activities that will link commercial sex workers to HIV Volunteer Counselling, and Testing, PMTCT, Care Treatment and Support services at both the facility and community levels.
- To reduce the number of new HIV infections among commercial sex worker population, with a specific focus on young women and girls
- Work along with community members for strong condom distribution network.
- Build the capacity of commercial sex workers to serve as peer educators to crate HIV/ AIDS awareness among high risks population
- Work along with stakeholders and community members to understand the advocacy program that will be introduced in their communities.
- To protect the rights of sex workers in the society as well as encourage positive sex worker to access HIV care and treatment services
- To develop advocacy materials that will reduce the level of abuse among commercial sex workers as well as addressing behavior that put communities and populations at risk for HIV
- To build a link for most at risk population and community members to access health facilities for care and treatment services
- Holding monthly meetings that will take them through mediation and step up those problems that will address their attitudes for information sharing and lesson learn.
- Provide commercial sex worker with Motivational Talk for those who are need of transformation for self-improvement to stop prostitution for behavior change
- To raise awareness among young women about HIV prevention and treatment on local radio station
- To provide HIV discussion clubs established for awareness raising on HIV prevention and stigma reduction
- To increase the abilities of young women in specific geographical locations (locations with very high prevalence rates) to reduce behaviors that put them at risk for HIV infection.
Outcome(s): Equip Sex worker with skills to access user friend services that will help increase the uptake for safe sex pratices and the provision of vocational training to help create opportunities for alternative income for behaviour change.
Increased health education amongest Female Sex workes including other s high risk population as well as allowing communities to have knowledge on the significant role these group plays in reduceing the rate of HIV in our society.
Sustainability of the Project
The organization will implement lessons learn from the project implementation that will promote local participation of all stakeholders in taken up ownership for development processes, this will ensure the unique partnerships and resilience of longevity after project phase out. This will also help us to maintain whatever resources acquire as a blue print to expand ongoing findings from local partners in supporting girl’s knowledge on HIV prevention and build their capacity in generating income for great empowerment and sustainability in their attitudes and project.
Implementing partner(s) Promoting Public And Social Development Programes In Health (PPSDPH)
The organization shall conduct STI /HIV and AIDS awareness among commercial sex workers in eight (8) communities with in Montserrado county and link them to HIV Volunteer Counselling and Testing, Care Treatment and Support services as well as negotiating both female and male condom use in makeing positive decisions for behavior change and introducing them to vocational programs such as skills building that will help them enhance their skills to generate income and develop their confidence inorder to maintain a healty life style.
Strategies
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- Strengthen collaborations amongst stake holders at the community levels
- Strengthen and Provide support for the networking among implementing communities
- Training of commercial sex workers, community leaders, and hot spots owners as focal person for HIV prevention activities
- Mobilizing communities’ leaders to participate in HIV prevention activities to address the behavior of commercial sex workers
- Mobilizing commercial sex worker to be trained as peer educators
- Recruiting commercial sex worker to be trained with life skills programs that will be utilized for self-improvement and economic empowerment.
Process of Evaluation
The Organization will ensure that funders examines the implementation of the project during the different program activities that will be delivered.This will include all documentations,timeframe,reporting system on the different activities . The organization will follower these procedures to determine how well the project was managed with appreciated feedback to project staff and funders, which will demonstrate on how activities were carried out as well as the impact on the targeted population. Moreover, this will strengthen the organization’ ability to run successful projects; and provide evidence of achievements.
