LIK LIK MONI, BIKPELA SIPAK

Transcription

1 LIK LIK MONI, BIKPELA SIPAK Non-commercial alcohol and HIV risk in Papua New Guinea Andrea Fischer, Centre for International Health, Burnet Institute Chad Hughes, Centre for International Health, Burnet Institute Joan Usan, Tingim Laip, Burnet PNG Judy Tokeimota, Tingim Laip, Burnet PNG

2

3 Community based HIV programs need drug and alcohol content

4 Simple and low-cost interventions work

5 4 Pillars: TINGIM LAIP 1. Condom Promotion and Distribution 2. STI referrals 3. VCT referrals 4. Supporting and caring for people living with HIV/AIDS Component 5: Drugs and Alcohol, Harm Minimization and HIV REDUCE LEVELS OF INTOXICATION TO REDUCE LEVELS OF RISKY BEHAVIOR (unsafe or unwanted sex)

6 DRUGS AND SEX About 40% of females surveyed report being forced to have sex in the last 6 months Of these cases 60% involved alcohol. l Few reported that t cannabis was involved. Alcohol l Increases sexual desires People reported engaging g g in more unsafe sex when drunk Is associated with violence Sexual violence (rape) Retaliatory t violence for sex with another s partner Increased unwanted and unplanned sex Reference: Alcohol, Homebrew, betel and cannabis: The impact of drug use in Papua New Guinea, Baldwin, S., Kolka, B. and Power, R. (draft)

7 FRAMEWORK FOR INTERVENTIONS Based on facts, not on beliefs Empowerment individual responsibility not enforcement Inclusive include drug users Multiple strategies and Multi-sectoral Realistic people e take drugs to feel good Non-judgmental Reference: Alcohol and Harm Reduction, the International Coalition on Alcohol and Harm Reduction, 2003, p.9

8 Photo: Andrea Fischer

9 EFFECTS OF DRINKING 1. Euphoria Mi hamamas tru 2. Excitement Mi hamamas lik lik 3. Confusion Mi faul 4. Stupor Mi eye raun 5. Coma Mi spak no gut tru nau mi dai 6. Death Em mi die Focus on skills s and options o to keep people e at level 1 or 2

10 OPTIONS Stay in control of your actions Reduce amount drunk Extend period of drinking Delay drinking Drinking water or coke etc Only take one drug at a time Choose a day Choose a time Encourage legal vs illegal Buddy system Negotiate sex prior to drinking Make sure you carry condoms Refuse sex with drunk client Eat food Delay age of drinking

11 Photo: Andrea Fischer

12 Photo: Andrea Fischer

13 MESSAGES Target Group Target Behavior Key Message Women exchanging Sex Unsafe Sex Sex Before Drink No Condom, no Sex Out of School Girls Exchanging sex for Luk aut I stap long yu yet beer Youth Bikpela Sipak Delay Sex, Delay Alcohol In-school boys Drinking leading to Study hard, play safe unsafe sex Delay Sex, Delay Alcohol

14 EVALUATION Qualitative focus groups with participants. p Increased awareness Willingness to incorporate messages Reported behavior change Ongoing commitment Photos: Andrea Fischer

15 WHAT NEXT? Structural change is needed to support individual behavior change and community interventions. ti Phase 2 -advocacy with donors, and commitment from communities means opportunity for further interventions

16 ACKNOWLEDGEMENT Site Committees and volunteers of: Joyce Bay National Capital District RD Tuna Factory - Madang Siar Community Madang Redscar Business Area - Madang Photos: Andrea Fischer