PRESENTED BY ALICE ANIKA ACU COORDINATOR PWANI UNIVERSITY

PRESENTED BY ALICE ANIKA ACU COORDINATOR PWANI UNIVERSITY

Introduction Background information Justification of the problem Objectives Methodology Expected output and indicators Conclusion

Pwani University houses a population of about 5000 students and about 500 staffs. The majority of youths from this University are among Kenyans aged 15-24yrs. This group is among the youth in general who have been identified particularly as vulnerable to HIV infections, sexually transmitted diseases, alcohol and drug abuse and related health issues in Kenya and in other regions of the world. (NCAPD, 2005).

Over the past two decades, Kenya s Ministry of Health has recognized that reproductive health among youth requires specialized attention, and has worked to develop policies that support youth-friendly sexual and reproductive health services. New HIV infections among Kenyan youth continue to be high despite government-led efforts. It still requires further action to improve the socio-economic situation of youth in order to see results on the HIV front.

Pwani University joined the nation at large in the call to fight HIV and AIDS prevalence and infection which was threatening the human kind. The move was also an attempt to protect the PU fraternity against the scourge that was directly affecting the Kenya nation at large. (1999 Presidential declaration of HIV/AIDS as a national disaster) It was also aimed at bringing about behaviour change among the community of PU.

CATEGORY DATA SOURCES 1) GLOBALLY AIDS related deaths 2M GLOBAL AIDS REPORT 2011 ON ARVS 12M,, 2 SUB-SAHARA AFRICA WHO 2011 AIDS related deaths 15M,, On ARVS 5M,, 3) KENYA CIA WORLD FACT BOOK 2013 PREVALENCE RATE 7.4% reduced 6.3% currently to 5.9% UNAIDS 2012, WHO,UNICEF ON ARVS 432,621 GLOBAL HIV AIDS

HIV awareness level is reported at 80% in many survey studies;, KDHS, 2007; KAIS, 2008; ACU PUC, 2010; UoN, 2009; KU, 2008, baseline survey,unesco global universities response survey, (2007). However the knowledge by itself does not always lead to lower rate of transmission. Many people find it very difficult to change their sexual behaviors even though they are aware that the major form of HIV virus transmission is through unprotected sex.

PLACES CATEGORIES DATA SOURCE GLOBALLY PLWHI 7.3M UNAIDS 2011 SUB-SAHARA AFRICA WOMEN 4.5M,, MEN 5.4,, NEW INFECTION 41% UNAIDS 2011 PLWHIV 3.3M,, WOMEN 76%,, KENYA HIV INFECTION 45% UNICEF 2011 ORPHANED 47% Kenya National Bureau of Statistics, 2010). WOMEN 4.3%,, MEN 3.7%,, KILIFI COUNTY PREVALENCE 3.2% District health information system

Pwani University having been situated at the coast region and at the foot of tourist attraction resorts is bound to attract the students into various activities which might put them at risk. Coast region receives both local and international tourists. Therefore the environment poses a holiday feeling which attracts risky sexual behaviors, commercial sex workers, men having sex with men, multiple sex partners and immigrant workers. Therefore the cosmopolitan environment calls for serious awareness campaign to enhance behavior change among the youth in the university

o PU ACU was established in 2010. o Since the conception of the University s Sub-ACU, the unit has achieved; The establishment of a VCT unit to promote the knowledge of HIV status, Developed work place policy, Carried out baseline surveys both for HIV and ADA, Education on family planning and reproductive health. Campaign awareness to educate members to access free VCT services, PMTCT, PEP, CT, VMMC, condom distributions Made Referrals ; for ARVs, drug addiction, VMMC,PEP, PMTCT,STIs Screenings. Developed IEC materials. These facilities laid a fertile ground for funding.

The relationship between a nation s development and the health of the young people is of paramount concern to any institution. The youth population forms the human resource body who contributes to the subsequent economic development of the country and across the continent. The youth are a critical resource to African nations and represent an untapped source of creativity and ingenuity for employment opportunities and social services which have been seen for along time as an economic burden. There is need to run HIV/AIDS programmes to deter the youth s focus from risky sexual behaviors which may expose them to HIV infection and drug addiction.

The UN General Assembly Special Session on HIV and AIDS had also pledged to reduce HIV prevalence in young people by 25 % by the end of 2010-2015. The realization of this achievement brings NACC and Commission of Universities together for total fight against the scourge and the vision 2030 agenda. Many countries including Kenya have worked to meet these targets and made health services and behavioral messages more accessible to the young people. However, global HIV prevalence report (2012)among the youth had only fallen by 12 % (UNICEF, 2012b).

Another strategy was developed in 2010 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) called Getting to Zero. This new program acknowledged the inadequacy of prevention efforts among the youth, and a new goal was introduced: to reduce new infections in young people by 30 percent by 2015 (UNICEF, 2011b). The ACU Programmes are therefore geared towards supporting the above commitments in reducing HIV prevalence among the youth.

Education remains the most effective dosage to bring about behavior change among the youth since it provides young people in particular with the knowledge values and skills which should empower them to make healthy decisions. It is important to note that the observable behaviors of the youth in the university is characterized by; high poverty level, poor skills in sex negotiations, lack of exposure, alcohol and drug abuse, multiple sex partners, unprotected sex and I don t care attitude. These characteristics calls for healthy positive behavior change among the youth.

To bring about behavior change among students,staffs and immediate university community by informing, educating, protecting and providing care to those who may either be infected or affected with HIV and AIDS while providing guidelines on how to develop, facilitate, and implement relevant interventions approaches with HIV/AIDS database and alcohol and drug abuse.

1) Create educative campaign awareness among the PU and the university immediate community to bring about behavior change through activities such as ; VCT, referrals, PMTCT, condom distribution, development and distribution of IEC materials, video shows, Moon light and students HIV open days, fun day 2) Conduct outreach activity. 3) Conduct training and workshops for peer educators as trainer of trainers induct lecturers in curriculum mainstreaming in HIV and AIDS, alcohol and drug abuse. 4) Provide bursary to the students who are affected and infected.

The study used descriptive survey research design to yield qualitative data. The resulting indices are reflective of various indices on effect of behavior change activities at Pwani University. The survey was viewed as the most appropriate design since it allows the gathering of baseline information on the success and effectiveness of the programme.

Questionnaires Interview schedules., Content analysis of the PSI technical reports for the three quarters approved and forwarded to the relevant organisations

A total sample of 350 participated in the study From the population of 535 employees, a sample size of 50 was selected to participate. The participating employees were departmental representatives and other teaching and non-teaching staffs. 300 questionnaires were administered to students. 150 to peer educators and 150 to the other students. Stratified random sampling technique was used to select the respondents.

NO CATEGORY POPULATION SAMPLE SIZE 1 ACU STAFFS 3 3 100% 2 DEPRT REP 30 17 100% 3 LECTURERS AND OTHER STAFFS 535 30 80% 4 PEER EDUCATORS 150 150 90% 5 OTHER STUDENTS 3850 150 80% TOTAL 4535 350 RESPONSE RATE

0BJECTIVES ACTIVITIES INDICATORS 1. Education VCT, Referrals, Condom distribution, IEC material, video shows, orientations/speeches, live testimonies, Moonlight, Students fun day 2.Training training peer educators and staffs HTC record book % returns, Referral book, No distributed, No developed &distributed, The film, no attendants, Pictures attendance, participants, No counseled and tested, Invited guest, report. No of trained staffs 3. Outreaches VCT services No counseled and tested 4. Support Bursary for students No of students awarded bursary

TECHNIQUE Questionnaire Interview schedule Content analysis (PSI technical report) Data from students, peer educators, ACU departmental representatives and staffs on the funded activities. Data from the ACU management on the funded activities Planned, actual and cumulative data from the ACU funded activities

Activities for Behavior Change Baseline Respondents Evaluation Results Awareness 95% VCT 85% Outreach 70% Training 90% Support for Affected and Infected 80% Average 83%

PSI TECHNICAL REPORT This report captures the various activities carried in relation to behavior change in HIV prevention. The analysis shows the following:

Activities Planned Actual Variance SUPPORT FOR THE AFFECTED AND INFECTED 100 100 0 TRAINING 165 165 0 OUTREACHES 300 450 150 AWARENESS -Condom distribution 10,000 10460 460 -Video show 200 300 100 -moon light 500 620 120 -IEC Materials 7500 7500 0

Condom distribution went up. Sensitization is high Moonlight VCT did very well and it was most liked by the PU community Training was well attended at 100% Outreaches had its own challenges which were not catered for in the budget but it posed a unique experience of serving the community from joined efforts by various stake holders. There is need for continuous reaching out and follow up.

YEAR STUDE NTS POP TOT NO COUN SELLE D HIV STATUS MALE FEMALE + - + - 2010 3180 409 O 208 0 201 0 2011 3500 502 1 268 3 230 +4 2012 3800 1200 5 400 8 800 +13 2013 3900 408 3 212 5 188 +8 TOTAL 9 1088 48 1419 TOTAL +25-2507

YEAR STAFF POP TOT NO COUN SELLE D HIV STATUS MALE FEMALE + - + - 2010 150 7 O 2 0 5 +0 2011 300 19 1 10 2 6 +3 2012 500 218 5 101 7 100 +12 2013 517 34 3 15 4 12 +7 TOTAL 9 128 13 123 22 TOTAL +21 TOTAL Staff 21 and students 25 = + 46

What were the performance gaps and causes of these gaps? Activity Area Lecturer s training Acquisition of other project items- Causes of Gaps Delay in release of funds interference with University Calendar Procurement procedures

Over 60% of the respondents stated that the resources were adequate. The resources were in the form of: Managerial support and decision making Procurements procedures Transport Conducive environment

Improvements Activity Improved Performance as per the target TOWA Funding Funding - PU Funding Funding 60% Behavior Change Communication Activities Condom Distribution 100% (actual10460; target of 10,000) VCT Target met of 1740 IEC MATERIALS 100% (4500) REFERALS Support for the affected Training Outreach 100% (207 referrals) 100% (100 students funded) 100% (165 target met) Planned 2; Met

80% of the participants consented that the programme is important and the government should continue funding it. 80% fro peer educators responded suggested inclusion of peer educators 70% asserted that more funds should be directed to this programme because they were able to get bursary fee from it without stigma and discrimination because the funding process was very well handled by the committee unlike the CDF funds.

76% Felt that there is increase in demand as the University population has increased over the years to the current level of 4000 students and 500 staff members by 2013 78%The communities in the neighborhood have showed increased interest and need for ACU services and follow up should be done 75% Felt that next funding should support research based funding with the university immediate community and agricultural production efforts to boosts nutrition for those infected and affected

Accessing ARVS immediatly Delay in release of funds Stigma and discrimination Overwhelming demand of follow up in outreaches Need for more trainings.

More ACU personnel to be recruited due to increased demand More training for peer educators staff and students on basic skills to handle their peers ARVs should be availed at the clinic Funding should be released early to go by the university academic calender Activities should start early at the beginning of each academic year Intensify outreach programmes

More support for affected and infected Campaign against Alcohol and Drug Abuse (ADA) should be intensified Intensify work on weird sexual behavior such as: men who have sex with men Bench mark with other universities Target churches and mosques Further management trainings on mainstreaming should be conducted to strengthen the coordination of the programme

Prevention works but a lot of support and funds not enough, The most vulnerable to infection and marginalized groups are more likely to fall beyond the realm of prevention efforts if attention is not given to them There must be a balance and link between prevention, care and support if we must reap large social and economic benefits of this country, sustain and develop positive human resource for this country. The provision of effective treatment care and support strengthens prevention efforts and help reduce prevalence rate among the youths. Investing in prevention among young people offer great hope for altering the course of the epidemic and saving the nation future human resources. Behavioral change and cultural transformation most often is not automatic as a challenge but continued education is key. Poverty among students is still a major big challenge and there is need for support of funds to provide bursaries. until povert is reasonably alleviated the spread of HIV and AIDS cases will be on the increase.

The outcome of this study has indicted that behavior change process can facilitate the reduction of HIV transmission and AIDS among the youth in the universities since it has proved to be an effective tool for dealing with youth health and academic related problems. Attitudes and behavior towards sexual issues amongst young people is still largely unchanged despite various communication strategies. Each semester counts its causality. Despite the favorable response from participants about the programme, there is still low accessibility of the VCT by the students and staff population. Studies should be conducted to find out students attitude and perception in accessing the VCT services, effective language use in HIV and AIDS prevention and control.

THANK YOU