E.P.H.C RURAL TANZANIA REPORT KAHAMA HIV/AIDS HIGH RISK GROUPS TRAINING FORUM

E.P.H.C RURAL TANZANIA REPORT KAHAMA HIV/AIDS HIGH RISK GROUPS TRAINING FORUM 2 nd DECEMBER, 2012 Forum Held At Pine ridge Hotel- KAHAMA 2 nd December 2012 Prepared by: E.P.H.C rural Tanzania E.P.H.C RURAL TANZANIA 1

Abbreviations and Acronyms. AIDS- Acquired Immunodeficiency Syndrome. Ag DMO - Acting District Medical officer. Ag DMFP - Acting District Malaria Focal personnel. DMO- District Medical Officer E.P.H.C rural Tanzania- Enhancing Primary Health Care in rural Tanzania. FRFW - Food and Recreational Facility Workers. HIV-Human Immunodeficiency Virus PICT- Provider Initiated Counseling and Testing. SWHAP- Swedish Workplace HIV/AIDS program. TBC- Tanzania Broadcasting Corporation. VCT- Voluntary Testing and Counseling. E.P.H.C RURAL TANZANIA 2

ACKNOWLEDGEMENT The management of E.P.H.C Rural Tanzania wishes to express their sincere gratitude to all who supported Kahama HIV/AIDS High Risk Group training Forum, Atlas Copco Company at Buzwagi, SANDVIK Company and Swedish Workplace HIV/AIDS Program for their moral and material support. We would also like to extend our appreciation to Kahama district hospital and (TBC) Tanzania Broadcasting Corporation for their efforts to make this event successful. Thanks equally goes to all participants from small restaurant( mama nitilie), female saloons, guest houses and hotels, night clubs, Bars and female working at Buzwagi gold mine, volunteers workers for their interest to share their experiences and openly reflect on HIV/AIDS forum at their locality. 1. Introduction: It s scientifically known that female food and recreational workers (FRFW) are the highest risk and most affected group in the mining communities of Kahama.(Source link: http://www.ncbi.nlm.nih.gov/pubmed/12902582).as part of ongoing Behavioral change program for FRFW in Kahama district,this HIV/AIDS forum was conducted to create awareness on HIV/AIDS with regard to the World AIDS Day s (December 1, 2012) theme: Getting To Zero: Zero New HIV Infections, Zero Discrimination and Zero AIDS Related Deaths. Most of the targeted participants invited were Food and recreational facility workers that included women working in different guest houses and hotels, Bars and groceries, night clubs, small restaurants (mama nitilie) and those working in different female saloons. It known and reported by Dr.Nyembea H.J(Ag DMO.Kahama), during the forum,that, the up to 2012 Kahama HIV infection prevalence is 8.8%,and national HIV/AIDS prevalence in Tanzania is 5.7 and according to recent studies, the prevalence among female food and recreational workers in mining communities is 42%, this figures puts a challenge on how the community can be involved to reach zero New HIV infection. 2. Goal and objectives : (i)the Ultimate Goal To bring together women from different female food and recreational around Kahama and Buzwagi goldmine to create awareness about HIV/AIDS and provide an opportunity for public and private partners to spread awareness about the status of the pandemic and encourage progress in HIV/AIDS prevention, treatment and care among high risk groups in kahama and communities around Buzwagi goldmine E.P.H.C RURAL TANZANIA 3

(ii) Objectives The objectives of the training forum were to:- Enable participants to became aware about HIV/AIDS infection, stigmatization and treatment. Help participants disseminate targeted information on HIV/AIDS to all persons living in kahama district. Help participants understand the relationship that exist between New HIV infection, stigmatization and HIV related deaths. Call for voluntary HIV testing among high HIV risk groups in Kahama and ensure primary health care in collaboration with Kahama district hospital. To decrease the prevalence of behaviors that place people at high risk for HIV infection and to foster supportive and enabling environment for people Living with HIV/AIDS. 3. Date of the workshop: Kahama HIV/AIDS high risk group forum was conducted on December 2 nd December, 2012. 4. Training venue: The HIV/AIDS forum was conducted at Pine Hotel in Kahama District, its natural and conducive environment enabled and open discussion among participants. 5. Facilitators The training was facilitated by the experienced doctors; Dr. Theophil W.A Shangali (Buzwagi mine doctor), Dr. Nyembea, H.J (Ag DMO Kahama District hospital), Dr. John Duttu (AgDMFP) and John Ngonyani (Clinical Social Worker from AAR HEALTH INSURANCE). The knowledge and working experiences of the facilitators HIV/AIDS, was among the key contributing factors of the success of HIV/AIDS forum. E.P.H.C RURAL TANZANIA 4

6. Participants The total number of 35 women participated, in 2nd December 2012 HIV/AIDS Highest risk groups forum in Kahama district; 2 female employees from SANDVIK Company, 1 female employee from Atlas Copco Company and 32 female representatives from female saloons, Guest houses and hotels, night clubs and small restaurants (mama nitilie). 7. The Process a. Planning: The HIV/AIDS forum was preceded by a planning meeting conducted on 31 st November 2012, the meeting was headed by Dr. Theophil (as a chairman), Dr. Nyembea H.J, Dr. Duttu J, TBC representative and John Ngonyani (Clinical Social Worker); met to discuss the modalities of conducting the workshop. Therefore, it was agreed that time be allocated according to the number of targeted participants available. The training had to focus on World AIDS Day s theme Getting To Zero; Zero New HIV Infection, Zero Discrimination and Zero AIDS Related Deaths E.P.H.C RURAL TANZANIA 5

b. Actual Group Forum: i. Opening session: The workshop was officially opened by Dr. Theophil (Mine Doctor) and Dr Nyembea (Acting DMO-Kahama District Hospital), who briefly explained the purpose of the workshop encouraging participants to how they can implement World AIDS Day s them getting to zero. Dr. Nyembea (Acting DMO-Kahama District Hospital) Dr Theophil (Buzwagi mine) ii. Facilitation methods; The workshop was facilitated in participatory and interactive way whereby various methods like focused group discussions and questions and answers were used. E.P.H.C RURAL TANZANIA 6

iii. Evaluation methods: Evaluation was conducted throughout the workshop; methods employed were questions and answers, direct observation and discussion. The results showed that participants acquired knowledge. 8. Areas/topics covered The topics covered during the workshop include; Difference between HIV and AIDS Ways through which HIV is transmitted from one person to another and its prevention. Risk behaviors that may lead to increased infection rate. Getting to zero new HIV infection, zero discrimination and zero AIDS related deaths. How can stigmatization lead to high infect rate and AIDS related deaths. E.P.H.C RURAL TANZANIA 7

9. Major achievements. Forum objectives and the content were covered effectively as observed by trainees participation, sharing experiences; questions got responses concerns, as well as process reviews. Attendance of the participants was very high, (almost 100%) that facilitate a diverse experience sharing and team work among the participants. Knowledge gain and attitude change as observed through various evaluation methods, participants became aware with issues related to HIV/AIDS like difference between HIV and AIDS, HIV prevention such abstaining, use of condoms and being faithful to one partner who has tested HIV. The notion of Zero New HIV infection, Zero discrimination and Zero AIDS related deaths was well presented, participants understood how stigmatization may lead to high rate infection and AIDS related deaths. Improved participants knowledge, competencies and confidence particularly on Voluntary HIV testing and how they can be champions of behavioral change for zero new HIV infection. 10. Key Findings and Recommendations. The 71% of the participants admitted that there is high involvement of women working in different food and recreational facilities in risk behaviors. There is little knowledge on the effectiveness of condoms and some of the participants were aware about female condoms and how they are used, the responses indicated that there is high rate of practices of unsafe sexual intercourse. Therefore, there is a greater relationship between the level of changes in risk behaviors and HIV infection, changes in behavior will result in changes in HIV incidence and prevalence. Changes in behavior may be reduced by effective prevention strategies or by the heightened awareness of the problem particularly by reaching more individuals in kahama town and surrounding communities. When asked about Stigmatization in families, 85% of responses indicated that there is high rate of stigma and discrimination among those who are tested positive. The results indicate individuals in rural areas and kahama district at large lack knowledge on how discrimination may lead to high HIV infection and the chances of People Living with HIV/AIDS. However, when asked about voluntary HIV testing, an average of 38% of the participants said service provision in the clinics and HIV testing centres is not friendly, while some of participants seem to be disappointed by inadequate professional counselors and lack of confidentiality was reported to be one of the factors that hinder voluntary counseling. Most of mine workers spend much of their on weekends in clubs and bars when they engage themselves in unsafe sexual intercourse with bar maid, women working in hotels/ guest houses and commercial sex workers which put them in higher risk of getting HIV infection. Female working at Buzwagi gold mine revealed that there is no enough HIV/AIDS awareness training and information among workers, and most of the companies put emphasis on production and neglecting important issues related to HIV infection at workplace. This necessitate an immediate action to find out if there any effective E.P.H.C RURAL TANZANIA 8

workplace HIV/AIDS programs among contractors/companies ( Sandvik and atlas copco inclusive) workforce, however, there is ongoing HIV program in Buzwagi mine which is facilitated by Buzwagi mine health team currently. 11. Looking Ahead. HIV/AIDS Workplace programs for mining workers should be evaluated for its efficacy and pin point an area of improvement Training and sharing of HIV/AIDS knowledge among all high risk groups should continue and enhance the coverage of provision of sensitization HIV/AIDS education to Mining working force (especially female mineworkers) and Women working in food and recreational facilities. To create a stronger collaborations among Key stakeholders such as Kahama Hospital, Kahama NGO s(e.p.h.c rural Tanzania inclusive) and Buzwagi companies (Sandvik and atlas copco inclusive) aiming at establishing a stronger and sustainable innovative HIV/AIDS behavioral change program such as: HIV/AIDS weekend outreach Program for Mining communities of Kahama What is the program? The HIV/AIDS Weekend outreach program, is a way for mobilize high risk groups in the mining communities to come together for a day in a confidential, open and safe Environment to remind each other and learn more about HIV, form friendships, talk about challenges on the fight about the diseases and celebrate successes with each others on prevention of HIV/AIDS in the society. Program facilitators: The program will be facilitated by peer s educators from among recreational facility workers (FRFW) and experts from E.P.H.C rural Tanzania (Medical doctors, HIV specialists, counselors and others).the outreach activities will serve as a vibrant and empowering break from the isolation commonly faced by High risk groups for HIV. Program activities: The program will be having the following activities: HIV awareness training through public meetings and brochures, updated Statistics and information s of the disease will be given to the targeted high risk groups, such as Mining workers and female food and recreational facility workers (FRFW). Female and male condom distribution, Counseling in all HIV/AIDS related issues and to give opportunities among targeted groups for professional and confidential VCT and PICT NOTE: Depending on available resources from the Key stake holders, the program activities can be conducted on a monthly basis or every three months etc. E.P.H.C rural Tanzania will communicate with Key stake holders on this in the near future. E.P.H.C RURAL TANZANIA 9