Reducing Stigma and Discrimination in Response to HIV and AIDS in the Caribbean of shame and blame Breaking down the walls DFID Project Contract No: CNTR 200808315 PANCAP HIV/AIDS Stigma & Discrimination Unit Associates for International Development, Caribbean
HIV Related Stigma in the Caribbean Context Our Region The Caribbean is still the second most affected by HIV and AIDS in the world, after Sub-Saharan Africa. Heterosexual contact is the major transmission route for HIV. HIV continues to disproportionately affect vulnerable groups and in particular key populations including marginalised groups. The burden of HIV/AIDS on key populations is exacerbated by the high levels of stigmatisation due to socio-cultural beliefs and norms which are in turn reinforced by legislative barriers. Stigma and discrimination has been shown to reduce the efficiency of the Regional AIDS Response by reducing access of these groups to much needed HIV related preventative, curative care, support and information services. Unlike many larger middle income countries with land borders, Caribbean small island states are fairly homogenous: each country is like a community in which stigmatising trends and impacts of medical confidential breaches and other stigmatising messages spread like wildfire Against this background, regional responses to the epidemic are placing a greater emphasis on tackling and disentangling the complex web of stigma and discrimination in order to positively promote the livelihoods and greater involvement of key people in the AIDS Response. Thereby participating actively in their own care, prevention and empowerment. Expressions of Stigma 1 [Comment made at recent s.gma and discrimina.on (S&D) workshop with vulnerable popula.ons and pivotal actors for the Department for Interna.onal development of the United Kingdom (DFID) Private Sector Sub Project, Barbados] In responding to the unique needs of the region, There has been a unified call to create a centre of excellence, 1 A Stigma Unit to design, implement and deliver sustainable programmes through strategic partnerships with national and international leaders working in the area of stigma reduction.
Reducing Stigma and Discrimination 2
Project Outputs Output 1 CARICOM/PANCAP Unit to tackle stigma and discrimination, related to HIV and AIDS Strategies 1.1 Project Start up completed tightening the project agenda with key stakeholders 1.2 Stigma Unit functional 1.3a Project Advisory Group in place- Implement partnership mechanisms for ongoing advocacy, awareness and profile raising of the issues 1.3b Establishment of National Community Advisory boards - Implement partnership mechanisms for ongoing advocacy, awareness and profile raising of the issues 1.3c Selection of Ambassadors or Champions and national and regional level, working with existing champions in the CfC process 1.4 Sub-unit Institutions strengthened and functional Output 2 Effective stigma and discrimination programmes designed and implemented in the selected countries. Implementation will be phased, but will cover the OECS, Belize, Guyana and Jamaica Strategies 2.1 Expand regional advocacy agenda, building public places for action by key populations 2.2 Advocacy skills and leadership development programme initiated 2.3 Undertake policy research and support development initiatives 2.4 Four National Pilot BCC programmes initiated and evaluated by end of phase I Output 3 Baseline, Operational research and evaluation work, with strong gender focus, supports and informs the development of effective programmes at national level Strategies 3.1 Decision support and information sharing using CORE (Community Based Operational Research) and PEER (Participatory Ethnographic Evaluation and Research) approaches 3.2 Conduct rapid needs assessments in 12 countries Level 1 Communicate lessons learnt on an ongoing basis Level 2 Using research output as training and advocacy tools Output 4 Best practices and tested methodologies disseminated by PANCAP, Horizontal Technical Cooperation Group (HTCG) and other groups, elsewhere in the region, in Latin America and internationally Strategies 4.1 Disseminate and share information on a ongoing basis through various mechanisms and media 4.2 Disseminate information through media in partnership with UWI, CARIMAC, CBMP 3
Use of Novel Behaviour Change Communication Approaches Where they do not exist, the project team will support the design, pilot implementation, evaluation and scale up of innovative, targeted national initiatives/programmes. Examples of such include the Champions for Change and Puppets4Life initiatives and integrating with other regional and global initiatives. Champions for Change Key Activities Our proposed project strategies and activities effectively demonstrate alignment of the 4 desired outputs, with the recommendations for scaling up Champions for Change (CfC) that emerged from the recent external evaluation commissioned by DFID. Champions for Change was a joint initiative of DFID and PANCAP and played a leading role in attempting to tackle stigma and discrimination in the region. In order to build on this initiative, the consortium partners will recruit high-profile, wellrespected and committed individuals in the community to act as project 'Champions' in each country. These volunteers will have the responsibility of promoting the project at the sectoral, national, and regional levels, based on extensive networks and networking skills and they will also be expected to educate and sensitise policy level decision makers, CEOs and managers. Puppets4Life AIDInc is collabora.ng with Kids4Kids Caribbean, but specifically with the communica.ons expert and founder of Puppets4Life and the Rennie project. The project will use the art of puppetry and mascots from the Rennie project to empower and promote change and leadership in young children and youth from all walks of life. The puppets and mascots would form part of the Champions for Change team suppor.ng champions with public faces in the delivery of messages to key groups. Scale up through the will occur through training of puppeteers in ar.s.c expression and communica.on, and suppor.ng them in rolling out the communica.on sessions at venues including schools, churches, na.onal events. Integrating with regional & global strategies AID Inc will build upon our new partnerships with World AIDS Campaign (WAC), Dance4Life, Caribbean Broadcast Media Partnership (CBMP) and CRN+. The aim will be to roll out Dance 4 Life Caribbean in phases across the targeted countries and to work with WAC and CBMP in designing and building upon existing regional and Global Campaigns and initiatives which include the HEROS, LIVE-UP and the Leadership pledge. We will also integrate with CRN s human rights and leadership development initiatives 4
Project Timeline For this 3 year project, the initial preparatory (inception) phase will involve capacity building to ensure effective roll out of interventions over the 2-year implementation period. INCEPTION PHASE (9 MONTHS) Needs assessment in all countries to better understand the stigma and programme needs, the political climate and local civil society capacity to respond Network and partnership building activities Establishment of national and regional advisory boards Capacity building in key areas BCC pilot priority programmes Pilot programmes in 2 countries based on priorities and capacities Sub-project design workshops Scale-up of human rights mechanisms currently in place in 9 target countries to include additional 3 countries Production and pilot implementation of BCC materials Anti-stigma building sessions for youth, women, FBO and health workers IMPLEMENTATION PHASE ( 2 YEARS) Communications plan in place to disseminate best practices and proven methodologies in conjunction with CARIMAC (Caribbean Institute of Media and Communication UWI), CBMP (Caribbean Broadcast Media Partnership) and UWI Establishment of National Community Advisory Boards Further development of sub-project designs indicated based on needs assessment and workshop design discussions Implementation of sub-projects Scale-up of sub-projects in target countries Second tier of Capacity Building workshops with all sub-project stakeholders in key areas of programme implementation. Targeted BCC programmes Scale-up of anti-stigma building sessions to police, immigration and legal professionals and other gatekeepers Regional forum led by PANCAP stigma unit with all participating National AIDS programmes and other key stakeholders Sustainability planning work with private sector and municipalities to advocate for ongoing funding of projects beyond Year Three, from Non- DFID sources. 5
Project Reach Ensuring Success The project approach has key components that will influence the successful achievement of project outputs: 1. An integrated project methodology a priority setting approach to building national programmes 2. Use of Innovative approaches to programming 3. Building formal and informal sector collaboration 4. Pilot methodology 5. Gender mainstreaming 6. Promoting the multi-sectoral approach 7. Use of Champions 8. Capacity Building for All partners 9. Sub-granting as a catalyst for innovation 10. Decision support 11. National, Regional and Global Programme sharing It will reach the Caribbean region, specifically the Eastern Caribbean States, Belize, Guyana and Jamaica. The target group of the antistigma programme is indicated below: Key Populations PLHIV, MSM, WOMEN, SEX WORKERS, YOUTH, OVC, PRISON POPULATIONS, EX-PRISONERS, DRUG ABUSERS Pivotal Community Actors Bus/Mini-van Drivers, Rum shop owners, Brothel Owners, club proprietors, SW (Sex workers) Clients, Lifeguards Women s support NGOs, Youth support NGOs, Community Leaders, Uniformed services, migrant populations, Faith-based organisations, Health Care Workers, Civil society organisations, existing Champions, National leaders, NAPs, key line ministries, media, regional and international agencies implementing anti-stigma programmes 6
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SOME OF OUR PARTNERS PLHIV support groups, Human rights desk advocates National AIDS Programmes, FBOs and Local NGOs of The OECS, JAMAICA, BELIZE, GUYANA Produced and Published by Associates for International Development 2008 Reproduced 2010 Contact Us admin@aidincorporated.org Tel (1 246) 429-6859 Fax (1 246) 435-0569 Kingsley House, 2nd Avenue Belleville, St. Michael, BARBADOS Front cover: Donovan Emmanuel, member of an organisation for vulnerable groups and Peer Outreach Educator