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HIV/AIDS Prevention and Control Project

The main objective of the SCA HIV/AIDS project is to contribute to the national development strategy of maintaining HIV prevalence below 0.05% in the population, in order to prevent morbidity and mortality associated with HIV.

Afghanistan is a low prevalence country currently with 565 HIV positive cases, in total 9 deaths have been reported so far. HIV prevalence data reported 3% among Intravenous Drug Users (IDU) living in Kabul, 10% among prisoners and 0.2% among TB patients in 2006. Blood safety screening as part of this project has also indicated higher rates of HCV ((Hepatitis C Virus) among IDUs than expected. Out of more than 400,000 blood screening tests since 1989, there have been 487 HIV positive results (NACP, 2008). According to UN and WHO estimates, there are 1,000 to 2,000 HIV positive cases in Afghanistan.

The SCA strategy to prevent the spread of HIV/AIDS is in line with the 4th national objective: ‘to raise public awareness on prevention and control of HIV/ AIDS and STIs, and ensure universal access to “behaviour change communication” (BCC) on HIV for the population, especially targeting vulnerable and at risk groups’. In order to raise awareness in this regard, SCA is providing HIV/AIDS training for different categories of beneficiaries in SCA programmes.

The need for the current project is immense since Afghanistan is considered to be a country at high risk for spread of HIV infection which a number of case studies already have indicated. The reasons behind this are several: over two decades of protracted armed conflicts, the extremely low socio-political and economic status of women, huge numbers of people displaced internally and externally, the extremely poor social and public health infrastructure, drug trafficking, use of injecting drugs and lack of blood safety and injection practises. These factors have led officials at the National AIDS Control Programme (NACP) to warn of the urgent need for early interventions to prevent a potentially rapid spread of HIV in Afghanistan.

In the light of this, the project is significant because it is directed towards vulnerable as well as high risk groups to HIV infection. In addition, the project will operate through the Basic Package of Health System (BPHS) and train the health staff on testing, care and treatment. Moreover, the project team intends to focus more on stigma and discrimination given that it remains an enormous barrier to effectively fight the HIV epidemic, particularly in a conservative society like Afghanistan. Mainstreaming and surveys will also be an integrated part in order to decentralise the activities and map the knowledge, attitude and practise among the people.

The project does also operate in a wider context since the above mentioned components is key objectives and an incorporated part of the Afghanistan National AIDS Strategic Framework (ANASF), 2006-2010. The main objective is to maintain a low prevalence (<0.5%) of HIV in the population and to reduce the mortality and morbidity associated with the HIV/AIDS by the end of 2010. The project does as well reflect elements in the revised BPHS guideline as well as other strategic line polices from NACP. These documents have been developed in collaboration with key stakeholders and the aim is to have a clear vision of how to support the efforts by the government to stem a potential outbreak of HIV in Afghanistan.

Awareness Trainings

In total, 7,339 (2,256 F) people have been trained since 2006 through 10 master trainers. The percentage of women trained was consistent in 2006 and 2007, with 29% of women trained out of the total number of trainees, increasing to 34% in 2008. A total of 2,256 women were trained in different project offices since August 2006.

In 2006 a total number of 1,274 (377 F) people were trained in 4 training centres including KMO. In 2007, 3,796 (1,102 F) people were trained, including 351 BPHS staff and health staff, 98 NSP council officers, 113 CRDW (45 CRDW then had HIV/AIDS education sessions with patients) 17 drivers, 209 SCA project staff, 1,636 SCA school teachers, 552 CHWs, 204 religious leaders, 230 policemen and women, 87 barbers, 80 private practitioners, 92 MOPH staff and 96 CDC members.

In 2008 a total of 2,269 (777 F) people were trained in four project offices. The number of people trained was less than in 2007, because supervisory visits have been paid more frequently in 2008 to follow up check there has been a change in behaviour as a result of the trainings.

The three project offices; Jalalabad Project Office (JPO) Wardak Project Office (WPO) and Ghazni Project Office (GPO), started their activities in August 2006, but trainings were provided in GPO from July 2007. Consistent numbers of participants have been trained in different project offices for the duration of the project.

2,256 women were trained in various project offices since August 2006. The percentage of women trained was consistent in 2006 and 2007 as 29% of total trained people, which increased in 2008, reaching 34% of total trained people
Generally, variation in the number of trainings is due to variation in training requirements for different categories of SCA staff, the merging of equivalent staff, avoiding retraining for similar staff, prioritizing vulnerable groups and tracking planned staff based on necessity.

As an example, between 2006 and 2008, the number of SCA staff trained in HIV/AIDS decreased from 362 (73 females)to 209 (39 females) and to 104 (8 females). This was due to the fact that SCA programme staffs have been given priority so in 2006 SCA started with a high number, which slightly decreased in 2007 as some staff had already been trained and finally, in 2008, a very small number of staff was trained as a result of turnover in SCA.

Dissemination of Information

To increase the awareness among the general population of SCA catchment’s areas, 30 session HIV/AIDS messages were broadcasted through local radios on monthly basis in Paktika, Kundus, Wardak and Jalalabad.
Posters (3,000) brochures (3,000) and HIV/AIDS training manuals (3,000) have been disseminated annually to SCA catchment’s areas. Meanwhile 10 messages were broadcasted through Kunduz and Jalalabad television on a bi-monthly basis. A HIV/AIDS magazine (4,000) has been published for HIV/AIDS training beneficiaries.