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The Preventive Alphabet Toolkit A The Preventive BAlphabet Toolkit Innovative Approaches to Abstinence and Being Faithful (AB) Communication with Adolescents In July 2011, FHI became FHI 360. FHI 360 is a nonprofit human development organization dedicated to improving lives in lasting ways by advancing integrated, locally driven solutions. Our staff includes experts in health, education, nutrition, environment, economic development, civil society, gender, youth, research and technology – creating a unique mix of capabilities to address today’s interrelated development challenges. FHI 360 serves more than 60 countries, all 50 U.S. states and all U.S. territories. Visit us at www.fhi360.org. The Preventive Alphabet Toolkit Innovative Approaches to Abstinence and Being Faithful (AB) Communication with Adolescents 2 The Preventive Alphabet Toolkit The Preventive Alphabet Toolkit: Innovative Approaches to Abstinence and Being Faithful (AB) Communication with Adolescents © 2011 by FHI ISBN: 1-933702-69-9 Acknowledgments Shahana Chaudhury, an FHI consultant, organized the innovative approaches to HIV/AIDS prevention and behaviour change communication used by the SAMARTH demonstration project staff to reach out to children and adolescents. The staff and children of the demonstration projects—the Young Women’s Christian Association (YWCA); Salaam Baalak Trust (SBT); and Women’s Action Group (WAG)–CHEL- SEA (Children, Health, Education, Ladies, Senior Citizens, Environment, and Awareness)—contributed their ideas and time to this toolkit. The FHI/SAMARTH team provided technical input and the illustra- tions. The FHI/SAMARTH team would like to thank several of FHI’s U.S.-based production staff members who contributed to the publication of this toolkit. In particular, we would like to thank Debbie McGill for editorial supervision, Dick Hill for layout and design, and Jesse Hastings for copyediting and managing the U.S. production team. This document is made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of Cooperative Agreement #386-A-00-06-00161-00 to FHI. The contents are the responsibility of FHI and do not necessarily reflect the views of USAID or the United States Government. FHI/India H-5 Green Park Extension (Ground Floor) New Delhi—110 016 Telephone: +91–11–4048 7777 [email protected] www.fhi.org All photographs are courtesy of FHI. Cover photo by Sanjay Kumar The Preventive Alphabet Toolkit 3 Table Of Contents Foreword iv Preface v Part I: Prologue 1 Part II: Overview 3 The SAMARTH Project 3 The ABC Approach 4 Part III: The Toolkit 7 Activity A: Draw Along 9 Activity B: The Board Game 10 Activity C: Flash Cards 13 Activity D: Clippings 14 Activity E: Breaking News 15 Activity F: Create a Story 16 Activity G: Tell a Story 17 Activity H: Participatory Production 18 Part IV: Conclusion 21 Foreword HIV/AIDS is one of the major public health problems in India. Children, especially adolescents, are more vulnerable to sexually transmitted infections including HIV/AIDS due to the very characteristics of their being at the developmental stage, their experi- menting nature and their lack of information. Among these, children in slums are more vulnerable to both sexual abuse and unprepared initiation of sexual activity. In a world of fragmented relationships, physical proximity is often developed out of unfulfilled emotional needs and fragile self-esteem. In this context, the AB(C) approach has been a critical part of the President’s Emer- gency Plan for AIDS Relief (PEPFAR)-supported projects. This AB toolkit is an effort to capture various approaches to HIV/AIDS prevention and behavior change communication among adolescents. Each approach is based on expe- riences with vulnerable children from three different projects supported by the United States Agency for International Development. It should be a useful tool for those work- ing with adolescents and vulnerable children. I commend the efforts of FHI in developing this toolkit. Kerry Pelzman Director Office of Population, Health and Nutrition iv The Preventive Alphabet Toolkit Preface Sexually active children who live in poverty are a particularly vulnerable demographic group. Their lack of risk awareness and abundance of opportunity to experiment with sex and drugs can lead to emotional and physical traumas such as child pregnancy, sexually transmitted infections, and the very real and frightening risk of unprotected sex: HIV infection. The purpose of this toolkit is to reach out to children and adolescents with HIV/AIDS prevention and behavior change communication messages. The toolkit provides eight different adolescent-friendly and easy-to-use approaches that outline innovative ideas. Each approach can serve as a framework for the development of other intervention strategies. The AB toolkit is a very useful guide for nongovernmental organizations and caregivers—both in the area of HIV and AIDS and in other fields—who wish to integrate HIV prevention strategies into their interventions with children and adolescents. I commend the efforts of the USAID/FHI–SAMARTH team to develop this toolkit. Bitra George Country Director FHI/India New Delhi, India The Preventive Alphabet Toolkit v Poonam and her sons play and laugh together at their home in Delhi. (Photo by Sanjay Kumar) Prologue 1 [The community organizer (CO) returns the smiles of children gathered around her at a community center in a Delhi slum.] CO: If you do not go to school, what else do you do all day? Child: We sift through garbage and then play. CO: What do you play? Child: Pakdan Pakdai. Chor police. Cricket. CO: Cricket? That’s nice! Do girls here play as well? [A small boy no more than eight years of age speaks.] Child: Sometimes. When there are girls, we also play “house-house.” CO: “House-house?” How do you play that? [Several children chime in with explanations.] Child 1: Oh, someone is father and someone is mother. The younger ones are usually children. Child 2: Yes, mothers cook, while fathers smoke bidis and drink and say, “Cook the meat.” Child 3: Then, after eating, the children have to pretend to sleep. CO: Why? Child 1: So that the mother and father can do their mother–father thing. [The CO is intrigued.] CO: “Mother-father thing”? What’s that? [The answers are provided nonchalantly.] Child 1: What mothers and fathers do at night after children go to bed. Child 2: Yes! We do it just like them. We even take our clothes off! The Preventive Alphabet Toolkit 1 Here, a WAG–CHELSEA caregiver (right) counsels a young woman. (Photo by Sanjay Kumar) 2 The Preventive Alphabet Toolkit Overview: The SAMARTH Project In India, HIV spreads mostly heterogeneously through groups at higher risk of infection, such as sex workers, men who have sex with men (MSM), injecting drug users (IDUs), and truck drivers. However, because India already has the third-largest HIV-infected population in the world, there is a danger that the virus could spread from high-risk groups to the general population. Government and civil society groups have an urgent need to take all necessary measures to prevent the spread of the epidemic. 1 2 SAMARTH is a program funded by the United States Agency for International Development (USAID)/ India that provides evidence about HIV prevalence in India that can be used to inform policies and programs. SAMARTH is managed by a consortium led by FHI that works with government and civil society groups to facilitate a fast and strategic response to HIV. SAMARTH runs pilot projects to demon- strate the feasibility of implementing promising HIV-prevention practices for vulnerable groups, and it provides innovative program designs for the government and other stakeholders to adopt and scale up. SAMARTH staff recognize that children who live in slums or on the streets are a vulnerable group. Through SAMARTH’s partners—the Young Women’s Christian Association (YWCA), Salaam Baalak Trust (SBT), and Women’s Action Group–Children, Health, Education, Ladies, Senior Citizens, Envi- ronment, and Awareness (WAG–CHELSEA)—the staff run demonstration projects based in New Delhi. Each project receives program management and technical support from FHI on effective HIV preven- tion, care, and treatment interventions for vulnerable adolescents (especially girls). The table below summarizes the partners’ work under the SAMARTH project. Table 1: SAMARTH partner organizations and their functions within the project Organization Focus group Role within the SAMARTH project SBT Street children SBT runs its own short-stay homes, institutional care cen- ters, and rehabilitation programs for street children. Its main role within the SAMARTH project is to provide HIV/AIDS prevention information, life skills educa- tion (LSE), abstinence (A) and abstinence/being faithful (AB) messages, as well as counseling and medical support services. SBT also provides technical support to local organizations to build their HIV-related institu- tional capacity. YWCA Children of sex workers, rag The YWCA provides vocational pickers, snake charmers, and training, remedial classes, nutri- ear cleaners tion support, LSE classes, and A or AB messages. The YWCA engages children in meaningful ways, with the dual purposes of keeping them off the streets and encouraging them to work for a better life. 1SAMARTH means, “being equipped to be effective”; it stands for Strengthen Abilities to Manage And Respond effectively To HIV/AIDS in India. The Preventive Alphabet Toolkit 3 WAG–CHELSEA HIV-affected/infected children WAG–CHELSEA runs programs who live in slums for the poor and the marginal- ized. Under the SAMARTH project, it provides medical care, HIV testing, AB messaging, LSE classes, and counseling support to the HIV-affected/infected children who live in slums. Like SBT, WAG–CHELSEA also provides technical support to local organizations to build their HIV-related capacity. The ABC Approach ABC is an acronym that stands for abstinence, being faithful to one partner, and correct and consistent condom use.
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