Contents Love Patrol – the Pacific’S Own HIV Prevention TV Series

Secretariat of

no 32 – November 2007

Peer educators – Safe Festival Campaign during Hibiscus Festival

Contents Love Patrol – the Pacific’s own HIV prevention TV series...... 2 CEDAW works for HIV prevention too...... 20 Doctors and journalists forge new partnerships...... 5 Female condoms – empowering Pacific women Universal access to HIV treatment achieved to protect themselves...... 22 in Pacific small island countries...... 8 ICAAP: Speaking out against HIV discrimination at sea...... 23 UNESCO Global Network of Young Media Producers ICAAP: In the face of gender inequality, married women on HIV reaches new territories in Melanesia...... 10 are among most vulnerable to HIV...... 24 Update on second-generation surveillance surveys...... 12 ICAAP: Stigma lessons arriving from the Pacific...... 26 OSSHHM news...... 12 ICAAP: Prioritising male sexual health in the Asia Pacific....27 Peer education: Still an effective IAS: Talk with us, not about us...... 28 behaviour change tool in Fiji...... 15 Confused? Bored? Not any more!...... 30 Together We Can...... 16 Review of HIV/AIDS Media Guide...... 31 Male sexual health and HIV in the Pacific – The Pleasure Project...... 33 first Pacific consultation...... 18 Drumming for HIV...... 34 Update on the National Council of Churches and Pacific Regional Strategy on HIV/AIDS news...... 35 Faafafine Workshop on HIV and AIDS...... 19 UNFPA provides free condoms to NGOs...... 36 Media

Love Patrol – the Pacific’s own HIV prevention TV series Robyn Drysdale, Behaviour Change Communication Specialist, HIV & STI Section, SPC Jo Dorras, Scriptwriter and Co-founder, Wan Smolbag Theatre, Vanuatu Tamara Kwarteng, Team Leader, Pacific Regional HIV/AIDS Project

prevention that has recently arrived on our shores. The idea is to have a popular TV series made by and for Pacific people that will draw viewers into the story and keep them entertained while providing important information on HIV and other sexually transmitted infections (STIs). The stories raise topics that stimulate dialogue in the community and encourage individuals to examine and change their behaviours.

During a random street poll in the streets of Port Vila, Vanuatu, a number of people empathised with Elizabeth, including one interviewee who said Elizabeth played a part that showed the life of many women in Vanuatu today: ‘It is good for men to see ‘Love Patrol’ in action “Love Patrol” so that they can see the pain that women go through when their husbands cheat on n the amber colours of the Christian girl, she MUST go back to them all the time.’ I afternoon, scenes – ugly ones her husband … – flash in front of Elizabeth. What Unlike one-off productions, the if? she keeps pondering. Nasty Elizabeth is one of the main series allows viewers to identify memories of the past months characters in ‘Love Patrol’, the more closely with characters and haunt her to the depths of her Pacific’s own 10-part TV series, themes across time and opens being, and her stomach tightens as which premiered in Vanuatu and the way for the material on HIV she thinks the worst. Her husband’s Fiji in April and is already proving and other development issues to extramarital affairs have left her immensely popular with TV become part of the conversational on the darkest side of midnight. viewers in both countries. fabric of a community. Tapping Not only is she pregnant, she is into these advantages, ‘Love Patrol’ also possibly infected with HIV. Her ‘Love Patrol’ is the product of portrays strong characters with mother thinks that she is a good an innovative approach to HIV whom the audience can identify.

Pacific AIDS Alert Bulletin n° 32 – 2007 Media

Many of the respondents to the ‘Soul City’ – poll stated that ‘Love Patrol’ lessons learnt from South Africa mirrored ‘real life and real people’ Soul City Institute is a dynamic and innovative multimedia health and showed ‘what is actually promotion and social change project. Through drama and happening in Vanuatu today’. entertainment, Soul City reaches more than 16 million South A police officer said that he felt Africans. Its two main brands are ‘Soul City’, targeted at adults, and that the depiction of the police ‘Soul Buddyz’, targeted at 8–12-year-olds and the adults in their lives. The second big programme in which Soul City Institute is involved in ‘Love Patrol’ was indicative of is a regional programme – a partnership with local organisations the police in Vanuatu and ‘police in eight southern African countries. As well as South Africa, ‘Soul officers should watch it so they City’ has also been broadcast in many other parts of Africa and can learn from it’. in Latin America, the Caribbean and Southeast Asia. It examines many health and development issues, imparting information and Another respondent said the series impacting on social norms, attitudes and practice. It is aimed at raised issues that were hard for individuals, communities and the sociopolitical environment. Through its multimedia and advocacy strategies, Soul City Institute aims to people to talk about, but ‘when it create an enabling environment that empowers audiences to make comes out on TV, we don’t blame healthy choices, both as individuals and as communities. For more anyone for raising those issues information, go to http://www.soulcity.org.za/. and it becomes an avenue to begin talking about important issues’.

This approach to HIV prevention As a result, the Pacific Regional characters, storylines and scenes is called ‘edutainment’ and has HIV/AIDS Project (PRHP), that were relevant to the region. been developed over the last the HIV & STI Section of few years in a growing number the Secretariat of the Pacific In addition to being screened of countries around the world. Community (SPC) and the well- on TV, all episodes will be Its positive impacts have been known Vanuatu theatre company distributed widely on DVD documented in detail; the most Wan Smolbag thought the time across the region along with well-known example is the ‘Soul was ripe for the Pacific to have back-up print materials. Initially City’ TV series in South Africa. its own TV soap opera, with they will be an important source

Reaching out to youth Across the Pacific, and especially in Melanesia, many young people drop out of or never attend school. At the same time, some countries, such as Solomon Islands and Vanuatu, have very high rates of STIs and are extremely vulnerable to an HIV epidemic. Kiribati is already facing a high per capita infection rate and is dealing with the issue of rapid urban migration and a high number of youth at risk. The challenge is to find a form of educational material to which the younger generation can relate. Many people in this age group are unable to read or have little access to books, whereas DVD players are ubiquitous even in quite remote areas – as is a love of watching DVDs.

It is not only early school leavers or those who never go to school who are at risk. School teachers, parents and traditional authorities often find it hard to talk to youth, at school or outside it, about issues related to sexuality. If an HIV epidemic is to be averted, there is a need to find a way to make it easier for parents, teachers and youth to discuss these issues without fear or shame. Edutainment, in particular TV soaps that are culturally relevant to viewers, can open the door to such discussions.

Pacific AIDS Alert Bulletin n° 32 – 2007 Media

all these places it has been met with a great deal of enthusiasm. Vanuatu’s random street poll showed that over 85 per cent of people were watching every episode (even the repeats).

‘Love Patrol’ started on Fiji One TV on 15 October. You can follow the lives and loves of Elizabeth, Mark and the cops of the Love Patrol at 8:00 p.m. on Fridays. Viewers in the Cook Islands will be able to see ‘Love Patrol’ from January 2008. Stay tuned to the Patrol – it’s coming your way!

For more information, please contact: Robyn Drysdale, Behaviour Change Communication Specialist, HIV & STI Section, SPC, ph: +687 26 20 00, email: [email protected]

* This article was originally published in Islands Business magazine, November 2007.

of information, education and for 2008. Indeed, there were many communication (IEC) materials calls for a continuation of the series for the region’s schools, with during the street poll, with some plans for support materials for respondents comparing it with the non-school environment Wan Smolbag’s radio soap opera (non-governmental organisations, ‘Famili Blong Serah’, which has clinics and village communities) now been running for seven years. further down the track. To date, ‘Love Patrol’ has been The impact of the series will be shown in Papua New Guinea, closely monitored and documented Vanuatu, Solomon Islands, Fiji to inform any future HIV-related Islands, Kiribati, Tonga and video projects in the region, Tuvalu, as well as in Samoa during including a second series planned the South Pacific Games. In

Pacific AIDS Alert Bulletin n° 32 – 2007 Media

Doctors and journalists forge new partnerships Nicole Gooch, HIV & STI Communications Officer, Public Health Programme, SPC, and Lisa Williams-Lahari, Pacific Media Trainer

arlier this year SPC’s Public EHealth Programme initiated a partnership with the Pacific Islands News Association (PINA), the regional organisation covering mainstream Pacific media, in an acknowledgement of the huge role played by the media in public health information dissemination and advocacy.

PINA hosts a biennial convention with an umbrella theme selected by the host country organisers. The event usually includes pre- Debating issues in health journalism convention workshops, which feed into a convention plenary and culminate in outcomes Unit in Solomon Islands. Key technical organisation whose documents being presented to the advisers from SPC, including work is based on a regional vision PINA executive for discussion, the Public Health Programme of healthy Pacific Islanders. The endorsement or recommendation. Manager, Dr Thierry Jubeau, initiation of a Pacific media and With the Media Association of attended the workshop. health network at this PINA the Solomon Islands (MASI) meeting, as well as a record convening the May 2007 ‘Sharing our news-driven turnout of SPC technical advisers meeting, a proposal by SPC to experience and our personally to any PINA media meeting, host a Pacific media and health driven ownership of the issues is an acknowledgement that workshop in the lead-up to the surrounding health reporting, media partners are important convention was accepted. we have had an eye-opening, stakeholders in that vision.’ thought-provoking three days The three-day workshop, with SPC,’ said Matai Akauola, For more information, called ‘Building Bridges in PINA executive and media and please contact Nicole Gooch, Health Communication’, was health workshop participant, in HIV & STI Communications organised by the SPC HIV & his presentation to the convention Officer, ph: +687 26 67 71, STI Communications Officer, plenary. email: [email protected] Nicole Gooch, and facilitated by Pacific media trainer Lisa ‘We’ve seen commitments and Williams-Lahari and national health priorities facing the counterpart George Herming of world, the region and our own the Government Communications villages through the eyes of the

Pacific AIDS Alert Bulletin n° 32 – 2007 Media

Media and health workshop participants

Recommendations from the Launch of the Health-e network health and media workshop Health-e, an online network for journalists o In-country initiatives led and owned by covering health issues in the region, was national media associations. The objective is launched at the PINA 2007 conference. As the to bring health and media partners together network develops, it will provide opportunities in an open, non-confrontational forum so to build information-gathering, information- that both sectors can understand the differing sharing and information-checking bridges information needs. between journalists and our regional health o Support for wider public awareness and sector. Among its benefits, Health-e will give media literacy programmes to understand journalists direct access to regional technical the work of news journalists in the Pacific advisers and other key health experts as and the differences between content they join the online group, and will provide formats, particularly advertising and news. an online discussion space for newsrooms to link up and raise questions, table stories, o Development, publication and distribution of seek contacts and dig deeper into Pacific user-friendly, plain English newsroom guides health issues. Health-e was created on the that simplify the jargon around specific issues, recommendation of the regional media and including HIV. health workshop conducted in the lead-up o Fellowships for Pacific journalists that would to PINA by SPC’s Public Health Programme allow them to develop in-depth reports on in collaboration with PINA and the Media specific issues, and/or the introduction of a Association of the Solomon Islands (MASI). health journalism award.

Pacific AIDS Alert Bulletin n° 32 – 2007 Media

Challenges for health journalists Journalists play a critical role journalist, which can make in creating debate and change good reportage difficult to around health issues affecting achieve. These challenges Pacific nations. Yet, routinely, include issues such as: HIV and other health issues are o the high pressure of reported as press releases and newsrooms; rarely go beyond coverage of o the high rate of turnover drugs and doctors. and lack of education of journalists; In order to make a difference, o limited access to sources coverage of health should such as health specialists; entail investigating health as o the lack of Pacific-specific a development issue, and that information on the means linking it to issues of Internet and in print; gender relations, economic o perplexing medical jargon impacts, reproductive rights, and statistics; and national security, human o catering for communities that rights legislation, etc. It also do not necessarily understand means being aware of one’s the role of the media. responsibility as a journalist, in terms of the impact news And the list goes on. stories may have on a person’s life, be it negative or positive. Furthermore, health issues are often emotional issues, which On the other hand, many are even more difficult to cover challenges remain outside in a balanced, objective and Lisa Williams-Lahari helping to build the realm of the individual accurate way. bridges in health communication

Pacific AIDS Alert Bulletin n° 32 – 2007 Treatment, care and counselling

Universal access to HIV treatment achieved in Pacific small island countries

eople living with HIV in all Dr Rogers is concerned that not ‘This achievement Pof the small island countries all people living with HIV in of the Pacific now have access to is a testament to Pacific Island countries realise the effective treatment. the determination difference that HIV treatment can of Ministries of make. ‘There is no cure for HIV The start-up of a programme to Health in Pacific and antiretroviral medications provide antiretroviral therapy need to be taken for the rest of to people in Tuvalu last month small island the person’s life, but treatment can means that every Pacific small countries to make restore positive people’s health island country where there are sure that people and keep them well indefinitely significant numbers of people living with HIV as long as they take their pills living with HIV can now provide can take advantage carefully,’ he says. effective treatment for the condition. of the effective HIV Some people taking HIV treatment that has treatment experience significant Dr Gary Rogers, Treatment, been available in side-effects, so a critical part Care and Counselling Cluster developed countries of the treatment programme Coordinator in the HIV & STI for the last decade.’ has been helping Pacific Island Section at SPC, says that the roll- doctors and nurses to develop out of antiretroviral therapy has the skills to monitor and support been achieved through in-country their patients. Dr Tenneth training of HIV core teams. That Dalipanda, Chief Physician at training has been provided by the National Referral Hospital SPC in collaboration with the in Honiara, says that the in- World Health Organization country training and follow-up (WHO) and other partners, with mentorship provided by SPC funding support from NZAID, have been very important in AusAID, the Global Fund and the making an HIV treatment Asian Development Bank (ADB). programme effective in Solomon Islands. ‘The training in Honiara ‘This achievement is a testament gave our HIV care team the to the determination of Ministries been pleased to support them. opportunity to work through the of Health in Pacific small island What’s important now is for problems we were likely to face, countries to make sure that people who have been diagnosed with an experienced HIV doctor,’ people living with HIV can take with HIV, and anyone who feels he says. ‘Since the workshop, we advantage of the effective HIV they may have been at risk, to have been able to get ongoing treatment that has been available engage with health services so that support from SPC by email and in developed countries for the last they can benefit from treatment telephone, which has been really decade,’ Dr Rogers says. ‘We have when they need it.’ helpful.’

Pacific AIDS Alert Bulletin n° 32 – 2007 Treatment, care and counselling

Sites where HIV care services are available Comprehensive HIV care, including antiretroviral therapy, is now available through clinics in the following Pacific small island centres: - *Federated States of Micronesia: Chuuk, Kosrae, Pohnpei and Yap - *Fiji Islands: Labasa, Lautoka and Suva - Guam - French Polynesia: Papeete - *Kiribati: Tarawa - *Marshall Islands: Ebeye and Majuro - New Caledonia: Noumea - Northern Mariana Islands: Peati Maiava with her doctor in Samoa Saipan - *Palau: Koror

Dr Rogers emphasises that - *Samoa: Apia even though the small Pacific ‘There is no cure - *Solomon Islands: Honiara Islands now have universal for HIV and - *Tuvalu: Funafuti access to treatment, the systems - *Vanuatu: Port Vila for providing HIV care remain antiretroviral fragile in several countries in the medications need *Support provided by SPC, PRHP region. ‘Lots of ongoing support to be taken for the and WHO, utilising funding will be required to make sure that assistance from NZAID, AusAID, effective antiretroviral therapy, as rest of the person’s the Global Fund and ADB well as the broader aspects of HIV life, but treatment care, continue into the future. But there are some really dynamic can restore positive teams in the Pacific and their people’s health and enthusiasm will be a critical factor keep them well in ensuring that this programme is sustainable,’ he says. indefinitely as long as they take their For more information, contact pills carefully.’ Dr Gary Rogers, ph: +687 26 22 77, email: [email protected]

Pacific AIDS Alert Bulletin n° 32 – 2007 Media

UNESCO Global Network of Young Media Producers on HIV reaches new territories in Melanesia Etivina Lovo, Media Training Associate, Regional Media Centre, SPC

hree short documentaries on Aukuso, Deputy Director-General THIV were proudly launched ‘Young people of SPC, told the participants at by six young media producers understand each the launch of the documentaries. from Papua New Guinea, other and they know Aukuso advised the young Solomon Islands and Fiji Islands ways of changing producers that it is important to following a two-week workshop the mindsets of do follow-up activities and to find on advanced documentary and the tools and the means to ensure script writing held from 16 to 27 their peers.’ that the newly learnt skills are not July 2007 in Suva, Fiji Islands. wasted.

o The workshop was organised by the Dr Jiko Luveni, Executive Aren Baoa, TV and Video Communication & Information Director of the Fiji Network Production Officer, RMC, called Sector, UNESCO Office for the of Positive People (FJN+); upon employers to support the o Pacific States, Apia, in cooperation Elizabeth Cox, Regional young producers to produce with the Regional Media Centre Director of the United more documentaries: ‘Where the (RMC) of SPC, to train young Nations Development Fund methods taught are practised, I media producers in how to make for Women (UNIFEM) could safely say that the training is documentaries about young people. Pacific; truly successful.’ o Nurse Caroline Mataitoga of ‘Young people understand each the Fiji Ministry of Health With the completion of the other and they know ways of STI clinic; and three documentaries, the young o changing the mindsets of their Jovesa Saladoka, Behaviour producers qualify as members of peers. The workshop was about Change Communication the UNESCO Global Network of young people “making it for (BCC) Officer, HIV & STI Young Media Producers on HIV themselves”, excelling in the world Section, SPC. & AIDS. of film making – young people getting interested in film making, The ideas developed for the The first workshop was held in Fiji going out conducting interviews, documentaries targeted behaviour Islands in 2006; it is hoped that filming and producing relevant change, from ignorance to subsequent workshops can be held film documentaries. They get first- knowledge and action, from in the North Pacific (2008) and in hand understanding of the issues stigma and discrimination to Polynesia (2009). during the process,’ said Pacific behaviour that is caring and film-maker and playwright Larry supportive, and from being For further information, contact: Thomas, Coordinator of RMC. afraid of seeking treatment to Etivina Lovo, ph: +679 337 0733 ‘treatment-seeking behaviour’. ext. 259, fax: +679 337 0021, Guest speakers invited to share email: [email protected], or their expertise with the young ‘Practice is important. Put in Abel Caine, UNESCO, Apia Office, producers included: use what you have learnt,’ Falani email: [email protected]

Pacific AIDS Alert 10 Bulletin n° 32 – 2007 Media

Three short films on HIV

It’s Better to Know Documentary that follows a young Papua New Guinean woman through voluntary confidential counselling and testing (VCCT). She is an HIV advocate and wants to lead by example. She takes the audience through the process of VCCT in order to encourage young people like herself to get tested.

Femidom Empower Women Documentary about ‘femidom’, the female condom. Female condoms increase the otherwise limited options available to women to initiate the use of protection, particularly where Aren Baoa (left) helps workshop participants to perfect their skills men are reluctant to wear a condom or have not thought to carry them. Women are Global Network of Young Media Producers especially vulnerable to HIV for HIV & AIDS because of gender inequality and high rates of gender-based ‘The purpose of the Global Network of Young Media Producers for violence. In this environment, HIV & AIDS is to harness the creative energies of youth and talent relying on male condoms to to produce high-impact documentaries,’ says Abel Caine, Adviser protect women is not enough. for Communication & Information, UNESCO Office for the Pacific States, Apia, Samoa. ‘It started in Asia, then Africa, and now in the FJN+ Rekindle Hope Pacific. The UNESCO–SPC RMC partnership has been instrumental in Documentary about Dr Jiko setting up the Pacific branch of the Global Network.’ Luveni, founder and Executive Director of FJN+, the Fiji The workshop provides young Pacific Islanders with advanced Network for Positive People. media and ICT skills to capture, broadcast and easily distribute FJN+ is an NGO that cares for documentaries (in the great Pacific Island storytelling tradition of and supports people living entertainment and information) that are local and highly relevant. with HIV. It facilitates medical This approach increases local content for broadcast media and the treatment and training and Internet, and preserves indigenous languages. offers other STI prevention services in Fiji Islands. As a result of the first two workshops, 11 young Pacific Islanders are now trained members of the network and have produced five provocative films for widespread distribution.

Pacific AIDS Alert 11 Bulletin n° 32 – 2007 Surveillance

Update on second-generation surveillance surveys Janet Knox, Surveillance & STI Response Cluster Coordinator, HIV & STI Section, SPC

o n the implementation of the the Samoa, Solomon Islands, Report on Second Generation Isecond round of second- Kiribati and Tonga surveys Surveillance Surveys of HIV, generation surveillance (SGS) will commence in the first other STIs and Risk Behaviours surveys in Fiji, Vanuatu, Samoa, quarter of 2008. in 6 Pacific Island Countries Tonga, Solomon Islands and (2004–2005), go to: Kiribati, consultations and In the first round of SGS, the http://www.spc.int/hiv/downloads/ activities to provide technical University of New South Wales second-generation-surveillance- assistance and support will be undertook data entry (for some surveys/. ongoing. Funding support comes countries), analysis (for all from ADB and the Global Fund. countries) and report writing. For the second round, these tasks will The SGS surveys need to be be completed in-country with completed before July 2008, with technical assistance and training the final report produced shortly provided by SPC. after that. It is planned that: o the Fiji survey will commence For more information, contact Janet in the fourth quarter of 2007; Knox, ph: +687 26 20 00, email: and [email protected]. For a copy of the

OSSHHM news

he Oceania Society for Sexual International AIDS Society health-care workers in the THealth and HIV Medicine Conference in Sydney in June region to be empowered through (OSSHHM), which was launched 2007, and it was registered increased knowledge and hence to in March 2007 at the Pacific officially in Fiji as a not-for-profit be able to provide better care for Ministers of Health Meeting, is company – as Oceania Society for their patients. As a professional, rapidly growing and gaining in Sexual Health and HIV Medicine I would also like to see that what strength while being increasingly Limited. It is about to employ a we offer is based on evidence. recognised in individual full-time executive officer, who This means cutting across political countries throughout the Pacific will be based in Suva, Fiji. barriers, and of course we need as a professional organisation to take into account various representing health-care workers. For OSSHHM president levels of care and understand the Dr Tenneth Dalipanda, one of limitations – but in any case we OSSHHM’s inaugural general the most important objectives should provide the best we have to meeting took place during the of the society is for ‘professional offer under the circumstances.’ Pacific AIDS Alert 12 Bulletin n° 32 – 2007 OSSHHM

OSSHHM’s inaugural meeting at the IAS in Sydney

In July this year OSSHHM we get all the Pacific countries published Recommendations for ‘We recognise that represented in OSSHHM, HIV medicine and sexual health each country is we can get all the differences care in Pacific small island countries different and we together and represent all of them as one region. This can only & territories. An updated edition cannot expect to just is due out early in 2008. happen if health-care workers in use a carbon copy for all the countries join OSSHHM ‘There are many different players the whole region. and use the OSSHHM in sexual health care and HIV But we feel that if Recommendations as much as medicine in the region, and we get all the Pacific possible.’ different guidelines, not only in countries represented treatment but also for instance in OSSHHM, OSSHHM membership now in lab standards, testing and stands at 64, with individuals counselling,’ says Dr Dalipanda. we can get all the hailing from 10 Pacific Island ‘We recognise that each country differences together countries and territories. They is different and we cannot expect and represent all of include a number of doctors to just use a carbon copy for the them as one region.’ as well as nurses, counsellors, whole region. But we feel that if scientists and lab technicians. Pacific AIDS Alert 13 Bulletin n° 32 – 2007 OSSHHM

OSSHHM first board meeting, Fiji, September 2007

Dr Dalipanda says, ‘We all need to issues relating to sexual health work in collaboration and respect ‘We all need to work care and HIV medicine,’ says different opinions so as to foster in collaboration and Dr Dalipanda. ‘This however professional development. I don’t respect different also means recognising the fine believe in a “right versus wrong” opinions so as to balance between being heard approach, or in forcing beliefs on and managing a heavy workload. countries. Instead, we would like foster professional OSSHHM can help by working to include all the various players in development. I don’t on finding a mechanism to enable the region and make sure everyone believe in a “right health-care workers to be heard.’ is involved and working together.’ versus wrong” approach, or in forcing Another objective of OSSHHM beliefs on countries. is to give Pacific Island health- care workers a voice at regional Instead, we would For more information, please contact and international levels. ‘Until like to include all the Dr Tenneth Dalipanda, now they have seldom been heard various players in the office ph: +677 28321 or as advocates and advice providers region and make sure +677 23600 ext. 317, at such a level, yet they should everyone is involved email: [email protected] or Dr Gary Rogers, ph: +687 24 22 27, be able to play a real role in the and working together.’ dialogues that take place around email: [email protected] Pacific AIDS Alert 14 Bulletin n° 32 – 2007 BCC action

Peer education: Still an effective behaviour change tool in Fiji Leone Tupua, Youth Development Hub, Adventist Development & Relief Agency (ADRA)*

liana Waqa was part of the ISafe Festival Campaign during the Vodafone Hibiscus Festival, one of Fiji’s largest annual events, held from 18 to 25 August 2007 at Albert Park in Suva. Twenty- two peer educators, four of whom were supervisors, participated in the campaign.

The peer educators were involved in planning, organising and implementing this activity. When it came to implementation, they were involved in outreach from 3 to 9 p.m. daily during Peer educators at work during Young female the festival and participated the Hibiscus Festival in the float procession to mark I smiled when I approached the end of the festival. They her and gave her some disseminated information on A group of pamphlets and a referral card. HIV, AIDS and other sexual young males She asked where the open door health topics, including STIs and health check centre was so I gave her directions. She asked teenage pregnancy, based at a We asked them if they want- what services were offered. booth set up at the main festival ed condoms. Their response I explained to her the specific was like, ‘Can we use it on shopping centre. Peer educators services for women, such as pap you?’ I said, ‘No, it’s not with- also buddied up to approach smears, contraceptive implants, in our work policy.’ They said, individuals hanging around the family planning, VCCT and other ‘OK, OK. Sorry, sorry’ and then services such as circumcision festival grounds and pass on they wanted a demo. So I and doctors’ opening and information in that way. went ahead with it. After the closing hours. She listened session they thanked me and intently and said ‘vinaka’ and The peer eds were instrumental said that they learnt a lot. that she will go and check the They thanked me for the job in motivating people to make use clinic out. of the VCCT services available and wished me luck. through the Marie Stopes Peer educator outreach journal Peer educator outreach journal extract: Nanise Christine, International Pasifik VCCT extract: Iliana Waqa, Hibiscus Hibiscus Safe Festival Campaign Clinic at the festival shopping Safe Festival Campaign 2007 centre. Clinic manager Atunaisa 2007 Dokonivalu reported that client

Pacific AIDS Alert 15 Bulletin n° 32 – 2007 BCC action

turnout increased during the Male organising an HIV float with evenings, when the peer educators taxi driver messages motivating people to were doing outreach. seek VCCT at their nearest centre. Really desperate for condoms In addition, the peer educators and brochures. He told us that The campaign was a collaborative made condoms more accessible to we were doing a very good job effort of the Fiji Ministry of and he said, ‘Make sure you people at the festival throughout Health’s Adolescent Health guys give plenty condoms to the campaign. In all, they taxi drivers.’ and Development Programme, distributed 5968 condoms during SPC, Marie Stopes International Peer educator outreach journal the festival. Pasifik and the Support and extract: Hibiscus Safe Festival Campaign 2007 Empowerment Network for Peer A total of 2608 people aged Educators in Fiji (SENPEF). 10–49 years were reached during the festival. The peer educators *Article written on behalf of the Fiji concluded the campaign by Ministry of Health and SENPEF

Together We Can Sevuloni R. Ratu, HIV & AIDS Programme Team Leader, Fiji Red Cross Society

Lautoka, Suva, Levuka and Labasa branches. ‘Together We Can’ aims to reduce the vulnerability of young people to HIV and other STIs.

The overarching goal of the project is to provide young people with accessible and appropriate knowledge, skills and resources on HIV and other STIs so that they are empowered to gain better control of their environment, make effective, positive changes Together We Can group activity and reduce their vulnerability to STIs. The project uses the peer education methodology with a ‘Before I used to be shy and present in front of people.’ behaviour change approach. never mix around with people – Red Cross peer educator or have ever presented in front A workshop was held from 27 of people; after the training I’m Early this year the Fiji Red August to 7 September 2007 in able to socialise and this builds Cross Society commenced its Suva, sponsored by ADB. It was my confidence and now I can new HIV project in its Rakiraki, attended by 21 participants from

Pacific AIDS Alert 16 Bulletin n° 32 – 2007 BCC action

the five Fiji Red Cross branches named above and two from the Adventist Development Relief Agency (ADRA) Youth Project. Also present were representatives from the Fiji Ministry of Education and UNAIDS.

The training prepared the participants to be peer educators in their communities. As part of that empowerment process, the participants visited a group of police recruits at the Fiji Police Academy in Nasova, Suva, where Workshop participants – Together We Can they tested their peer skills with small groups. The response from the recruits was very positive. 4. train participants in proper significant ones as a way of acquittal and quality narrative monitoring immediate outcomes The key objectives of the reporting; and and impacts. workshop were to: 5. develop an implementation plan. 1. enhance the skills of Participants were asked to identify participants to better provide The MSC technique is a form three significant changes for peer education outreach by of participatory monitoring and them during the workshop. These using the behaviour change evaluation. Essentially, in this changes could relate to knowledge, approach; process, peer educators collect attitudes, beliefs, skills or practices. 2. enhance the knowledge significant change stories and The box below contains a selection of participants in HIV, systematically select the most of the changes they identified. AIDS, other STIs, sexual o I used to neglect people living with HIV [PLWH] and treat them as reproductive health, unclean people because I thought they were full of diseases because sexuality, gender violence, this is what I heard from other people. Now after attending the conception and contraception, training I accept and respect PLWH the same as other members of the communication and community and will always be there to support them. This came about relationship skills, VCCT, during our visit to a PLWH group during the training. stigma and discrimination, o I didn’t know how to persuade my boyfriend to use a male condom, and the roles and now I know how to address and persuade him on the use of a male responsibilities of a peer condom. educator; o I didn’t know much about facilitation skills in order to conduct a 3. train Red Cross participants community session and the training has changed that for me by giving me the skills and confidence to visit the community and share this in the use of the most knowledge with them. significant change (MSC) technique as a monitoring and evaluation tool; For more information, contact: Sevuloni R. Ratu, ph: +679 331 4133, email: [email protected] – Website: www.redcross.com.fj Pacific AIDS Alert 17 Bulletin n° 32 – 2007 MSM news

Male sexual health and HIV in the Pacific – first Pacific consultation George Mulipola, Samoa AIDS Foundation

he Pacific Network of Men was attended by representatives The final consensus was that the Twho have Sex with Men from eight Pacific nations and network will: (MSM) held its first consultation one guest observer from India, o capitalise on building solid in Samoa from 28 to 31 August who was from the Asia Pacific structures for MSM in the 2007, during the South Pacific Coalition on Male Sexual Health Pacific; Games. (APCOM). Participants from o collate relevant global different cultural backgrounds information for the region; The Male Sexual Health and shared their perspectives on the o support MSM legislation HIV in the Pacific Regional growing HIV pandemic in the reform; Consultation (PMN-07) endorsed region and agreed on the need o increase the network’s both freedom of expression and for better legislation on the exposure to global funding; the need to uphold and respect human rights of MSM and more and the rights of MSM as human constructive assistance from o increase networking to plan rights and as essential tools in the governments. They also noted and develop sustainability in response to HIV. that the network needs to make the Pacific and within the the most of the Pacific’s access unique Pacific context for The goals of the consultation were to funding from neighbouring projects concerning MSM to: regions and assistance to sustain and HIV. 1. discuss issues relating to the HIV community outreach social well-being of MSM in programmes, especially for The network’s vision is to build the Pacific; marginalised groups that are capacity and inclusiveness 2. explore a solid foundation currently invisible. throughout the entire Pacific. that can support HIV awareness and prevention Elections were held for a Pacific PMN-07 was made possible initiatives for MSM in the representative on the Governing through funding and support Pacific; and Board of APCOM. Joey Mataele, from UNAIDS. 3. formulate an MSM founding president of the Tongan partnership of Pacific nations. Fa’kaleiti Association, was For more information on APCOM, elected to the post. His alternate go to page 27 of PASA. For more The four-day meeting, chaired by representative is Carlos Perera of information on PMN-07 and other Stuart Watson from UNAIDS, Equal Ground Pasifika, Fiji. related material that we anticipate will be available throughout the Pacific in 2008, go to the Samoa AIDS Foundation’s website: www. safinc.ws. For more details on the Pacific Network of MSM, email Joey Mataele at [email protected].

Pacific AIDS Alert 18 Bulletin n° 32 – 2007 Religion

Update on the National Council of Churches and Faafafine Workshop on HIV and AIDS George Mulipola, Samoa AIDS Foundation

re faafafine – males with informed of the risk of HIV and colour, sexuality or religion – to Astrong female attributes – AIDS,’ said Rev. Fepa’i Kolia, unite as equal human beings in despised and abandoned by Secretary of the Samoa National the response to HIV. their families, communities Council of Churches. and most respected religious It has been agreed that this denominations? Are their ways The challenge of finding ways to significant workshop will become of life simply natural or simply move forward led to an interesting an annual event coordinated by artificial? Do you think the discussion with the faafafine, the Samoan AIDS Foundation. churches and the faafafine should who have strong opinions about support one another in the fight relationships, respect, rights, For more information, please contact against the HIV epidemic? Is recognition and reconciliation. Roger Stanley, email: there a way forward for faafafine Faafafine called on the church to [email protected] and the churches in light of the pay particular attention to low- HIV crisis? status individuals (that is, young faafafine) in their respective These were some of the hard denominations. questions up for discussion during a two-day workshop in July 2007. ‘Most young faafafine who get The workshop was facilitated by involved in criminal activities the National Council of Churches are those who are not living and the Samoan Faafafine with their families – they have Association, with funding from either been kicked out of home PRHP and the Samoan AIDS or voluntarily moved away, from Foundation. being outcast and unvalued by family members and village,’ Leaders from different church explained a 19-year-old faafafine denominations gave impressive from the village of Apia. ‘These presentations on how the church are the faafafine that the church has played a central role in and the community at large need family values and community to reach out to.’ development in Samoa. They also expressed their view that the role In summarising this important of the church is not to judge. dialogue on understanding and respect, Elder Rev. Oka Fauolo, ‘We the church need to stand Chairman of the National together in the battle of HIV. The Council of Churches, reiterated message of God shall be honest, that the way forward is for faithful, peaceful, loving and well everyone – no matter what age,

Pacific AIDS Alert 19 Bulletin n° 32 – 2007 Gender and HIV

CEDAW works for HIV prevention too Ruci Mafi, Pacific Way Reporter, Regional Media Centre, SPC

s the HIV pandemic takes In Fiji Islands, a number of transmission and as part of the Aroot in Pacific societies women who were asked about process of empowering women. and communities, women are their rights had no idea. Many At a 2004 regional meeting of confronted with yet another had heard of fundamental parliamentarians, Dr Nafis Sadik, challenge. What rights do they human rights enshrined in the former Executive Director of the have in the context of the HIV constitution of their country and United Nations Population Fund pandemic – which is surrounded in the international Convention (UNFPA), said that the paradox by debate and discussion on the on the Elimination of all forms of of low risk and high vulnerability spread of the virus – and the law? Discrimination Against Women among women and girls is evident (CEDAW). But they didn’t know across Asia and the Pacific region, what those rights were or how they as well as in the rest of the world. applied to HIV. That is, their behaviour is low risk in terms of the usual risk factors Educating associated with becoming infected, women on yet their situation – including low their rights levels of education, unequal access is vital to formal employment and income, to help and low social status – heightens prevent their vulnerability and underlies HIV the feminisation of AIDS.

‘Fifty per cent of all new infections globally are found among women and girls,’ Dr Sadik said.

At the 10th Triennial Conference of Pacific Women in Noumea, New Caledonia, Dame Silvia Cartwright, former CEDAW committee member and former Governor-General of New Zealand, said there was a great need to align educational messages with the modern realities of the virus.

Yet the challenge seems as Dame Silvia Cartwright and SPC Director-General Dr Jimmie Rodgers ominous as ever. In Pacific Island

Pacific AIDS Alert 20 Bulletin n° 32 – 2007 Gender and HIV countries and territories, the task ‘Money spent on recognised that the number of of engaging women to participate women always women infected with the virus in their own development is pays dividends, for is increasing and that illness hindered by traditional, religious themselves, for their and loss among a productive age and cultural practices that in many group, including many mothers, families and for the communities keep women in have a major impact. ‘Families are secondary positions. whole of society’ being raised in poverty by ageing grandparents, and health care, Some countries are still grappling, education and housing – too, with the idea that CEDAW the most fundamental of human is here to stay. If a country falls rights – are at great risk because of short of full implementation the impact the illness has caused,’ of CEDAW, there can be an Dame Silvia noted. adverse impact on women’s impact for the expenditure rights, including their right of precious public resources. Pacific Island countries and to work and their sexual and Money spent on women always territories need to realise that the reproductive rights. With health, pays dividends, for themselves, spread of HIV is an urgent issue education, political participation, for their families and for the for women and for the survival of employment and other key factors whole of society,’ Dame Silvia the whole population. ‘Improving encompassed in CEDAW, experts said. Leadership must focus stability, financial and civil, should consider making this treaty on education, HIV testing and ensuring that women – particularly part of the fight against the spread improved health services. those who support families – can of the virus. To see action on ‘A message which shows love, have access to paid work, and above CEDAW, advocates and activists and understanding of the plight all educating them about how to must urge their government to set of many women, and combines it keep safe, are all urgent priorities,’ up policies, laws and mechanisms with practical medical and other said Dame Silvia. that will improve the lives of support may save the whole Pacific women. community from a terrible tragedy.’ For more information on the 10th Triennial Conference of Pacific ‘Every society needs to review and Participants at the 10th Triennial Women, go to: revise policy to ensure maximum Conference of Pacific Women http://www.spc.int/hdp/index.html

Pacific AIDS Alert 21 Bulletin n° 32 – 2007 Gender and HIV

Female condoms – empowering Pacific women to protect themselves SPC/UNAIDS press release by Nicole Gooch, HIV & STI Communications Officer, SPC

condoms to protect women is not While women, whether married enough.’ or not, may be at risk of infection through their own sexual Access to female condoms is practices, they are mainly exposed crucial as they are highly effective to STIs, including HIV, as a result in preventing unwanted pregnancy of the other sexual relationships and STIs and are one of the few of a male partner, and from the protection methods entirely made violence – including rape and for and controlled by women. forced sex – that can occur inside or outside marriage. According to Stuart Watson, UNAIDS Coordinator for the ‘If we, as a region, are serious Pacific sub-region, ‘female athletes’ about preventing HIV and other right to make choices about their STIs, we need to acknowledge mid the tally of medals won own health and safety, through the the unbalanced power dynamics Aby our Pacific athletes at the availability of female condoms, between men and women and Games in Samoa, distribution of is directly in line with the their different sociocultural other small objects of value also Millennium Development Goals: positions within each society,’ proved a great success. These were Promote Gender Equality and said Dr Iniakwala. ‘We need to female condoms, made available Empower Women (Goal 3) and recognise that women are not to all by the organisers of the Safe Combat HIV/AIDS, Malaria and always in a situation where they Games Campaign through peer Other Diseases (Goal 6), as well can negotiate safe sex through educators. as CEDAW.’ the use of male condoms because they may be afraid of violence ‘While male condoms offer or negative social consequences. effective protection, a female ‘Women are especially Female condoms increase the condom allows women more vulnerable to STIs otherwise limited options say in the negotiation process such as HIV because of available to women to initiate as it is the woman and not the gender inequality and use of protection, particularly man who wears the condom,’ high rates of gender- where men are reluctant to wear said Dr Dennie Iniakwala, head based violence. In this a condom or have not thought to of SPC’s HIV & STI Section. carry them. environment, relying ‘Women are especially vulnerable to STIs such as HIV because of on male condoms to ‘Short of changing women’s status gender inequality and high rates protect women is not in the Pacific today, we need of gender-based violence. In this enough.’ to make the most of protective environment, relying on male devices such as female condoms,

Pacific AIDS Alert 22 Bulletin n° 32 – 2007 ICAAP update

which empower women and at Facts on female condoms last give them the ability to make their own decisions on their sexual o Female-controlled and reproductive health and o Comfortable for men and women welfare.’ o Offer greater protection (cover both internal and external genitalia) According to Dr Iniakwala, o Very convenient (can be inserted up to 8 hours pre-sex) ‘By energetically endorsing the o Strong (polyurethane is 40% stronger than latex) availability and use of female o Designed to fit all women and suitable for women of all ages condoms, we could be reducing o CAN BE USED ONLY ONCE. If used more than once, they offer HIV and other STIs as we speak. less protection against STIs and unwanted pregnancy. We need to be making them as accessible as possible!’

ICAAP: Speaking out against HIV discrimination at sea

n Tuesday 21 August that testing for the virus should be a condition that poses a threat O2007, Dr Asif Altaf, the voluntary. to public health in relation to International Transport Workers shipping because, although Federation (ITF) Global HIV/ The statement itself is reproduced infectious, HIV cannot be AIDS Project Coordinator, in full below. transmitted by casual contact or delivered a statement against the mere presence of a person with Joint IMHA–ITF statement on HIV discrimination at the HIV. HIV is transmitted through HIV/AIDS at sea, delivered 8th International Congress on specific behaviour which is almost at ICAAP, Sri Lanka, 19–23 AIDS in Asia and the Pacific always private. The occupational August 2007 (ICAAP). He spoke on behalf of exposure risks of HIV infection the General Secretary of ITF and Through this statement and the at sea are slight and limited to the President of the International position it lays out, ITF and IMHA the treatment of injuries and to Maritime Health Association aim to increase their support procedures undertaken by the (IMHA), Dr Nebojša Nikolić. for international and national small number of health-care staff commitments to protect the rights working on large vessels. There Dr Altaf made it clear that and dignity of seafarers and all are well-established precautions IMHA and ITF consider HIV to people living with HIV/AIDS. to avoid these risks. Sexual or be a workplace issue that should IMHA and ITF consider HIV as blood-borne transmission are not be treated like any other serious a workplace issue that should be likely routes for transmission of illness or condition on board a treated like any other serious illness/ infection in the normal course of vessel. Other key points were condition on board a vessel. work at sea. that it is not a threat to public health in shipping, that it is not We believe that HIV/AIDS There should be no discrimination a cause for discrimination, and should not be considered to be against seafarers on the basis of

Pacific AIDS Alert 23 Bulletin n° 32 – 2007 ICAAP update

that many countries require HIV testing for immigration purposes and many employers for pre-recruitment and periodic medical assessment of seafaring personnel for the purposes of establishing fitness, IMHA and ITF recommend that such testing be conducted only when accompanied by counselling for both HIV-positive and HIV- negative individuals and referral to medical and psychosocial services for those who receive a real or perceived HIV status. on HIV status as unacceptable. positive test result. HIV infection is not a cause for HIV testing should be a termination of employment at matter for the individual and That testing must be performed sea and persons with HIV-related his/her clinical advisers, and only when clinically appropriate, illness should be able to work not a condition for obtaining and accompanied by consent, has for as long as medically fit in an employment. to remain at the heart of all HIV available, appropriate workplace. policies and programmes in the Any travel or work-related The purpose of maritime medical shipping industry, both to comply restriction should only be imposed fitness assessment is to ensure with human rights principles and on the basis of an individual that any medical condition does to ensure sustained public health interview/examination. not put other people at risk and benefits. that the individual is not at excess ITF and IMHA consider personal risk from the condition selection for employment based while working at sea. Recognising

ICAAP: In the face of gender inequality, married women are among most vulnerable to HIV Robyn Drysdale, Behaviour Change Communciation Specialist, HIV & STI Section, SPC

lively debate at ICAAP on its own – Abstinence, Be faithful high levels of sexual violence AWednesday 22 August 2007 and Condoms – is ineffective in against women and young girls, ended in the conclusion that in reducing HIV infection. incest, and sex under the influence countries with high levels of gender of alcohol and drugs, as well as inequality, such as Papua New ‘Contributing factors which the demands of daily living costs Guinea, the ABC approach on undermine abstinence include forcing women into commercial

Pacific AIDS Alert 24 Bulletin n° 32 – 2007 ICAAP update

sex and extramarital sex,’ said Kritoe Jinn Keleba of the Papua ‘Negotiating New Guinea Institute of Medical safer sex in a Research at the session ‘Identity in Gender and Sexuality’. marriage can be

‘Moreover, cultural complexities more difficult in the use of sexual language, because it implies youth culture and cultural rituals involving sex are further unfaithfulness challenges to abstinence. In the PNG context, abstinence and husbands may is practically futile. Therefore, a become angry and more profound and achievable model [of prevention] should violent, raping be incorporated into PNG’s response to HIV. I believe their wives.’ reducing HIV infection should include promoting 100 per cent ‘Negotiating safer sex in a the bride price so this made it very condom use and the lifting of marriage can be more difficult difficult to get out of this violent cultural taboos associated with because it implies unfaithfulness relationship.’ the use of sexual language to and husbands may become angry enable effective HIV awareness and violent, raping their wives. Mea’s moving story put a face and the dissemination of related Furthermore, due to the poor to gender-based violence in our information.’ economic situation some married region in the only truly Pacific women turn to [commercial] sex session of the 8th ICAAP – In a parallel session, ‘Violence as a means of survival.’ a symposium called ‘Gender and Risk: Identifying and Violence in the Pacific: Breaking Reducing Vulnerabilities’, The situation was personalised in the Silence’, organised by participants were reminded that a powerful story told by Maura UNAIDS. Other speakers said married women are one of the Mea of the PNG organisation that empowerment for women most vulnerable groups to HIV Igat Hope. Mea described how was a critical part of addressing in PNG. Barbara Kepa, also of anger and violence were features their vulnerability and referred the PNG Institute of Medical of her married life as a young to strategies such as income- Research, explained that women woman. When she was diagnosed generation schemes for women in PNG, having had their with HIV before her husband was, and Stepping Stones training relationship officiated with bride he blamed her for the infection, as potential approaches towards price, have little or no ability to yet she ‘found out afterwards that becoming empowered. They also negotiate for safer sex. Husbands he had a string of girlfriends and highlighted an urgent need to are frequently required to leave had been involved in gang rapes’. increase women’s access in the the village for long periods to Mea reiterated the role of bride Pacific to female-controlled safe look for work, and they engage price, saying, ‘I had a traditional sex commodities, such as female in extramarital sex. Kepa said, marriage and my husband paid condoms.

Pacific AIDS Alert 25 Bulletin n° 32 – 2007 ICAAP update

ICAAP: Stigma lessons arriving from the Pacific Jimmy Peter, Health & Development Networks Key Correspondent, Papua New Guinea

he islands of Fiji could be attitude of positive people,’ said Ta source of one of the first Cati, who was also a speaker at waves of hope and change in the ICAAP opening ceremony. fighting HIV-related stigma and ‘Positive people can be stigmatised discrimination in the Pacific. and discriminated against perhaps because of the lifestyle they Who can say this with confidence? choose to live and their approach Ms Jokabeci Tuberi Cati, the first to being positive, and maybe Pacific Islander to go public about for the perceived high level of her positive status, and a leader VIP treatment positive people in the Fiji Network of Positive sometimes expect, but generally People (FJN+). Speaking between in Fiji I feel that stigma and sessions at the 8th ICAAP, Cati discrimination will be gotten rid of.’ said Fijians have been educated Jokabeci Tuberi Cati at ICAAP and are now knowledgeable about According to Cati, one way AIDS. If 22 members of FJN+ to encourage acceptance and learn how to tackle stigma and have not reported any stigma and reduce stigma is to develop a discrimination with the numbers discrimination, then ‘we must be close working relationship with as they increase,’ said Willy. doing something right’. community leaders and sero- ‘While we can learn from the negative people, who each play experience of PLWH, we can ‘While this may suggest that important roles in prevention also learn from the way Fiji stigma and discrimination do campaigns. handles HIV-related stigma and not exist in Fiji, the 247 positive discrimination issues.’ people from Fiji may have While Fiji may seem to be in calm their own stories of stigma and waters when dealing with stigma This wave of change against discrimination,’ said Cati. ‘We and discrimination, nearby island stigma and discrimination may won’t pretend that everything is nation Vanuatu might be headed take time, but will ultimately reach all right, but at the same time this for a storm. Nelly Willy, also at the shores of other islands in the could be a clear sign that Islanders ICAAP, on an Oxfam scholarship, region. Hopefully that time will are realising that people living said there has been a great deal come soon. with HIV are the same people of stigma and discrimination that we work with, live with and surrounding the three positive Source: Based on the online love before infection. people there. One of those people coverage by the Key Correspondent has since passed away. Team, coordinated by Health & ‘For me personally, I have Development Networks (HDN), never experienced stigma and ‘His wife would not allow the 8th International Congress on AIDS discrimination since I went public body to be brought home and in Asia and the Pacific in Colombo, in 2003, but I guess this also this is sad, and it is even sadder Sri Lanka, 19–23 August 2007. boils down to the personality and to say that Vanuatu will only http://www.TheCorrespondent.org

Pacific AIDS Alert 26 Bulletin n° 32 – 2007 ICAAP update

ICAAP: Prioritising male sexual health in the Asia Pacific

groundbreaking coalition male sex is being treated as if it Aaiming to build, strengthen ‘Male-to-male sex does not exist. The reality is male- and increase interventions is being treated as to-male sex occurs in all countries addressing HIV-related if it does not exist. and cultures.’ vulnerabilities of men who have The reality is male- sex with men (MSM) in the Asia to-male sex occurs Open to regional and subregional and Pacific region was launched at in all countries and networks, as well as national the 8th ICAAP. cultures.’ networks and individual organisations, APCOM will The Asia Pacific Coalition on be governed by a 19-member Male Sexual Health (APCOM), Governing Board comprised of an autonomous, regional community representatives from coalition of civil society groups, seven subregions of the Asia government sector representatives, Pacific. In addition, the board will donors, technical experts and the consist of representatives from United Nations system, plans the transgender community, the to conduct targeted advocacy government sector and donors, with stakeholders, including and a communication adviser. governments and donors, UNAIDS, the United Nations to improve the HIV policy Development Programme framework, increase investment the access of most-at-risk (UNDP) and the United and evidence-based research, scale groups to HIV prevention and Nations Educational, Scientific up programmes, and promote the treatment services. And analysis and Cultural Organization individual rights of MSM and of national AIDS budgets (UNESCO) will support transgenders. indicates that even countries APCOM with technical advice. with concentrated epidemics Despite evidence establishing often fail to allocate meaningful APCOM is a direct outcome male-to-male sex as one driving resources to programmes that of the Male Sexual Health and force of HIV transmission in specifically address the needs of HIV in Asia and the Pacific Asia and the Pacific region, the populations at highest risk of International Consultation held in relatively few MSM interventions HIV infection. New Delhi in late 2006. strategically focus on prevention, treatment, care and support ‘How long can we remain silent for MSM and transgender spectators in the face of such populations. neglect, particularly when the population at risk is so big in Source: Medical News Today, Furthermore, almost half (45 number?’ asked Prasada Rao, 29 August 2007; http://www. per cent) of countries have laws Director, UNAIDS Regional medicalnewstoday.com/ in place that actually hinder Support Team in Asia. ‘Male-to- articles/80778.php

Pacific AIDS Alert 27 Bulletin n° 32 – 2007 IAS news

MSM – some definitions

1. The term ‘men who have sex with men’ is used within the context of understanding that the word ‘man’/’men’ is socially constructed. Moreover, its use does not imply that it is an identity term referring to an identifiable community that can be segregated and so labelled. Within the framework of male-to-male sex, there are a range of masculinities, along with diverse sexual and gender identities, communities, networks and collectives, as well as just behaviours without any sense of affiliation to an identity or community.

2. Broadly speaking, transgender people are individuals whose gender expression and/or gender identity differs from conventional expectations based on the physical sex they were born into. The word ‘transgender’ is an umbrella term that is often used to describe a wide range of identities and experiences, including female-to-male and male-to-female sexual reassigned persons, cross- dressers, drag queens, drag kings, gender queers, and many more. [In the Asia and Pacific region this would include hijra, some kothi, zenana and meti, kathoey, waria, bakla, faafafine, etc.] Because transgender is an umbrella term, it is often thought to be an imprecise term that does not adequately describe the particulars of specific identities and experiences. (For example, the identity/experience of a post-operative female-to-male transsexual will probably be very different from that of a female-identified drag king who performs on weekends, but both are often lumped together under the term ‘transgender people’.)

Source: UNAIDS

IAS: Talk with us, not about us Maura Elaripe Mea, Igat Hope*

y name is Maura I went through a very difficult other positive people to form an MElaripe Mea, and I time when I was diagnosed organisation for positive people am from Igat Hope, a national with HIV in 1997. We had no in Papua New Guinea, and we network of positive people in counselling or care and support named our organisation Igat Papua New Guinea. I am deeply services in place to help us. I saw Hope. Igat Hope in the Malaysian honoured to be asked to speak to great pain and suffering around Fijian of Papua New Guinea you this evening at the opening me, particularly from the stigma simply means ‘There is hope’. ceremony of this very important and discrimination that frequently And it is that hope that I cling to AIDS Conference here in Sydney. accompany public knowledge of – believing that things could be being HIV positive. In the face of very different. This evening, I will tell you some my struggle and the struggle of things about me and what HIV so many positive people having During my involvement with Igat is doing to my country, and I to deal with HIV, I took the step Hope, I have advocated with other will talk about how to improve of talking openly about HIV to members for access to life-saving the future of HIV-positive try and break down some of the treatment and comprehensive people. barriers. I came forward with 19 sexual education to protect the

Pacific AIDS Alert 28 Bulletin n° 32 – 2007 IAS news

community through prevention the epidemic – from policy and from HIV infection. I have strategy development through strongly advocated that I, like all to implementation nationally, other women, should have my regionally and globally. GIPP sexual and reproductive rights has been shown time and time respected. again to be a central component of an effective and successful Despite all the efforts made, even response to the epidemic. Apart now I am struggling at times to from ensuring that responses be heard. Certainly, stigma and are relevant to the needs of discrimination remain a huge HIV-positive people, I call upon burden on the lives of positive individuals, communities, non- people. In other Pacific countries, governmental organisations, such as Fiji, they are experiencing donors and governments to ensure Maura Mea presenting at the increases every year in diagnosed that GIPP is implemented in all International AIDS Society cases, with very few care and of their work. Conference in Sydney support structures. It is hard to deal with HIV when you are The treatment must involve against us, to allow us to work and already struggling financially and positive people as key players move ourselves out of the poverty have little or no opportunities because there are a lot of that HIV so often brings and to for employment and no other challenges and issues we face allow us to help prevent others means of income. This is a time starting and staying on treatment. from becoming infected. where judicial and policy-makers We need governments to agree to need great resolve to address the action to make sure we all have There is a fundamental deeper growing crisis that is unfolding equitable access to medicines principle. The principle is: talk in the region, particularly in my and medical care: not just with us, not about us. So, once homeland, Papua New Guinea. antiretrovirals, but treatments again, talk with us, not about us. for opportunistic infections and Thank you. One of the keys to addressing common co-infections such as TB the HIV epidemic is to address and hepatitis C. *Keynote speech at the opening stigma and discrimination. An session of the Fourth International important way of doing this There is a huge need for improved AIDS Society Conference on is to put a real human face to health infrastructure and trained HIV Pathogenesis, Treatment the epidemic and embrace the HIV practitioners who are both and Prevention, hosted by the principles of Greater Involvement skilled and experienced. The need International AIDS Society of Positive People (GIPP) in for beds by people with AIDS and Australasian Society for decisions that affect their lives. in the main hospital in Papua HIV Medicine, 22 July 2007. Those principles are as important New Guinea outnumbers the bed Original transcript provided by today as they were when they were capacity. There is a need for better Kaisernetwork.org. Full transcript first developed in 1994. These care and support programmes, is available from http://www. principles tell us how important which are often in short supply. kaisernetwork.org/health_cast/ it is to involve HIV-positive We want people to stop being uploaded_files/072207_IAS_ people at all levels of response to afraid of us and discriminating Opening2_transcript.pdf.

Pacific AIDS Alert 29 Bulletin n° 32 – 2007 M & E

Confused? Bored? Not any more! Kamma Blair, Monitoring and Evaluation Officer, HIV & STI Section, SPC

Dear Aunty Kamma, exchange views with member What is UNGASS? states. From Floundering in FSM

Also part of the 2006 meeting Dear Floundering, were a series of panel discussions and roundtables covering Don’t panic! UNGASS stands for diverse topics. Building on these United Nations General Assembly discussions, a high-level meeting Special Session. In 2001, took place on the third day. heads of state and government This meeting culminated in the representatives of 189 nations adoption of a political declaration gathered at the first-ever Special progress towards realising the aimed at reaffirming and again Session on HIV and AIDS at the commitments set out in the expressing commitment to UN headquarters in New York. Declaration of Commitment and the full implementation of the They unanimously adopted the to: Declaration in the coming years. o Declaration of Commitment on review progress in HIV/AIDS, acknowledging that implementing the For the political declaration, the AIDS epidemic constituted Declaration, focusing on see http://data.unaids.org/ a ‘global emergency and one of both constraints to and pub/Report/2006/20060615_ the most formidable challenges opportunities for full HLM_PoliticalDeclaration_ to human life and dignity’. The implementation; ARES60262_en.pdf. o Declaration of Commitment consider recommendations covers 10 priorities, from on how the targets set in As you are from FSM, you may prevention to treatment to the Declaration might be be interested to know that the funding. It was designed as a reached, including through Federated States of Micronesia blueprint to meet the Millennium the ‘towards universal access is a signatory to the UNGASS Development Goal of halting and processes’; and declaration. In 2006 FSM o beginning to reverse the spread of renew political commitment. provided an UNGASS country HIV by 2015. report. The meeting involved all sectors For a summary of the Declaration of the international community: For the FSM country report, of Commitment, see http://data. governments, civil society and see http://data.unaids.org/pub/ unaids.org/pub/report/2002/ the private sector. For the first Report/2006/2006_country_ jc668-keepingpromise_en.pdf. time, a person living with HIV progress_report_micronesia_ addressed the General Assembly en.pdf. The follow-up to the 2001 plenary – a right normally Aunty Kamma meeting was again held in reserved for member states and New York, from 31 May to UN officials. There was also a civil 2 June 2006. The main purpose society hearing, which provided of the meeting was to review civil society an opportunity to

Pacific AIDS Alert 30 Bulletin n° 32 – 2007 Resources

Dear Aunty Kamma, information to help people these reported changes. When What is the Most Significant manage the programme. It the technique is implemented Change (MSC) model? contributes to evaluation because successfully, whole teams of people From Figuring It Out in Fiji it provides data on impact and begin to focus their attention outcomes that can be used to help on the programme’s impact. Dear Figuring It Out, assess the performance of the Then staff and stakeholders can programme as a whole. make decisions about future Don’t panic! The MSC model is a programming in relation to qualitative method of monitoring Essentially, the process involves lessons learnt from the significant and evaluation that is now being the collection of significant change change stories. used quite widely in the world stories coming from the field of M&E. The MSC technique level, and the selection of the most Check out these websites for more is a form of participatory significant of these stories by panels information: monitoring and evaluation. It is of designated stakeholders or staff. o Rick Davies and Jess Dart’s participatory because many project The ‘Most Significant stakeholders, such as communities, The designated staff and Change’ (MSC) Technique: are involved in both deciding the stakeholders are initially involved A guide to its use: http:// sorts of change to be recorded and by ‘searching’ for project impact. www.mande.co.uk/docs/ analysing the data. Once changes have been captured, MSCGuide.htm various people sit down together, o Zahmoo’s Evaluate and It is a form of monitoring read the stories aloud and have Monitor Projects Using because it occurs throughout the regular and often in-depth Stories: http://zahmoo.com/ Aunty Kamma programme cycle and provides discussions about the value of

Review of HIV/AIDS Media Guide Trevor Cullen, Head of Journalism, Edith Cowan University

he figures are difficult to year that up to 100,000 people governments to account. A more Tgrasp: 65 million people could be living with HIV within immediate problem, though, around the world have been the country. Further, it stated that is: How can journalists report infected with HIV and 25 million PNG could experience an AIDS effectively on a disease that has people have died since the epidemic similar to the one that been around for more than 20 disease was first detected in 1981. has devastated several southern years, as it has been in PNG? Currently 38 million people are African countries, in which more living with HIV and this figure than 25 per cent of the population In light of this troublesome could double by 2020. is infected with HIV. question, the HIV/AIDS Media Guide is a timely publication as Closer to home, the National Certainly the media have it aims to improve the reporting AIDS Council in Papua New a significant role to play in of HIV worldwide. The booklet, Guinea announced in May this informing the public and holding published by the International

Pacific AIDS Alert 31 Bulletin n° 32 – 2007 Resources

Overall, the survey revealed an improvement in media coverage of the disease. More stories were covered in print (281) than in the broadcast media (75). At the same time, it identified a strong need to use new angles when reporting on HIV. One weakness of the research, however, was its limited scope. The single week that it covered in each continent coincided with World AIDS Day on 1 December, when there are always more stories on HIV and AIDS. Different results may have been obtained if the research had been conducted at a different time of the year. Nonetheless, the Media Guide provides a snapshot of what is happening in the six countries that were surveyed.

I would highly recommend this booklet, because HIV is more than a disease that infects an individual. It is linked to the wider community through social Federation of Journalists (IFJ) The section on research focuses and economic issues such as and sponsored by the Swedish on three countries in Asia – the poverty, domestic violence, gender trade union movement, is divided Philippines, India and Cambodia equality, and religious and cultural into three parts: the basics, the – and three in Africa – Zambia, beliefs. It is a story that needs this media, and more about HIV. It South Africa and Nigeria. The wider perspective together with provides answers to frequently Media Guide is available in the informed and accurate reporting. asked questions and presents languages of these countries: The booklet provides essential explanations on transmission, English, French, Tamil, Tagalog facts and writing tips to achieve treatments, opportunistic and Khmer. The research these outcomes. infections and alternative terms involved monitoring the media For more information, contact to use so as to avoid promoting for two weeks (one week in Asia Dr Trevor Cullen, ph: +61 8 9370 misconceptions about people and the other in Africa) in late 6354, email: [email protected]. living with HIV and AIDS. November and early December TheHIV/AIDS Media Guide is These sections are extremely 2005 in order to determine the available on SPC’s HIV & STI Section useful, especially for their clarity quality and quantity of their website. Go to www.spc.int/hiv and and precision. HIV reports. click on Downloads and then Media.

Pacific AIDS Alert 32 Bulletin n° 32 – 2007 Resources

The Pleasure Project: Putting the sexy back into safer sex

ne of the organisations Oexhibing at ICAAP was the Pleasure Project, an educational organisation promoting safer sex that feels good. In contrast to the many safer sex and HIV prevention programmes that are negative and disease-focused, the Pleasure Project takes a positive, liberating and sexy approach to safer sex. Think of it as sex education … with the emphasis on ‘sex’.

This organisation aims to make sex safer by addressing one of the major reasons people have sex: the pursuit of pleasure. outlets. It provides innovative For more information, go to: training, consultancy, research www.thepleasureproject.org. The Pleasure Project works with and publications to sexual health Adapted from ‘The Pleasure Project: a wide variety of organisations trainers and counsellors, NGOs What we do’. and individuals: NGOs, the and others who want to take a http://www.thepleasureproject.org/ public health sector, erotic media more sex-positive approach to section4. Retrieved from the Internet producers, journalists and media their work. 17 October 2007.

Pacific AIDS Alert 33 Bulletin n° 32 – 2007 World AIDS Day

Drumming for HIV Zoe Bake Paterson, Communications Officer, Pacific Islands AIDS Foundation

he Pacific Islands AIDS the region to get together and HIV infections. It also means a TFoundation (PIAF) is calling play drums – and sing – in order Pacific where there is compassion on Pacific Islanders to join in to increase awareness of HIV and support – no one should be the rhythm of the drums in and AIDS. In the Pacific our discriminated against for living recognition of World AIDS Day communities are united by music. with or being affected by HIV; on 1 December 2007. Drums and song are used for no one should live in fear of dances, ceremonies, remembrance getting an HIV test. This is the second ‘Drumming and celebrations. They are for HIV’ campaign in the played by one person or many, in We call on the Pacific Islands Pacific Islands. Last year, over families or in other groups, for region to take up the message of 20 communities in more than rugby games or for church. To ‘Drumming for HIV’ for 2007. 14 Pacific Island countries came honour this important part of our HIV is happening to us now. Join together to participate in this island cultures, we are calling on together in ‘breaking the silence’ region-wide initiative: Cook people to drum for HIV. around HIV. Let’s make this year Islands, Federated States of an even bigger event! Micronesia, Fiji Islands, Guam, The goal is to show a communal Hawaii, Nauru, New Caledonia, unity in our effort to respond to For more information contact the Northern Mariana Islands, Papua HIV, to keep ourselves safe from Pacific Islands AIDS Foundation, New Guinea, Republic of Marshall infection, and to support people ph: +682 23 102, Islands, Samoa, Solomon Islands, living with the virus. email: [email protected] Tahiti Nui – and even Tonga, where drumming is not a tradition. It has been more than 25 years since AIDS was recognised as a At the 2006 gatherings, each new disease in the United States. community incorporated Since the first eight cases of HIV drumming in its own fashion were diagnosed in the region in to strengthen or create a World 1985, HIV cases have more than AIDS Day event. Drumming doubled every five years in the was included in public marches, Pacific Islands. It is time for us to at a secondary school student join together for an AIDS-free assembly, at a community market Pacific. information booth, during an HIV awareness football match, at An AIDS-free Pacific means a a concert, at speeches and at many Pacific where those living with other events. The campaign was a HIV have the treatment and great success. care they need to prolong a healthy and long life without Once again we are inviting AIDS. It means a Pacific people in communities across where we prevent new

Pacific AIDS Alert 34 Bulletin n° 32 – 2007 Regional Strategy

Pacific Regional Strategy on HIV/AIDS news Nicole Gooch, HIV & STI Communications Officer, Public Health Programme, SPC

Forum Leaders and suggestions, please also email endorse extension of Dr Iniakwala. Regional Strategy Leaders at the 38th Pacific Islands Forum held in Tonga on Pacific Regional 16–17 October 2007 ‘endorsed the Strategy extension of the current Pacific Implementation Plan Regional Strategy on HIV and (PRSIP) AIDS (2004–2008) for a further Partners in the Pacific Regional five years to cover 2009–2013 Strategy Implementation Plan and agreed that it be amended to (PRSIP) met in Fiji for five emphasise current and emerging days of planning from 12 to 16 trends of the epidemic, including November, jointly organised by other sexually transmitted SPC and UNAIDS. For the first infections’. time, the 50 participants broke into smaller groups, with each this epidemic are in our hands To download the Forum group focusing on an outcome here in the region. But we have to Communiqué, go to: of PRSIP in order to better plan confront and act on the need to http://www.spc.int/hiv/regional- activities for 2008. change our own ways of working strategy-on-hiv/. and behaving beyond rhetoric.’ In her opening remarks, Tuberi Cati of FJN+ highlighted the Dr Dennie Iniakwala, HIV & Regional Strategic outcomes of a recent needs STI Section Head at SPC, said he Reference Group analysis conducted among saw PRSIP as ‘a collective effort The Regional Strategic Reference PLWH in Fiji, which found five by all participating agencies and Group on HIV and other STIs is priority areas: treatment and care, stakeholders, with a primary focus currently developing the Pacific psychological support, financial on building and strengthening Regional Strategy on HIV and support, awareness, and support the capacity of Pacific Island other STIs (2009–2013). To view for the family. countries and territories to achieve the draft working document, an expanded and sustainable version 3, go to: http://www.spc. Stuart Watson, UNAIDS Pacific response to HIV and AIDS. int/hiv/regional-strategy-on-hiv/. Coordinator, took the opportunity PRSIP is a collaborative and to ‘reaffirm the UN’s ongoing coordination framework that Please send your comments commitment to enhancing facilitates complementarity of directly to Dr Dennie Iniakwala, coordination among the UNAIDS activities, minimises overlaps HIV & STI Section Head – co-sponsors and between the and duplications, proactively email: [email protected]. If you UN and regional organisations identifies gaps and challenges, and wish to receive a Word version of and donors’. He added that ‘all progressively bridges these gaps the document to insert comments the tools to change the course of and responds to these challenges.’

Pacific AIDS Alert 35 Bulletin n° 32 – 2007 UNFPA

UNFPA provides free condoms to NGOs

NFPA has agreed to ensure 3. have identified who will be Uthe supply, on a needs distributing the condoms basis, of condoms to NGOs. By in the community (e.g. peer distributing condoms to NGOs, educators) and be able to UNFPA hopes ‘to increase access demonstrate capacity to to free condoms in the Pacific, ensure that the condoms in the private and public sectors, reach the target groups; and and especially to reach the most 4. free distribution – the at-risk groups better, faster and condoms are not to be sold. more discreetly,’ says Dr Seta Vatucawaqa, Reproductive Health In return for providing the Commodity Security (RHCS) condoms, UNFPA expects to be Manager for the UNFPA Office able to collect distribution data for the Pacific. from the NGOs.

To receive the condoms, NGOs For more information, need to contact UNFPA and be please contact: able to fulfil four basic criteria: 1. be engaged in reproductive Mr Najib Assifi health work; UNFPA Representative & 2. have identified and be Director CST working with the most at-risk UNFPA Office for the Pacific groups in their community Private Mail Bag (such as youth, commercial Suva, Fiji sex workers, taxi drivers, Tel: +679 330 8022 ext. 108 wheelbarrow boys and Fax: +679 331 2785 seafarers); E-mail: [email protected]

PASA, The Pacific AIDS Alert Bulletin is a newsletter of the Secretariat The opinions expressed in articles in this magazine are those of of the Pacific Community (SPC) HIV & STI Section. the authors of the articles and are not necessarily endorsed by SPC.

Website: www.spc.int/hiv — Email: [email protected] © Secretariat of the Pacific Community, 2007 Coordinated by Nicole Gooch The use of a photo in this publication does not imply anything Design and layout by Muriel Borderie about the person’s HIV status. Printed by SPC Printery, Noumea Reproduction of this material whole or in part in any form is Original text: English encouraged in order to help spread the message before the virus, provided that SPC and the source document are properly Produced with financial assistance from acknowledged. Original SPC artwork may not be altered AusAID and the French Government or separately published without permission.

Pacific AIDS Alert 36 Bulletin n° 32 – 2007