Community leaders encourage greater demands for VCT services in Timor Leste
by Michael Johansson, CRS Technical Advisor, Timor Leste
CRS Timor Leste has implemented the Smart & Safe (S&S) prevention project as a sub-grantee of the Ministry of Health’s Global Fund Round 5 HIV grant since January 2008. The S&S project targets clients of sex workers in four districts using A and B social behavior change communication strategies and promotion of early (VCT) testing as a partner to the MoH HIV prevention program that focuses its intervention on higher risk groups such as Commercial Sex Workers (CWS), Men who have Sex with Men (MSM) and Clients of Sex Workers (CSW).
The approach of the MoH has proven successful in a number of ways including: an increased awareness of HIV and unsafe behavior and a greater uptake of VCT services among these higher risk groups; government, civil society and faith based organizations are paying more attention to these marginalized groups in society which has given many beneficiaries the strength to make important life-changing decisions continuing towards healthier lives.
However, S&S staff and volunteers have over the past two years identified that a considerable segment of the population at risk of HIV and other STIs are not being reached with current HIV and STI prevention messages because they either don’t consider themselves at risk or because they don’t know that they are at risk. For example, many wives and partners of CSW, MSM and CSW don’t always understand that they too are at risk of HIV and many are unaware of their partner’s unsafe behaviors. Another group that should be considered high risk is ‘youth’. However, as they have not yet been identified as high risk by the national intervention program there are only a few projects that focus directly on the needs and experiences of young men and women in Timor Leste. An unfortunate side effect of the Timor Leste prevention strategy that is becoming obvious is the stigma attached to accessing VCT services; since only people at risk need to do an HIV test, the assumption of the general public is that a person testing for HIV is involved in transactional sex and so the ramification of discrimination in society leads to a significant decrease in people testing for HIV.
For World AIDS Day (WAD) this year the CRS S&S team decided to try to deepen the general public’s understanding of HIV and VCT services with the rationale that a greater understanding and knowledge of HIV and risk will encourage a greater number of people to access VCT. By reaching ‘new groups’ (such as, but not limited to, partners of CSW, MSM, CSW and Youth) the S&S project wishes to encourage a more heterogeneous VCT client uptake which will assist to combat the stigmatization of marginalized groups and build the confidence and professionalism of the VCT counselors.
Together with CRS partners in Baucau, the second largest city in Timor Leste, CRS implemented a very successful WAD celebration under the global theme of ‘Universal Access’.
Not only did representatives from government district authorities such as Justice, Public Transport, Security and Health take part in the hour long campaign drive through central Baucau but many high profile participants attended the Mass conducted by Father Basilio Pereira and took part in the HIV quiz show held at the Baucau Diocese. The final event of WAD took place at the Regional Hospital in Baucau where a number of participants were publicly counseled and tested for HIV; among the pioneers that took part in this event was the District Administrator of Baucau, Mr. Antonio Guterres, and the Police District Commander, Mr. Armindo da Silva. Journalists from three leading news papers also tested for HIV and later wrote about their experiences in WAD specials. Mr. Antonio Guterres and all the other participants have shown the way in Baucau towards an important change in communities’ perception of risk and HIV in Timor LesteAntonio and Armindo are the two highest level civil servants that have tested publicly for HIV in Timor Leste and this is expected to have an impact on VCT service uptake in a country where the greatest barrier to effective HIV prevention is fear of stigmatization.
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