Condom social marketing (CSM) programs have been extremely successful in Rwanda and Haiti despite political and economic chaos. Hundreds of small sales outlets have been established throughout Rwanda for CSM. Using commercial marketing techniques, affordable pricing, and existing retail networks to promote, distribute, and sell condoms, the AIDS Control and Prevention (AIDSCAP) Project's nonprofit CSM programs have created enormous demand for condoms even in places where resistance to them used to be extremely strong. Overcoming cultural barriers to condom use is one of the great challenges facing CSM programs throughout the world. Cooperation amid chaos, violent civil conflict in Rwanda, and partnerships with communities, nongovernmental organizations, and other community-based organizations are discussed.
The AIDS Control and Prevention (AIDSCAP) Project's Regional AIDS Training and Education (RATE) Program over the course of 1993-96 trained 111 professionals from Thailand, Cambodia, Laos, Nepal, India, Bangladesh, the Philippines, Mongolia, Sri Lanka, Indonesia, and the South Pacific islands. Training was on behavior change communication, sexually transmitted disease management, policy development in HIV/AIDS prevention, and the training of trainers. To build the capacity of regional institutions to sustain such training after the end of AIDSCAP's involvement, centers of excellence were created at the following Thai universities: Dhurakijpundit University's Asia-Pacific Development Communication Center for training and behavior change communication, Mahidol University's Institute for Population and Social Research for policy development and journalism training, and the Women's Studies Center at Chiang Mai University for gender issues. The director of the RATE program from AIDSCAP's Asia regional office in Bangkok discusses the program's success and lessons learned on sustainability and capacity building.
Hundreds of thousands of tourists, traders, businessmen, truckers, migrant workers, and transient tribal minorities cross from Thailand into the Lao People's Democratic Republic (PDR) each day. Unlike Thailand, Lao has low rates of HIV infection. The significant cross-border flow of population, however, demands that Lao and its population take caution to avoid contracting and spreading HIV. Lao's Boat Race Festival is an event during which people are expected to lose their inhibitions. The Boat Race festivities held October 26-28, 1996, in Vientiane and two other Lao towns across the Mekong River from Thailand marked the launch of an innovative safer sex promotion campaign designed by the AIDS Control and Prevention (AIDSCAP) Project and CARE International to reach people from both sides of the river with timely HIV/AIDS prevention messages and methods. The project particularly targets people who regularly cross the Lao-Thai border and their sex partners. Mass education, condom distribution, and outreach activities were an important part of the 1996 festival.
After learning in 1993 that 9% of female prostitutes in rural Belgaum were infected with HIV, the Mysore Resettlement and Development Agency (MYRADA) together with PLAN International, set out to target the prostitutes with HIV/AIDS and sexually transmitted disease (STD) prevention messages. However, in so doing, the already stigmatized women would become even more ostracized and the rest of the community would receive the false impression that AIDS prevention does not concern them. A broad-based campaign was instead designed and implemented which reached out to inform and empower the entire community. The AIDS/STD awareness prevention and control program reached into every sector of the district and involved many thousands of its residents as outreach educators, condom sellers, street performers, youth leaders, health promoters, and much more. This is an example of a highly successful and sustainable grassroots project which demonstrates the value of using and building local capacities to design and lead HIV/AIDS prevention efforts.
Over the past decade, studies in Jamaica revealed widespread acceptance of sex outside of marriage or other stable relationships and a common perception that sexually transmitted diseases (STDs) are a natural and easily curable outcome of sexual activity. However, recent surveys suggest that these attitudes and behaviors are beginning to change. Jamaican men who once readily had 5 or more sex partners per year are choosing their partners more carefully and staying in relationships longer. Men and women report having fewer sex partners, while young male adolescents are waiting until they are older to begin having sex. This attitudinal and behavioral change may be attributed to the Ministry of Health's HIV/STD control program launched in 1987. The program is comprehensive, systematic, and sometimes uses an unorthodox approach to HIV/AIDS prevention. HIV/AIDS and STDs were linked in the integrated approach.
