Horizons | Research Summary | Greater Involvement of PLHA In NGO Service Delivery: Findings From a Four-country Study

RESEARCH SUMMARY

June 2002

Greater Involvement of PLHA in NGO Service Delivery: Findings From a Four-country Study

Country Context

Estimates of HIV prevalence in the general population vary considerably among the four countries (Ecuador, less than 1 percent; Burkina Faso, 6.5 percent; Zambia, 20 percent). In Maharashtra State, India, almost 2 percent of women attending antenatal services are infected, a figure suggesting the extent of the spread in the general population. In the two African countries, transmission is mainly heterosexual, whereas in Ecuador, homosexual and bisexual transmission account for about a third of AIDS cases. Transmission is also predominantly heterosexual in India, but there are important sub-epidemics among men who have sex with men (MSM) and injecting drug users. More than half of PLHA in Burkina Faso and Zambia are women, compared with about 35 percent in Ecuador and India.

PLHA are highly stigmatized in all four countries because of the association of HIV/AIDS with certain behaviors and population groups. Fear of stigma and discrimination means that few individuals are willing to divulge their HIV status or find out their status through HIV testing. In Burkina Faso, India, and Zambia, voluntary counseling and testing (VCT) services are not widely available, and access to antiretrovirals (ARVs) is limited to PLHA with money or international contacts. In Ecuador, ARVs are available to those eligible to use police and military hospitals and in one region to those with access to social security. Access to non-ARV treatment and care is particularly poor in Burkina Faso, India, and rural Zambia.

There are national networks of PLHA in Ecuador, India, and Zambia, but visible involvement of PLHA is low in all four countries. The mobilization of PLHA started in the late 1980s and early 1990s in Ecuador and Zambia, but is a relatively recent phenomenon in Burkina Faso and India. In all four countries the main impetus for greater PLHA involvement has come from international donors, NGOs, and activists, which have supported the development of PLHA organizations and networks and encouraged governments to give higher priority to PLHA involvement in the response to the epidemic.

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19 Oct 2007