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HIV and AIDS: Identifying Programs That Work
Horizons—a collaboration of six organizations led by the Population
Council—designs, implements, and evaluates innovative HIV prevention and
treatment strategies. The program runs until mid-2008 and is funded
through the United States Agency for International Development.One goal of Horizons is to prevent HIV transmission from mother to child
in sub-Saharan Africa, where the AIDS pandemic continues to devastate
individuals, families, and communities. Horizons conducted the first
evaluation of the mothers2mothers (m2m) program in South Africa, which
serves pregnant women and mothers living with HIV. M2m is a peer-support
program designed to help women accept their HIV status by addressing
problems resulting from stigma, and providing critical information to
assist HIV-positive women to take steps to safeguard their own and their
infant’s health.
The evaluation revealed that the program’s participants were more likely
than nonparticipants to seek and obtain drugs that reduce transmission
of HIV to their infants; to make appropriate choices regarding feeding
their babies; and to disclose their HIV status to family members. With a
proven track record, m2m is now expanding to other sub-Saharan African
countries in order to serve many more women and infants in need.
Horizons also conducts research among high-risk, hard-to-reach, and
often neglected populations. One such population, men who have sex with
men (MSM), is highly vulnerable to HIV infection, especially in
sub-Saharan Africa where governments have been slow to acknowledge the
existence of MSM or provide them with information about prevention of
HIV transmission and treatment. In Kenya, as in most African countries,
sex between men is illegal, which made a recently completed Horizons
project for men who sell sex to men in Mombasa, Kenya, especially
challenging.
The project’s goal was to estimate the number of male sex workers in
Mombasa in order to plan effective HIV prevention and treatment
programs. Mombasa, with a population of more than one million, is
Kenya’s second largest city and a major seaport and tourist destination.
Bars, nightclubs, brothels, public streets, and parks were among the 77
potential contact locations that the researchers identified.
Thirty-seven MSM peer leaders were trained to approach and identify male
sex workers. After conducting these activities on consecutive weekends,
the researchers concluded that an estimated 739 male sex workers operate
in and around Mombasa, a sizable population “who urgently need to be
targeted by HIV-prevention strategies.” Findings were published in an
article entitled, “‘Are you on the market?’: A capture-recapture
enumeration of men who sell sex to men,” in the journal AIDS in June
2007.
Following these activities, Horizons and its collaborators conducted a
survey of HIV transmission knowledge and sexual practices among male sex
workers. Results of the survey informed plans for implementing
transmission prevention and other services. Health-service providers and
peer educators were trained, and a drop-in center was opened to deliver
these services. A follow-up survey is scheduled for late 2007 to gauge
whether the services have increased knowledge and altered behaviors
among the men who receive them.
Other Horizons projects are also having a positive impact on policies
and programs important to those infected or affected by HIV and AIDS.
These include a study of adherence to antiretroviral therapy in Mombasa,
an evaluation of the Straight Talk mass-media communication program in
Uganda, and a study of male gender norms in Brazil and India. For more
information, visit the Council’s Web site at
www.popcouncil.org/horizons.(Return to issue contents)
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