AIDSTAR-One's Case Study Series documents innovative approaches in emerging areas of HIV. These engaging case studies are designed for implementers and program planners, documenting the steps from idea to intervention and from research to practice.
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Legal Units—Child Protection for OVC
Orphans and other vulnerable children (OVC) are susceptible to abuse, exploitation, violence, and neglect and often do not have access to support systems designed to assist in these instances. This case study examines Legal Units in Côte d'Ivoire, a network of individuals and resources that can be tapped as needed to protect the rights of children and their families.
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Coffee, Popcorn, Soup, and HIV
Chronic food insecurity is harmful to children and pregnant women living with HIV. In Ethiopia, where the malnutrition rate is particularly high, side effects of treatment threaten to reduce adherence to drug regimens. This case study examines how the Breedlove Project integrates HIV programming with nutrition programming to address needs of families in Ethiopia.
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Prioritizing HIV in Mental Health Services Delivered in Post-Conflict Settings
Undetected and untreated mental health problems have been shown to have a profound effect on ART adherence, symptom severity, and quality of life, which in turn can influence HIV progression. This case study examines the Peter C. Alderman Foundation's efforts to integrate HIV services and referrals into their mental health program in the post-conflict area of Northern Uganda.
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Promoting New Models of Masculinity to Prevent HIV among Men Who Have Sex with Men in Nicaragua
In Nicaragua, HIV prevention for "sexually diverse" populations, including MSM, is made significantly more difficult by societal norms that stigmatize same-sex sexual activity and favor conformity to strict gender roles. CEPRESI is working to change perceptions of masculinity in Nicaragua's general population and educating MSM on HIV prevention and treatment.
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Integrating Family Planning and HIV Services
In regions of high fertility and HIV prevalence, integration of family planning and HIV services has emerged as a promising strategy to prevent transmission of HIV, particularly from mother to child. This case study explores different models of integration and how they have been realized in Kenya and Ethiopia, two pioneers in family planning and HIV service integration.
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The Avahan-India AIDS Initiative
Launched in 2003, the Avahan-India HIV prevention program has become a global model for combination HIV prevention programming that meets the complex and varied needs of most-at-risk populations. This case study describes Avahan's behavioral, biomedical, and structural components and how the program was able to quickly scale up its activities across 82 districts in India.
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Health Initiatives for the Private Sector (HIPS)
The HIPS Project is a model for involving private providers in a national HIV/AIDS prevention and treatment approach, while strategically planning for long term sustainability. This case study looks at the issues around decentralization of HIV treatment to private providers, as well as how private sector engagement can support the goals of the PEPFAR strategy.
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Looking Within
An example of how assistance can be mobilized from within communities to protect young people's access to education, Youth Alive Tanzania's Youth and Parents Crisis Counseling Center (YOPAC) is implementing "community-enforced agreements"—simple and straightforward commitments of support—that give orphans like Jamilla confidence and optimism about their futures.
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PITC and the Private Sector
Provider-initiated testing and counseling (PITC) is an emerging model of HTC that aims to increase HIV testing rates. APHIA II Western is one of few programs engaging private providers in PITC efforts.
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"Club Risky Business"
Addressing multiple and concurrent sexual partnerships (MCP) and other drivers of HIV in Zambia, this fictional mini-series and its associated One Love Kwasila! multimedia campaign encouraged viewers to protect themselves and their partners by "cutting their connections to HIV."
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The Fataki Campaign
Little attention is paid to the potential risk of HIV exposure in intergenerational relationships, through which older men offer young women money or goods in exchange for sex. In Tanzania, the Fataki radio campaign uses humor and familiar stories to foster dialogue around the dangers of intergenerational sex and to empower community members to intervene.
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Alcohol Consumption and HIV Risk
Through their innovative Community Popular Opinion Leader (CPOL) approach, the Y.R. Gaitonde Center for AIDS Research and Education (Y.R.G. CARE) provided peer education on the risks of alcohol consumption and HIV in informal bars known as wine shops in Chennai, India between 2002 and 2007. Using "I statements" to convey relatable personal experiences, focusing more realistically on risk reduction rather than risk elimination, and continually seeking new information on the social and structural environment in Chennai helped Y.R.G. CARE develop an adaptable, peer-based HIV prevention program.
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Mental Health Care and Support, Vietnam
The mental health needs of people living with HIV (PLHIV) are often overlooked in care, treatment, and support programs. This case study provides a step-by-step example of how FHI in Vietnam integrated mental health services into a care and treatment program and a methadone maintenance treatment program to improve the quality of life among PLHIV.
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The International HIV/AIDS Alliance Ukraine
AIDSTAR-One's first case study in the Promising Approaches to Combination Prevention series examines the efforts of the Alliance-Ukraine to reach most-at-risk populations (MARPs) in Ukraine. Through its partner organizations, the Alliance-Ukraine provides the majority of HIV prevention services in the country, targeting the primary driver of Ukraine's HIV epidemic: injecting drug use. Community engagement, advocacy for supportive policies, and linkages to government services complement evidence-based programming.
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The O Icheke Campaign, Botswana
As a lynchpin of its bold goal of zero new HIV infections by 2016, Botswana's national O Icheke: Break the Chain campaign offers a wake-up call on the risks of multiple and concurrent sexual partnerships. O Icheke ("Check Yourself" in Setswana) combines mass media with district-level interventions targeting community norms change and individual behavior change.
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Wising Up: Reducing Alcohol-Related HIV Risk Behavior through Counseling
In South Africa, where rates of alcohol consumption and HIV are among the highest in the world, sexual risk taking and drinking frequently intersect. In Cape Town, the Phaphama ("Wise Up") program demonstrated dramatic behavior change in the months following a single, 60-minute counseling session offered to repeat patients at a sexually transmitted infection clinic.
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HIV Prevention on the U.S.-Mexico Border
Along the U.S.-Mexico border, a growing HIV epidemic fueled largely by commercial sex and injecting drug use threatens both countries. Working in an often dangerous climate, two Mexican NGOs provide most-at-risk populations in Tijuana and Ciudad Juarez with HIV prevention services that use a combination of approaches.
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Secret Lovers Kill
The first case study in the series examines the Makhwapheni Uyabulala Campaign in Swaziland. Translated as "Secret Lovers Kill," Makhwapheni Uyabulala was Swaziland's first national media campaign to focus on the HIV risk of multiple and concurrent sexual partnerships (MCP). The campaign promoted HIV prevention in the country with the world's highest HIV prevalence by broadcasting a powerful message that resonated with the public and encouraged behavior change. The Makhwapheni Campaign launched a widespread public exchange about multiple sexual partnerships and the spread of HIV, a topic rarely discussed in Swazi society.
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The Scrutinize Campaign
Victor Scrutinize was the animated star of the Scrutinize Campaign, a year-long series of HIV prevention ads launched on South African television in June 2008. Irreverent and humorous, with strong, colorful visuals, the campaign's ads were markedly different from previous South African HIV prevention campaigns for youth. Rather than telling the audience what to do, the Scrutinize campaign messaging encouraged those in the audience to scrutinize their own behavior and resulted in dramatic uptake of key HIV prevention messages.
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CEPEHRG and Maritime, Ghana
Men who have sex with men (MSM) have been neglected in HIV programming in sub-Saharan Africa, frequently ignored in national strategies and hidden in the face of intolerance, stigmatization, and punitive laws. In Ghana, community-based organizations (CBOs) have been at the forefront of HIV interventions for MSM. Among the small number of CBOs working with this highly vulnerable population are the Accra-based Center for Popular Education and Human Rights, Ghana (CEPEHRG) and Maritime Life Precious Foundation (Maritime) in Takoradi. With the support of PEPFAR, these two organizations have been part of much-needed efforts to reach MSM with prevention messages, condoms, and lubricant and to increase uptake of HIV-related services using cell phone-based communications.
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The Humsafar Trust, India
Recent studies confirm that globally men who have sex with men (MSM) are at significantly greater risk for HIV infection than other adults of reproductive age, due to a combination of biological, behavioral, and structural factors. In a sometimes difficult cultural and political environment, the Humsafar Trust works with MSM in Mumbai and successfully links community advocacy and support activities to the development of effective HIV prevention and health services. In India as elsewhere, the development of responsive programming and service options for MSM will help reduce their vulnerability to HIV and improve the overall effectiveness of the HIV response.
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