Implementing Best Practice In HIV Prevention Programmes

Background: Worldwide, HIV prevention strategies are constantly being adapted and developed. It is important that the Caribbean region learns and makes optimal use of effective prevention approaches. This paper highlights the sharing of ‘Best Practices’ in HIV prevention, to improve the effectiveness of prevention strategies.

Program background: The CARISMA programme (managed on behalf of CARICOM/PANCAP by Options Consultancy and funded by the German Financial Cooperation through KfW) uses social marketing approaches for HIV prevention and the promotion of sexual and reproductive health. The project will run until 2012 and activities are being undertaken in 13 PANCAP member countries to promote behavior change among the most at risk populations through the use of mass media, interpersonal communications, and social marketing of condoms. CARISMA partners employ various HIV prevention approaches, including: integrating sexual and reproductive health services into HIV prevention for migrant commercial sex workers, marginalized youth and men who have sex with men, working with NGOs to ensure large-scale distribution of affordable condoms to low-income neighbourhoods and high-risk zones; and supporting national governments to strengthen condom policies. In order to share these experiences and promote examples of Best Practice, CARISMA partners use a variety of channels, including an annual consultative meeting with prevention partners; a project website; the production of Best Practice reports; and Best Practice exchange trips among professionals from different countries.

Evaluation Methods and Results: Programmes are monitored and evaluated using annual TRaC studies, achievements of targets, levels of service usage, mystery shopping and user exit surveys.  A review of activities during 2010 shows that targets for outreach programmes and condom sales have been achieved and in many instances surpassed The key achievements of the project to date include:

• Increased access to condoms, in particular for Most At Risk Populations

• Regional acceptance of the Total Condom Market concept (the idea that it is important to grow all sections of the market, including free, commercial and social marketing condoms)
• The establishment of sexual and reproductive health behaviour change communications programmes targeting at-risk populations

Conclusions: We are at a point where we must integrate services and approaches instead of continuing to implement conventional methods in isolation. Sharing Best Practice provides innovative ways of improving performance and achieving positive results. While no one size fits all, a standardized set of best practice approaches that can be adapted to suit specific contexts can go a long way towards increasing efficiency and effectiveness. National HIV prevention programmes should endeavor to improve partnership working and strengthening ties with social marketers. This will allow them to use the lessons learned in their own programming, with the potential to make them more appropriate, focused and exciting.

Implications for research and/or practice: Comparative studies of countries without the Carisma Project need to be done to ascertain the full impact of the project.  And although the good practice in the existing programmes can be duplicated across the region many of them can be improved and enhanced to realize even greater benefits to the region's vulnerable groups.