Peer-led Approaches in Community-based STD Prevention

Background:
Rwanda,upset by the 1994 genocide, has yet to come to terms with its past. It caused the uprooting of hundreds of thousands orphans and widows representing the majority of rural population that has been resettled in villages, causing economic imbalance. Living standards and health conditions of the population have deteriorated considerably due to the domestic crisis. Needs assessment showed various needs apart from health, with strong inter-linkage and inter-dependencies. Lack of knowledge (illiteracy: 40% adults) about STDs causes high related morbidity and mortality. Rwanda village concept project (RVCP), an international, student-run project in the southern province has many goals including preventing AIDS and STDs through peer-led awareness and behavioral change achievement.

Objective:
Promote the health and living conditions of underprivileged communities, specifically reduce the prevalence of HIV/AIDS and STDs, and achieve sustainable behavior change in rural areas.

Method:
Interactive educational sessions have been conducted in different target groups: schooling and non-schooling youth, PLWHA, prostitutes. Evaluations of impact have been conducted using comparative studies.

Result:
More than 2,000 sessions reaching about 18% (4000 people reached) in Huye population, including health workers, villagers, school and non-school youth on HIV/AIDS STDs. Youth-led anti-AIDS clubs and income generating projects were launched and sustainability of club activities was ensured. 200 rural-based youth trained peer educators. Use of condoms increased from 23% to 67% in youth, aged 15-24, and behavioral change reached. STDs-related morbidity dropped in rural target area. A youth-network against HIV-AIDs is being developed. So far, about 40 international participants have actively participated in all the ground activities.

Conclusion:
Peer-led approaches showed good results in increasing knowledge and behavioral change against the HIV/AIDS and STDs. The excellent way to address those issues has been through community-based programs.

Implications:
The excellent way to address those issues has been through community-based programs.Lessons from Rwanda should be shared