Chapter 5 How selected population groups in Boksburg mining community respond to HIV/AIDS prevention/behaviour
5.6 Suggestions for improving STI/HIV/AIDS prevention interventions
5.6.4 Strengthen partnership with organizations on HIV/AIDS activities
It has been noted in this study that both government and private sector organizations are taking a part in the fight against the pandemic, by implementing activities that aim at changing peoples' sexual behaviours to prevent the spread of STIs and HIV/AIDS. It has again been observed that these organizations support each other in the implementation of these programs. For instance, the ERPM limited clinic at the Far East shaft benefits from free condoms and IEC materials obtained offered at Boksburg municipal hospital. In addition to these services, the clinic refers some of its patients to the hospital for thorough examination, particularly those in need of ARV and STI treatment.
On its part, the Far East clinic complements governments' efforts to bring down STI and HIV/AIDS infections in the community, by targeting one of the most risky population groups in this community; miners. However, although there is such a symbiotic partnership between these two organizations, some respondents felt that there are other partners which have been left out in this relationship, and this has implications on the success of STI and HIV/AIDS prevention efforts in the community. Respondents argued that there is little involvement of crucial social groups such as religious organizations (such as churches) and traditional healers in these programs. This oversight was argued to slow down effective implementation of these activities, and realization of desired change in people's sexual behaviours.
In one of the interviews, a respondent argued that due to limited partnership among relevant stakeholders in the fight against HIV/AIDS in this community, there are some hindrances to successful implementation of these activities. For example, some traditional healers argue that HIV/AIDS can be cured with traditional medicine, an argument widely held by many people (particularly from rural areas). Such a claim gives these people confidence to engage in risky sexual practices such as casual and unprotected sexual intercourse, with a belief that if they get infected they'll be cured by traditional medicine.
On the same note, while the clergy strengthen abstinence as the most important way to prevent the spread of STIs, the clinic and NGOs are promoting condom use, which have already been discredited by traditional leaders and the clergy. As such, there is conflict in messages getting to the people about how to prevent HIV/AIDS in the community. Furthermore, due to poor partnership among stakeholders, behaviour change interventions in this community have targeted selected population groups of interest to individual organizations implementing the programs, other than the whole community, considering that almost every member of the community is potentially at risk of being infected. Such a situation has led to other equally crucial population groups persisting with risky sexual behaviours, further putting other people (particularly with whom they interact sexually) at risk, creating an endless cycle of infections in the community.
In view of these factors, respondents suggested the need for strengthened partnership among actors as a way of effectively dealing the STIs and HIV/AIDS in this community, particularly religious and traditional healers as explained below.
'I think another thing is to enhance our relationship with even traditional healers, you know people also believe them. So if we tell them to teach people that yes traditional medicines are also there but they do not prevent a person from getting the virus and also do not curb the spread if a person does not use protection, say a condom. Yes, then may be people might then listen to them' (Key informant, EPRMFar East shaft, Borksburg central)
This chapter has discussed respondents' views on how people in the community understudy respond to sexual behaviour change or HIV/AIDS prevention activities to which they have been exposed. The discussion has also highlighted respondents' suggestions on how best to improve design and implementation of HIV/AIDS prevention programs in order to prevent further spread of the epidemic. Among other issues in this discussion, respondents' acknowledge that though awareness about risky sexual behaviours and HIV/AIDS is generally high in this community, people still engage in sexual behaviours that propagate the spread of STIs and HIV. As such, among other things envisaged to bring about the desired change are increased knowledge about HIV/AIDS, particularly availability of information that will make people reflect on their behaviours, and be motivated to change for the better.
It has further been suggested that there ought to be increased partnership among stakeholders particularly local government institutions, private organizations, the clergy and traditional healers, in order to have a multi-pronged strategy, which considers various factors influencing occurrence of risky sexual behaviours among different population groups in this community, so as to implement target specific and impact oriented activities. Such an approach is envisaged to ensure success of the programs as it takes into account both the general and specific factors spearheading occurrence of risky sexual behaviours among different groups of people in this community, (and how in view of those factors), to effect the desired change. More so, there is need for more programs to be scaled up to the community and places where most of the risky sexual practices take place.