Francisco M. Guerra Jr.
U.S. Peace Corps Volunteer
HIV/AIDS Project, Zambia
May 2005 – July 2007
Part of My Story
• My experience and work as a PCV: coming soon
• Challenges I faced: language, limited resources,
frustration with education and government related
issues, lack of inputs, lack of time, lack of
information.
• What I wished I knew before venturing to Zambia:
info about HIV/AIDS (initiatives, programs, country
specific statistics, etc.), info about “development”
theory and projects, history of international
involvement in all areas of life.
• Impact on my life, perspective, and future plans.
Thoughts…
• What are international careers in health like?
– Varied:
• Time: Fully committed to a few days visit.
• Focus: Medical practice, education in all sectors,
diversity of NGO targets.
• How do people get their foot in the door?
– Networking, GO/NGO projects, school linked
activities, and self initiative.
• What is an average day like?
– Where, what, for whom is… average…?
HIV/AIDS
GLOBAL ESTIMATES FOR ADULTS
AND CHILDREN, 2006
Data from UNAIDS/WHO AIDS Epidemic Update: December 2006
ADULTS AND CHILDREN ESTIMATED
TO BE LIVING WITH HIV IN 2006
ESTIMATED ADULT AND CHILD
DEATHS FROM AIDS DURING 2006
• “Sub-Saharan Africa bears brunt of global
epidemic. Two thirds (63%) of all adults and
children with HIV globally live in sub-Saharan
Africa.”
• “In sub-Saharan Africa, for every ten adult
men living with HIV, there are about 14 adult
women who are infected with the virus.
Across all age groups, 59% of people living
with HIV in sub-Saharan Africa in 2006 were
women.”
• “Across sub-Saharan Africa, women are more
likely than men to be infected with HIV, and
they are more likely to be the ones caring for
people infected with HIV.”
• “A little less than one quarter (23%) of the
estimated 4.6 million [4–5.4 million] people in
need of antiretroviral therapy (in sub-Saharan
Africa) are receiving it.”
• “At current levels of HIV prevalence, young
persons in Zambia face a 50% life-time risk of
dying of AIDS, in the absence of treatment.”
Zambia Stats
• “In rural areas, HIV prevalence increased
marginally from 11% to 12% in 1994–2004.”
• “Older pregnant women (30–39 years) in
urban areas, HIV prevalence rose considerably
(from 24% to 30%) in 1994–2004.”
• “Young pregnant women in some urban sites,
HIV prevalence has remained high (at 28%–
30% during 1994–2004), while in some rural
sites, infection levels almost doubled in the
same period (e.g. 7% to 14% in Kalabao).”
Data from UNAIDS/WHO AIDS Epidemic Update: December 2006 & Ministry of
Health Zambia, 2005
Time to feel UNCOMFORTABLE
DANGER!!!
Fear Based Messages…
HIV/AIDS and Morality
• “The tendency to link HIV and morality might
be related to the fact that affliction is often
perceived as an outward manifestation of a
moral transgression. “
• “In some Asian cultures, these perceptions
might be couched in terms of karma.”
• “In a number of African societies, specific
illnesses or sets of symptoms are associated
with having broken one or more social
prohibitions.”
…Morality continued.
• “Elsewhere, including the Judeo-Christian
traditions of North America and Europe, it is
not uncommon for people to believe that
illness is a punishment for one’s sins.”
• “Whatever its roots, the tendency to associate
illness with moral impropriety is a central
contributing factor to HIV and AIDS-related
stigma. “
Thoughts to think about:
Did you feel slightly embarrassed when I asked
whether you had been tested for a cold or the
flu?
Did you feel embarrassed when I asked about
having been tested for HIV?
If you felt differently, Why?
HIV/AIDS Related Stigma
• “This stigma is exacerbated by the seriousness
of the illness, its mysterious nature, and its
association with behaviors that are either
illegal or socially sensitive (e.g., sex,
prostitution, and drug use). Also relevant is
the perception that HIV infection is the
product of personal choice: that one chooses
to engage in “bad” behaviors that put one at
risk and so it is “one’s own fault” if HIV
infection ensues.”
Data/text from “Common at It’s Core: HIV Related Stigma Across Contexts”
by International Center for Research on Women.
Behavior Change
• “Unlike some infectious diseases, transmission
of HIV is mediated directly by human
behavior, so changing behaviors that enable
HIV transmission is the ultimate goal or
outcome required for HIV prevention. “
• “Sexual behavior, which remains the primary
target of HIV prevention efforts worldwide, is
widely diverse and deeply embedded in
individual desires, social and cultural
relationships, and environmental and
economic processes. “
From the UNAIDS website: www.unaids.org (under Behavior Change)
Work as a Peace Corps Volunteer
(PCV)
1. Helping the people of interested countries in
meeting their need for trained men and
women.
2. Helping promote a better understanding of
Americans on the part of the peoples served.
3. Helping promote a better understanding of
other peoples on the part of Americans.
Work as a PCV – HIV/AIDS
Extension Worker
• The overall project
purpose is to enhance
community-based
development,
coordination, and
implementation of
HIV/AIDS prevention,
care, and
socioeconomic support
in rural areas of Zambia.
• Examples:
– HIV/AIDS workshops
with NHCs, Women’s
groups, Farmers’ groups,
PLWHA Support Group
– Life Skills Lessons and
HIV/AIDS sensitization at
8 government schools
with students and
teachers
World AIDS Day 2006
World AIDS Day 2006
Mukungule RHC
Putting all of this into context…