1	HIV Prevention in South Africa- Muslims’ experiences
2	Global statistics UNAIDS Report, Nov 2005 Global estimate of people living with HIV 40.3 million 38 million adults 17.6 million women 2.2 million children New infections almost 12 % (4.9 million) AIDS deaths 3.1 million 0.57 million children despite the availability of HIV antiretroviral therapy which reduced the number of deaths in high income countries
3	"More than 25 million people..." More than 25 million people have died of AIDS since 1981 By December 2005, women account for 46% of all PLWA worldwide, and for 57% in Sub-Saharan Africa Young people (15-24) form half of all new HIV infections worldwide, more than 6000 infected with HIV everyday Of the more than 6,5 million people living in developing countries who need ARV’s, only 1million are receiving them
4	Sub-Saharan Africa Sub-Saharan Africa is the region of the world that is most affected by HIV & AIDS. An estimated 25.4 million adults and children were living with HIV at end 2003 Approximately 3.1 million new infections occurred in 2004. In that year the epidemic had claimed the lives of an estimated 2.3 million people in this region. Approx 2 million children under 15 years are infected and 12 million more have been orphaned by the epidemic
5	Leading causes of mortality globally WHO, 2002 Rank HIV/AIDS Ischaemic heart disease Tuberculosis Road traffic accidents Cerebrovascular disease Self-inflicted injuries Violence Cirrhosis of the liver Lower respiratory infections Chronic obstructive pulmonary disease
6	Leading causes of mortality in sub-Saharan Africa Rank HIV/AIDS Acute lower respiratory infections Malaria Diarrhoeal diseases Perinatal conditions Measles Tuberculosis Cerebrovascular disease Ischaemic heart disease Maternal conditions
7	AIDS Orphans By 2003, 15 million children under 18 had been orphaned by HIV/AIDS worldwide About 12 million of these live in sub-Saharan Africa, and it is expected that this number will have risen to more than 18 million by 2010 In sub-Saharan Africa, the number of orphans in some countries exceeds half a million, and, in some countries, children who have been orphaned by AIDS comprise half or more of all orphans nationally South Africa: 1,1 million orphans
8	HIV/AIDS in South Africa 5,3 million people out of a population of 40 million are living with HIV, equivalent to 21,5% of adult population Large country (1,2 million square kilometers) with large crowded cities and sparsely populated isolated and underdeveloped rural areas Accurate measurements of HIV prevalence difficult: antenatal HIV testing common Many obstacles: National Health policy, Education, Stigmatization and Attitudes, Availability of ARV’s
9	National HIV and Syphilis Antenatal Sero-Prevalence Survey (2004) 15^th survey conducted since the 1st of the series began in 1990 (0,8% in 1990 to 27,9% in 2003). Survey conducted at nearly 400 clinics countrywide with over 16 000 women attending antenatal care for the 1st time participating in the survey. Information gathered is very valuable in tracking HIV and syphilis trends. Although survey is conducted among pregnant women, it provides important information as an indicator of trends in the general South African population.
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14	Development of HIV/AIDS policies 1982: 1^st cases diagnosed – white gay men, same trends as elsewhere 1985: AIDS advisory council formed 1990: 1^st Antenatal surveys – 0,8% or 7400-120 000, annual surveys thereafter 1992: 1^st government response – Pres Nelson Mandela addressed the National AIDS Convention of South Africa (NACOSA) to develop a national strategy 1996: 14,2% prevalence, International Conference for PLWA, religious leaders invited to consult 1996: Thabo Mbeki, Deputy-President, acknowledged seriousness: 850 000 people infected
15	"1997" 1997: 17% prevalence, Religious Aids Programme (RAP) formed 1997: Muslim AIDS Programme (MAP) Islamic Medical Association: medical issues Jamiatul-Ulema: religious values Islamic Careline: awareness, care and support 1998: 22,8% prevalence, Treatment Action Campaign (TAC) launched – pressure group advocating rights of PLWA 2000: International AIDS Conference, Durban – Pres. Thabo Mbeki: AIDS caused by poverty! 2003: 27,9% prevalence, TAC campaign of civil disobedience, charged Minister of Health with Culpable Homicide, ARV’s still not freely available
16	"Explosion in HIV prevalence" Explosion in HIV prevalence, health policies not kept abreast with political and social changes, prompt action may have prevented deaths of thousands
17	Department of Health Mission Statement To prevent the spread of HIV, STI, and TB infection To mitigate the impact of the dual HIV/AIDS and TB epidemics on society Focus areas Prevention Integration of HIV/AIDS and TB Partnership support Interdepartmental support Care, Counseling and Support Capacity building The Youth programme
18	Public Health Approach Promotion of safe sexual behaviour. Promotion of comprehensive case management at public and private health centres. Specific interventions for high risk populations. Promotion of healthy lifestyles. Review of training, treatment guidelines and policies Case finding for research.
19	"Questionnaire – about AIDS information" Questionnaire – about AIDS information. Program started in earnest in 1998. Workshops conducted initially: Facts about AIDS Attitudes towards those living with AIDS Sexuality in Islam Death and dying Need for 3-day ‘train the trainers’ workshops Pre and post test counseling Home-based care Legal aspects of HIV/AIDS Use of interactive workshop with audio-visual assistance All MAP material has an Islamic ideological perspective Save Sex rather than ‘safe sex’
20	Mission To reduce new HIV/AIDS infections by implementing preventative measures including comprehensive life skills programmes To render spiritual and emotional care and support to those infected and affected by HIV/AIDS through effective therapeutic interventions To implement our strategy in partnership with other stakeholders in government, business and other organizations involved in HIV/AIDS
21	Mission contd. To mobilize, empower and develop communities by creating awareness and encouraging positive change in attitude to HIV/AIDS To develop capacities in volunteers with joint programmes and other coordinated services To regularly monitor and evaluate all MAP programmes to measure effectiveness and efficiency To develop community’s confidence in the programme through research to enhance programmes, services and projects
22	Goals To reduce new HIV infections through awareness and education and enhancing the present value – based programme To reduce the impact of HIV/AIDS on individuals, families and communities through comprehensive care and support including, facilitating access to existing services, education and mobilization To promote effective therapeutic interventions including ARV treatment, VCT support groups, home-based care and other therapeutic and palliative interventions To mobilize and organize a value-based AIDS response through faith-based organizations
23	Goals contd. To train volunteers to implement the programme at community/grassroots level To increase the number of awareness workshops in all areas and communities. To establish AIDS information and resource centres to serve the needs of infected and affected people. To provide AIDS education, drug awareness and related programmes to the youth. To implement an effective schools outreach programme which includes appropriate sex education and other life skills components.
24	OBJECTIVES To promote care, compassion and understanding for PLWA To discourage pre-marital as well as extra-marital sexual relationships. To encourage abstinence before marriage and faithfulness within marriage.
25	"To promote a value-based lifestyle..." To promote a value-based lifestyle with ethical and moral codes of conduct whereby chastity before marriage is regarded as the desired alternative for healthy family relationships. To challenge the assumption that condoms and ‘safer sex’ is the answer to stemming the tide of HIV/AIDS.
26	WORKSHOPS Education and Training AIDS Awareness workshops Train volunteers, health workers, religious and community leaders, service providers and care-givers AIDS education in the workplace Distribution of information, educational material, pamphlets and information brochures Participation in small, medium and mass media: national and community radio, newspapers, community activities Manuals and impact assessment tools produced Open training course provided to members of the public Quarterly newsletters Web-site: http://www.ima.org.za/muslim_aids_programme.htm
27	Workshop Presentation
28	Contents of AIDS awareness Workshops Attitudes towards HIV/AIDS and PLWA Explore individual attitudes and encourage compassion, acceptance and forgiveness. AIDS Facts To dispel myths and provide accurate facts to people Sexuality and Islam A value-based session which discusses sex and sexuality and encourages abstinence before marriage, faithful sex as well as the issues around condom use. 4. Death and Dying Issues around death and dying are discussed as this is a reality for PLWA. The content promotes living positively.
29	3-day ‘Train the Trainer’ workshop All the above as well as: Training techniques Counseling skills Basic home-based care Pre and post-test counseling Cultural concepts Legal aspects of HIV/AIDS This is an experiential workshop that is highly effective It includes individual presentations by participants.
30	Life Skills Definition: …” Abilities for adaptive and positive behaviour, that enables individuals to deal effectively with the demands and challenges of everyday life.” (Who, 1993) Goal: To promote physical and mental wellbeing in young people as they face the challenges of life. Philosophy: Young people should be empowered to take more responsibility for their own actions and make informed choices for their future. Skills necessary for successful living and learning and management of stressful situations.
31	Underlying Principles To promote the physical, mental and spiritual development of the individual - holistic approach. Islamically sound. Practical and sustainable - curriculum. Learner-centered. Factually correct Provide the opportunity and context to express concerns and feelings Behaviour change - Age appropriate, knowledge, skills, values and attitudes
32	AIMS and OBJECTIVES To know, understand and accept yourself. To change attitudes regarding HIV/AIDS and sharing the correct information. To understand sexuality from an Islamic point of view. To learn effective communication skills and self-esteem. To learn how to: Make decisions Set goals Think positively
33	MAP Life skills L – Learning to love Allah and other Human beings. I – Identify themselves as part of a dynamic religion. F – Foster pride and dignity to young Muslims. E – Empower them to become faithful in their actions.
34	"S – Sensitize youth to..." S – Sensitize youth to Islamic lifestyles and value systems. K – Kindness and compassion as part of Islam. I – Instill respect and responsibility. L – Listening skills form part of being empathic. L – Lessons for coping skills & for making informed choices. S – Socializing according to Islamic value system and moral code
35	Target population Life Skills programme Primary schools (grade 1-7), 4 sessions/grade, 600 learners per school, approx 20 000 per annum Empowered with life skills Abstinence programme Secondary schools (grades 10-12), 6-week programme, 150-200 per school, 6000-8000 per annum Greater HIV/AIDS awareness, healthy sexuality Educators trained in Life skills and AIDS awareness Life Skills manual and impact assessment tool developed
36	Volunteer programme Active recruitment of volunteers Vital support and additional capacity Structured supervision/support programme Involved in HBC, Fund-raising, relief, care centres Volunteer/lay counseling
37	Conclusion