User:Sizimth/sandbox

Proposal Title

Scaling up HIV and AIDS Responses in Zambia’s Basketball Community

Objectives

General objective:

Decrease incidence of new HIV infections in Zambia’s basketball community by promoting the combination prevention strategy and responding to the six key drivers of the epidemic.

Specific objectives:

(a)To raise awareness on HIV and AIDS in Zambia’s basketball community.

(b)To reduce high-risk sexual behaviour resulting into increased number of new infections between players and basketball fans.

(c)To reduce stigma and discrimination against basket ballers and fans living with HIV and AIDS.

(d)To promote linkages between Z.B.A and key stakeholders on HIV and AIDS that can frequently provide HIV and AIDS services to the basketball players and supporters.

(e)To promote linkages between basketball ballers and micro financiers so that the basketball players especially women access finances to start up businesses so as to prevent them from engaging into risky behaviour to keep up appearances.

(f)To empower basket ballers with business skills.

Implementing partners:

National AIDS Council, Ministry of Youth and Sport, Zambian Health Education Trust, Kara Counselling, OYDC, SHAREII, UNCIEF, UNFPA, Medical stores

Background

Zambia’s HIV prevalence is 14.3% in the age group 15-49 years and is among countries with the highest HIV prevalence worldwide. The epidemic has a feminine face for HIV prevalence rate is much higher in women (16.1%) than in men (12.3%) (ZDHS 2007). This is because women are more vulnerable to HIV and AIDS. They have no adequate access to information on prevention, and they also have low levels of negotiation skills and suffer from unequal protection under statutory and customary laws and traditions.

The Zambia Sexual Behaviour Survey (SBS:2005) showed that the median age at first sex among young people aged 15 to 24 years old has continued to show a steady increase, from an average of 16 years (1998) to 16.5 years (2003) to 16.1% of the females. Young people aged 15 to 24 years account for 7.7 % of the HIV – positive population. The percentage of young people (aged 15-19) reporting having sex with a non- regular partner has decreased; in 2005, 80.2 of all respondents aged 15- 19 years indicated they had a no non- regular partner in the past year, compared to 77.8% in 2000. Despite these positive developments, only 26.1% of young women 15 to 24 years old reported using a condom the last time they had sex with a non- regular partner.

Despite much effort directed at the HIV and AIDS fight, Zambia has continued to record new cases of HIV infections. In 2009, adults newly infected cases were estimated to be 82,681. This development, saw policy makers, donors and cooperating partners conduct a study on the drivers of the epidemic in the country in 2008/2009. This study aimed at informing the Government, stakeholders in the fight of HIV and all Zambians, the factors that precipitate the spread of HIV in the country. The study identified drivers of the epidemic to be multiple concurrence sexual partners (MCP); low and inconsistence condom use; vulnerability and marginalised groups; vertical transmission from mother to child; low rates of male circumcision; denial and stigma and discrimination. Other drivers were untreated, especially ulcerating sexually-transmitted infections (STIs); social-cultural practices and traditions; gender and sexual violence; high alcohol and drug abuse; cultural beliefs; low risk perception; high population mobility; and poverty (NAC 2009:4-5). Of the factors identified, the six key drivers of the epidemic are:

• I. Multiple concurrence partnerships (MCP); Zambians have a tendency of having more than one sexual partner. The 2007 DHS indicated that more of male respondents than female had more than two partners in the past 12 months before the survey. For the never married respondents, infidelity was estimated at 6.5% for women and 19.8% for men. Whereas married or living together accounted for 0.5% for women and 19.8% for men and the estimation for the divorced/separated / windowed was at5.7% for women and 27% for men.
• II. Low prevalence of male circumcision; The 2001/2002 ZDHS reported that only about 15% of the males were circumcised in Zambia, yet circumcision has been scientifically proven to offer men about 60% protection to contracting HIV. The 2009 Strategic Framework emphasizes the need to increase male circumcision hand in hand with emphasis on the importance of partners’ reduction, consistence and correct use of condoms, effective management of STIs and abstinence, where relevant(NAC: 2009)
• III. Low rate of condom use; Condom use is still very low among Zambians who are sexually active. The 2005 ZSBS reported that in 2000, 38.9% among men compared to 33% of women used a condom during the last sexual intercourse with a non-regular partner. The report further indicated that only 46.6% of men and 34.3% of women used a condom during the last sexual encounter, where as for the year 2005, condom use for men was estimated at 38.4% and 28.6% for women. This data clearly show that men use condoms more than women. This is due to the socialization process that hinders women from negotiating and demanding for safer sex. A study on misconceptions, folk beliefs and denial of HIV and AIDS in Zambia reviewed that even though awareness of HIV and AIDS prevention measures, like condom use is high, this knowledge is not transformed into positive attitudes and behaviour like consistent and correct condom use (Longfield, 2003). This to some extent is attributed to persistent myths about condoms, such as the common belief that HIV can pass through small pores.
• IV.Mobility and labour migration; Mobile populations are vulnerable to HIV infection in many ways. The report noted some of the factors making mobile populations to be vulnerable to HIV to be poverty and exploitation, separation from regular partners and social norms.
• V. Vulnerability and marginalized groups; It must be noted here that some groups in society are more vulnerable to HIV than others. For instance, women are more vulnerable to HIV than men due to their biological structure and the sociological process. Youth people and children also are vulnerable to HIV.
• VI. Vertical Transmission from Mother to Child; Despite favourable results on the prevention of HIV – positive mothers passing it to their newborns, thousands of newly born babies still get infected. The episynthesis report estimated 10% of new infections to be as a result of transmission from mother to child.

Problem Statement

With basic knowledge about HIV and AIDS of about 99% among the adult population (aged 15 to 49), Zambia’s HIV prevalence rate in this age group has only decreased slightly from 15.6% to 14.3% between 2001/2002 to 2007. This decrease in prevalence has not yielded much positive results with regards to the HIV and AIDS fight. This is because an HIV prevalence rate of 14.3% is still a source of great concern. The HIV prevalence is stabilizing at a high level as in most countries in the sub region and that the number of new infections outstrips the number of AIDS related deaths (NAC 2004 and 2007). The National AIDS Council, 2008 projected 74,263 new HIV infections in 2008 alone and that over 90% of these infections were mainly from stable and discordant partnerships.

In response to the epidemic, the Zambian Government has been creating an enabling environment to fight against HIV and AIDS. The National HIV/AIDS/STI &TB Policy was developed in 2005 and since 2006, the country has been implementing National HIV and AIDS Strategic Frameworks (NASFs). The current NASF (2011-2015)’s priority is to reduce the rate of new HIV infections by 50% by 2015. The strategy focuses on the implementation of a series of interventions using the ‘combination prevention strategy’’ and prioritised epidemic drivers. The combination prevention strategy is the scale up of HIV counselling and testing, promotion of abstinence and being faithful to one sexual partner, MC, condom use, PMTCT, treatment, care and support.

The Zambia Basketball Association is an umbrella body aimed at promoting basketball in Zambia. It has a total of …….. clubs and a total of …….. affiliated players. Estimated numbers of supporters range from ….. to …….. per day. Important to note is that the basketball players and fans are aged between 15 and 49 years which happens to be the most age group affected by HIV and AIDS in Zambia. Justification It must be note here that risky sexual behaviour has been observed during basketball games. Of particular concern are the young players joining ZBA from schools and youth leagues with so much innocence and ignorance about social life. In view of the foresaid, it is important to encourage the basketball community to undergo HIV counselling and testing. Further, advocacy for behaviour change, promotion of condom use as well as MC and treatment, care and support must be scaled up in the basketball community.

It is here by proposed that an advocacy and awareness raising strategy on HIV and AIDS focusing on the combination prevention strategy and prioritised drivers of the epidemic be developed for the basketball community. The development and implementation of this strategy would contribute to meeting the set national target of reducing new HIV infections by 50% by 2015. General objective: Decrease incidence of new HIV infections in Zambia’s basketball community by promoting the ‘’combination prevention strategy’ ’and responding to the six key drivers of the epidemic. Specific objectives:

• (g) To raise awareness on HIV and AIDS in Zambia’s basketball community.
• (h) To reduce high-risk sexual behaviour resulting into increased number of new infections between players and basketball fans.
• (i) To reduce stigma and discrimination against basket ballers and fans living with HIV and AIDS.
• (j) To promote linkages between ZBA and key stakeholders on HIV and AIDS that can frequently provide HIV and AIDS services to the basketball players and supporters.
• (k) To promote linkages between basketball ballers and micro financiers so that the basketball players especially women access finances to start-up businesses so as to prevent them from engaging into risky behaviour to keep up appearances.

(l) To empower basket ballers with business skills. Expected Outputs • Baseline conducted (the players and supporters that have under gone HIV counselling and testing). (Need to prepare a questionnaire on sexual behaviour for the basketball community so that the communication strategy to be developed will focus on real issues). • Communication strategy on HIV and AIDS prevention developed for the basketball community. • A gender sensitive HIV and AIDS policy developed for the basketball community. • HIV and AIDS programme developed for the basketball community. • M&E plan developed for the basketball community HIV and AIDS Programme. Management of the project This project will be managed by a technical steering committee on HIV and AIDS under ZBA. The committee comprises of basketball players and ZBA officials that are so passionate about HIV and AIDS. Linkages with NAC will be sought so as to ensure that information from the project is fed into the national M & E framework. Key partners Partner Why they need to be engaged Ministry of Sports and Youth Ministry responsible for sports NAC The National Coordinator of HIV and AIDS response ZHECT Provide training in HIV and AIDS Kara counselling Provide counselling services UNCIEF Lead UN agency on children issues UNFPA Lead UN agency on family and population Medical stores Responsible for the manufacturing and distribution of condoms SHAREII Offer technical support to institutions fighting HIV and AIDS in Zambia OYDC Centre for sports Basketball players and fans Primary stakeholders (beneficiaries of the project)