“AIDS is gone. That’s what they think” (Female Participant, FGD )

1. “AIDS is gone. That’s what they think” (Female Participant, FGD) College and University youth in Botswana share their thoughts on HIV, risk, behaviours, needs and interventions

2. Botswana Context Overview • Current Population: 2 038 228 • HIV prevalence is 17.6% for the general population • Estimated incidence rate is 2.7% • 2002 – Free ARVs to all citizens

3. Project Rationale: teAIDS Context in 2009 • Gap in interventions, policies, access to services etc. • Generation who has never known a life without HIV • Youth milestones/characteristics • “College Life” • Prevalence and Incidence

5. 12.3% existing prevalence + possible 20% incid. = 32.3%

6. The Perfect Storm • Incidence Rate • Normal Adolescent Stress and Milestones • Generation who has never lived a day without HIV • Existing Prevalence Rate • Gaps in Policies, Intervention & Access • Tertiary Life

7. teAIDS Study – Purpose and Objectives Purpose: Obtain a current, comprehensive and evidence-based snapshot of student’s knowledge, needs, opinions, access and behaviours, as well as to gain understanding of current prevention and support services being offered to students. Objectives: • Appreciate students knowledge of HIV and how this impacts/does not impact their behaviour • Determinehow students have been impacted by HIV and how this impacts/does not impact their behaviour • Provide students with a medium to identify their own needs in terms of support and prevention –what is relevant and needed by them?

8. Research Process Overview • Literature Review • Exploratory Institutional Workshops (Institutional Head, HIV Coordinator, Student Health Rep/SRC President) for input into process, tools, best practices etc • teAIDS Stakeholder Reference Team • Inception Document, Proposal and Tools • Ethical Considerations • Health and Research Development Council, Institution and Student Permissions • Confidentiality Clause, Consent Forms, Offer of Counselling

9. Data Collection Tools, Units of Research, etc

10. Methodology • Self-administered surveys to 10% of student body (n=4312) • Classes were randomly selected • Surveys contained 82 questions (qualitative and quantitative) • Focus groups were conducted • Trained administrators & facilitators • Participation was voluntary and anonymous • Counselling was offered

11. Socio-Demographic Information Student Participants Sex Year of Study Age

12. results

13. Behaviours and Attitudes • 73% of students are currently in relationships • 83% have engaged in sexual intercourse. • 54% of students know their status • Of the students who do not know their status, 55% are worried about their status • 45% know the status of their partners

14. Behaviours and Attitudes • 59% said they would not have a partner who is HIV positive • 79% said they would not have a sexual relationship with someone who is HIV positive • 91% said they would not have a child with someone who is HIV positive

15. Behaviours and Attitudes • 45% said they had already engaged in sex without a condom • 38% of students who were in a relationship said they thought their partner has other sexual partners • 34% said they had not been absolutely faithful to their partners since their relationship started

16. Needs and Gaps • 51% said they have known a family member who has died of AIDS • 8% said this person was a parent • 85% of students said they are not tired of learning about HIV • 38% said condoms have never been available since they arrived at school

17. Conclusions & current status

18. The Perfect Storm • Incidence Rate • Normal Adolescent Stress and Milestones • Existing Prevalence Rate • Tertiary Youth Behaviours, Attitudes and Practices • Gaps in Policies, Intervention & Access • Generation who has never lived a day without HIV • Tertiary Life

19. Conclusions • Irrespective of increased knowledge and impact from AIDS deaths within their households and families while they were young children, the sexual practices that gave rise to our current HIV epidemic in Botswana persist among tertiary youth. Therefore, strategies that focus on prevention of HIV should remain paramount in any intervention. • There is the capacity for the entire Education Sector (from pre-primary – lifelong learning) to act as a “Social Vaccine”, however the approach needs to be strategic, participatory, youth-driven, human resource intensive and sustainable.

20. Current Status • Results were disseminated to students, stakeholders etc. • Conducted informed focus groups to create strategy • Strategy completed • Proposal for funding was successful - Botswana National AIDS Prevention Support Project (BNAPS)

21. Ke a leboga • Students and staff who participated in the research • Conference organizers for seeing the value in this research • Tertiary Education Council • World University Service of Canada • 5 fabulous Research Assistants • Colleagues and Stakeholders • Deloitte and Touche • World Bank and National AIDS Coordinating Agency

22. It’s 100% good without using a condom, you can even think about it after sometime, ok? (male participant, FGD) The people who spread the messages should try something new…Youth just believe that taking the ARVS and you will be safe…What they think is that when you go onto ARVS you will never get sick…AIDS is gone. That’s what they think. (female participant, FGD) We always hope for better things to happen in our lives. (female participant, FGD)