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HIV PREVALENCE REDUCTION AMONG YOUNG PEOPLE THE ZIMBABWEAN EXPERIENCE

HIV PREVALENCE REDUCTION AMONG YOUNG PEOPLE THE ZIMBABWEAN EXPERIENCE. TUDOR HOTEL NEW YORK CITY 26 OCTOBER 2009. PRESENTED BY SIBUSISIWE MARUNDA ZIMBABWE NATIONAL AIDS COUNCIL. PRESENTATION OUTLINE. Background Information Working Definition Policy Environment

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HIV PREVALENCE REDUCTION AMONG YOUNG PEOPLE THE ZIMBABWEAN EXPERIENCE

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  1. HIV PREVALENCE REDUCTION AMONG YOUNG PEOPLE THE ZIMBABWEAN EXPERIENCE TUDOR HOTEL NEW YORK CITY 26 OCTOBER 2009 PRESENTED BY SIBUSISIWE MARUNDA ZIMBABWE NATIONAL AIDS COUNCIL

  2. PRESENTATION OUTLINE • Background Information • Working Definition • Policy Environment • Identified drivers of the epidemic • What is working well • Barriers • What can we do better

  3. Background Information Zimbabwe is a landlocked African country with a total land area of 390 757 squarekilometers with a total of 12,121,565 people of which 5, 870,088 are males while 6,251, 477 females

  4. HIV Historical trend

  5. The estimate of HIV incidence peaked in 1993 at 4.6%. In 2008 it is estimated at 0.98% and in 2009 at 0.96.

  6. Zooming on 2009 Statistics Summary of HIV Estimates 2007, 2008 and 2009

  7. Estimation Method Data Inputs ANC Sentinel Surveillance ZDHS+ 2005-2006 Census and Inter-censal Demographic Data Monitoring and Evaluation Data

  8. Working Definition of Youth • African Youth Charter 10-35 • United Nations 10-24 • Zimbabwe National Youth Policy 10-30

  9. The Response Zimbabwe adopted a multisectoral response to HIV and AIDS Response is underpinned by 3 Ones, i.e. #One national Coordinating Authority (NAC) #One national M & E system #One agreed Strategic Plan (ZNASP) Three ones create order, harmony and accountability in national response

  10. HIV Policy Environment • Zimbabwe national policies Draw from International and regional policies: • Millenium Development Goals • UNGASS • Regional policies • SADC Business Plan 2010-2015 • SADC Strategy on OVCY • Abuja Declaration • Maseru Declaration

  11. Policy Environment Contd • Regional Policies and Commitments inform the national umbrella policy: • The Zimbabwe HIV and AIDS Strategic Plan(ZNASP)-2006-2011. • Provides bases for advocacy, resource mobilization and programming. Informs the following sector policies: • National Behavior Change Strategy 2006-2010

  12. Policy Environment Contd • The Zimbabwe Health Sector HIV Prevention Strategic Framework 2007-2010 • Zimbabwe National Plan of Action on Women & Girls and HIV & AIDS 2006-2010 • National Adolescent Sexual and Reproductive Health Strategy 2009-2015 (Draft)

  13. Policy Environment Contd • National Female Condom Strategy 2006 – 2010 • The National HIV Testing and Counselling Strategic Plan 2008-2010 • Plan for the Nationwide Provision of Antiretroviral Therapy 2008-2012 • PMTCT and Paediatric HIV Prevention, Treatment and Care National Plan 2006-2010

  14. Policy Environment Contd • National Action Plan for Orphans and other Vulnerable Children 2004-2010 • National Youth Policy- seeks to proffer guidelines with regards to concerns of young people in Zimbabwe like ASRH, HIV and AIDS

  15. Identified key drivers of HIV: The ‘Highway of HIV Transmission’ • Multiple Concurrent • Partnerships • Combined with: • Low risk perceptionin long-term relationships • Low condom usein long-term relations • Low levels of male • circumcision “Dry sex”? Unprotected casual sex Early debut Sex workers MTCT STIs (HSV-2) Cross-generational relations Underlying vulnerability factors: Gender imbalances Stigma Mobility

  16. How has the Reduction in Prevalence rate been Achieved? Prevention of new infections has constituted the cornerstone of the national response. The ZNASP acknowledge the importance of: Maintenance and adoption of safe behaviors among young people Adolescence sexual and reproductive health programs including community based, peer education & youth friendly services Trained lecturers to teach life skills based on HIV&AIDS in teachers and technical colleges

  17. Conti… Improved support for individuals, families and communities, Through: support to OVC, the infected and affected by HIV and AIDS, livelihoods support, etc Effective management and coordination of the national HIV and AIDS response (including resource mobilization).

  18. Conti… Vulnerable Groups. The Young People are explicitly noted as a vulnerable group that requires innovative strategies, focusing on their empowerment & inclusion in decision making as well as allocation of resources Universal Access. The principle of UA will include deliberate targeting of the vulnerable groups including the young Evidence and Result-Based Strategies. These includes programs targeting youth which are tailored to meet their specific needs Adherence to International Goals and Principle.

  19. What is working well 1.National Young People’s Network on HIV and AIDS ( launched in 2007 by NAC facilitates youth involvement in the national response ) 2.Social Transformation Empowerment Project's (STEPS) Screening Program“Tariro” 3.Global Fund supported Youth friendly centres providing youth friendly reproductive health services

  20. What is working Well contd 4. The Nation wide campaign on the Zero Tolerance of Child Abuse which has created increased awareness and triggered an increase in reported cases of rape 5.The Young People We Care mulit-partner program 6. Pooling of resources to create basket funds eg ESP , POS-multi-partnerships 7. The National AIDS Trust Fund

  21. What is working well contd 8. Multi-partner Behaviour change Strategy role out- there are plans to scale out 9.Structured Coordination at all levels 10.Livelihoods programs for older OVC as an HIV prevention strategy 11. Use of the media to promote monogamy and fight stigma

  22. Barriers The legal age of consent for testing is 16-leaving out the 12-15 sexually active adolescents Children living outside the family The Ministry’s refusal to consider the option of condoms in schools

  23. Barriers Contd • Implementation gaps for legislation eg Domestic Violence Act and the Criminal Law Codification and Reform Act • The economic environment continues to create conditions conducive to transactional and intergenerational sex • Limited Linkages between programmes e.g mitigation should have stronger linkages with prevention

  24. What can we do better 1. Decline is encouraging but one in seven people among the 15-49 age group is infected 2. Support should therefore continue to focus on behavior change, scale up of prevention strategies and care and treatment to decrease incidence and mortality specifically: Make Participation of Young people in policy formulation and advocacy more meaningful The Young People’s Network on HIV should scale out to all districts and have clear linkages with other programs

  25. What can we do better • Continue Public education including law enforcement officers on relevant legislation • Scale up livelihoods programs to encourage economic independence for women and girls • Programmes for children on the streets should aim at reintergration. • There is room to build on Global Fund Youth Programmes-the UN could partner with NAC and the Family Planning Council • Continue use of the media and revive the Zero Tolerance of Child Abuse Campaign

  26. Thank you…

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