TCE China in the forefront of Preventing HIV and AIDS

June 23, 2009 - PRLog -- The Government of China proposed Linxiang District (285.000 population + 20.000 migrants) as pilot site for implementation of Humana People to People’s community mobilization program ‘TCE-Total Control of the Epidemic’.

Background
As of August 2005 the Yunnan Provincial CDC has declared 3 out of 16 prefectures as areas of ‘generalized epidemic’: Dehong, Honghe and now also Lincang, since then Wenshan Prefecture has been added. The definition of generalized epidemic in China is that 1% of more of pregnant women are found HIV positive. – All pregnant women in Yunnan are being tested before giving birth.

Linxiang District has been chosen because its prefecture has been declared a generalized epidemic and because it is a typical poor mountainous border county in Yunnan with a large ethnic minority population and a history of drug trafficking and use.
The 2004 screening revealed, that 2.88% of tested pregnant women were HIV positive, as well as 67% of IDU and 7.32$ of female entertainment workers.

The project started in January 2007. Field Officers were then selected and trained and started their work in each being in their own Fields after the official launch of the project March 2007.

Project Management Office
TCE has financial and technical assistance from Asian Development Bank for the first 2 years of the program.
TCE Project Management Office is implementing the project on the day to day basis. Linxiang District Government has appointed Linxiang District Fupinban (Poverty Alleviation Office) and Linxiang District CDC directors and staff to manage the work in cooperation with the international Project Leader from Humana People to People and other staff.

Objectives of TCE China
The objectives agreed with the partners are:
1. Create higher awareness about HIV/AIDS and how to avoid HIV/AIDS infection in the operation area. All people in the sexually active age group have been informed about HIV/AIDS and how to avoid HIV/AIDS infection through face-to-face meetings, street performances, and group lessons.
2. More than 80% of the sexual active population and individuals at high risk of HIV transmission have adapted behaviors that reduce the risk of HIV infection. People make conscious individual choices regarding their sexual and reproductive health (meaning that people can declare themselves TCE Compliant). We distribute condoms.
3. Increased capacity in local leaders (Communist Party branch leaders, county level government officials, township government officials, village committee leaders) and other community based organizations (Communist Youth League of China, All China Women’s Federation, China Red Cross, etc) that are involved in the fight against HIV/AIDS.
4. Referrals to services such as STI treatment, harm reduction, VCT, PMTCT and ARV treatment at Government hospitals have been substantially strengthened.
5. A substantial number of people with high-risk behavior have been tested for HIV.
6. The risk of transmission of HIV to children has been reduced.
7. The majority of the people in the operation area have been empowered to overcome fear, denial and stigma and to live according to their HIV status.

Program description
1. The program recruits, trains and deploys 60 Field Officers from the local area for 300.000 people, each Field Officer with a responsibility for a Field of 5.000 persons, and each TCE Area of 100.000 people with 20 Field Officers.
The Field is demarcated on a map, and defined in the field with a specific number of villages.
After having started in their field work, the Field Officers will be continuously trained with small courses every Friday through out the 3 years program on the so-called “Friday Meetings”. Here the TCE management and the 60 Field Officers together will monitor, evaluate and conclude on the program as they go door to door and inform, educate and mobilize the people.
These weekly gatherings create an invaluable exchange of experiences and conclusions and a participatory feed-back between program leadership and field workers.
After 6 month in the field the 60 Field Officers work as lay VCT counselors after receiving thorough training in this.

2.  Equipped with a map, a household register, an individual assessment tool and communication and counseling skills, the Field Officer walks through his field of 5.000 people day after day, knocking on doors, gathering people around him wherever they are, visiting schools and workplaces. His work is talking, listening, answering questions, facilitating decisions about safer sexual behavior, mobilizing people to become volunteers, training peer educators and referring people to the County Level CDC Center for Voluntary Counseling and Testing, PMTCT, STD Treatment and information.
Only the combined efforts and actions of all these 60 Field Officers as door-to-door visits, school program, workplace program, IEC materials, public gatherings and street rallies and the advocacy meetings together will create the critical mass of repeated interactions with each individual which is a necessary prerequisite for the desired behavioral change.

3.  Mobilization of Passionates (community volunteers) to be personally engaged in prevention of HIV and give support to educational activities and support to people living with HIV/AIDS. The Passionates will receive training and thus be a good support for the work of the Field Officers and secure sustainability after the project has finished. Passionates are often local health workers, village leaders, teachers or other influential people in the community, but also peer educators among high risk groups and ordinary villagers.

4. Educational sessions in schools and in workplaces. The Field Officer has a special task of reaching the youth and migrant workers who all could be vulnerable to HIV without proper knowledge and awareness. Lessons in schools are planned and organized with the headmasters so all students will be reached. The project maps out all workplaces in the Areas and makes agreements with management about training sessions for the staff. Sessions will be carried out several times in each work place to secure proper understanding. .

5.  Assist people to make an individual plan for how to be in control of HIV/AIDS. The TCE Field Officer will start this on their first time visits and during a second and often thirs time visit and talk secure that people are in control in terms of knowledge and behavior. All young and adults in receive a card with 5-6 demands to what you as an individual need to do to be “TCE Compliant” which means to be in control of HIV/AIDS. The Field Officers assist the people to make a plan for how to live up to these demands and thereby be in control of HIV/AIDS. Those in most need are targeted with repeated visits and counseling.

6.  Promoting partnership and networking on community level with organizations and institutions engaged in activities to combat HIV/AIDS.TCE will organize presentations and input to meetings held by networks within the Area, as well as invite for specific regular gatherings and events on village and district level where partners can come with input to the program and plans for common actions and activities can be decided.

8.  Facilitating of forming of Self-Help Support Groups for People Living with HIV and AIDS. The program will mobilize groups of 8-15 PLWHA to form ‘Positive Living Clubs’ (PLC), and provide emotional and technical support for care and treatment.


Activities and Achievements
A variety of methods to spread HVI/AIDS knowledge and mobilize people for behavior change have been used as a supplement to the total of 488.000 face-to-face meetings completed by end of December 2008:

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