Understanding HIV in our community:
Asking the right questions
Published by: The Centre for International Health, Macfarlane Burnet Institute for Medical Research and Public Health in collaboration with the ACID
Sometimes a community is unaware that they are at risk of spread of HIV. HIV can remain hidden to most in a community fora long period. The epidemic becomes visible when increasing numbers of people, especially young adults, become sick and die, and the links between the increased levels of sickness, death and HIV infection become more widely discussed and accepted.
Communities are sometimes not aware of behaviours which increase the risk of HIV infection, or they may not be willing to admit that such behaviours take place. The situation analysis can be a time to encourage open discussion about these matters. If the information is collected by community members and presented to key decision makers, it can be a powerful way to get agreement on the need to act and the choice of effective strategies.
The spread of HIV, and the quality of life of those affected by it, are influenced by social, cultural and economic factors which vary from place to place. An understanding of these background factors will help program planners and communities to identify the most important areas for action. It will also help us in adapting the experiences of other countries and communities.1
Once you have gathered information we need to analyse it to identify who is most vulnerable to HIV infection. You can also identify obstacles and opportunities to respond effectively to the need for prevention and care in the community. Sexual behaviours and drug using behaviours are usually complex and often hidden.
Before investigating these sensitive behaviours it is important to gain a broad knowledge of the community. The decision about how much to collect should balance resources available, process considerations (perhatian), the scope of the intended activity and the specific skills of the implementing agency. It may be useful to identify:
• information that is absolutely essential
• information that is useful but we could live without it
• information that would be nice to know, but that is all.
Useful national health, social and economic data is available in UNAIDS, WHO and World Bank publications and the UNDP Human Development Report. You can gather local information through rapid appraisal techniques that involve the community. The information that we need to collect about the make-up of your community Includes:
• demographic and socio-economic characteristics;
• local decision-making structures and processes, networks, interest groups, and elites;
• the health status of the community;
• existing health care, welfare and development services;
• relevant cultural beliefs and practices.
To be continued ……………………………………………..
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