Creating an Enabling Environment for Prevention

Ashok Pillai of IPN+ spoke of the strength and courage that coming out about his serostatus and pouring his energies into his network has given to him. Twelve years ago doctors gave him a short and dismal prognosis. Over the last few years Ashok has learned how to network and how to manage IPN+ network activities and its finances. Susan Paxton then presented the results of her multi-country study of thirty people with HIV in Asia and the Pacific. All had publicly disclosed their serostatus. Their motivation was to help others prevent infection, to decrease stigma and discrimination, or both. Susan's informants felt the lack of support of AIDS organisations and got their most valuable support from their peers and families. Most people had come out to small community groups or groups of professionals. They noticed fewer negative impacts than those who came out in the mass media. Almost all of them had no regrets about what they had done and most saw it in a positive light. Working with people on public disclosure issues is direct action to decrease discrimination. In what Susan called: "The Paradox of Public Disclosure", the thing that seems most dangerous is, in the end, the most liberating. She noted that people who come out should be paid for their work, require support and resources, and that capacity building is needed for groups of people who want to disclose. Major General Matiur Rahman from Bangladesh presented data to show that the prevalence of HIV in the Bangladeshi military is similar to that in general Bangladeshi society. He attributed it to the military's excellent HIV prevention program. Ton Kim of Cambodia described capacity building in Cambodia. Health workers were trained in HIV prevention first, followed by training for villagers. He stressed that creating an enabling environment required ongoing support and follow-up after training.

Ruthy Libatique explained how the 1998 Philippine AIDS Control Act has been used as an educational instrument throughout the archipelago. The legislation was heralded as best practice on HIV prevention and control, when it was promulgated. At the same time it was recognised that ensuring compliance based on a thorough understanding of the law's implications was a long-term endeavour, and something that would not happen without a concerted effort. Accordingly, the Philippine HIV/AIDS NGO Support Program (PHANSUP) was charged with the job of establishing a countrywide network of locally based advocates, who could educate government, business, the public sector and other arms of civil society in what the Act meant to them. This is being done through workshops, advocacy sessions, policies and practice for the entertainment and hospitality industry, workplace relations training and collaboration with local councils. Given that the Philippines is composed of 78 provinces, 82 cities, and 41,940 villages, it is hardly surprising that PHANSUP has only reached about ten percent of the population to date. They hope to extend their penetration to all key areas of the country within two years. This novel and creative approach to law enforcement has been the means whereby PHANSUP has been able to bring information about HIV to areas of the country and sectors of society, which otherwise might not see it as relevant to their daily lives. It seems that this approach has worked in the Philippines, with Dr Libatique reporting widespread acceptance of and adherence to the provisions of the national legislation.