MODULE 1:
Understanding your context

This Module sets the scene for the rest of the workshop. It starts with an overview of up-to-date regional and national data, looking not just at HIV and STI rates, but at other data including unintended pregnancy and abortion rates. It tries to identify clearly which particular populations or sub-populations are benefiting least from health initiatives in this area.

In order to increase ownership and legitimacy, it is preferable to have the national data presented by a national authority like the national AIDS Commission or Department of Health. This often provides an opportunity for stakeholders to engage with the national authority on what the data means for onward programming.

The second part of the Module looks at the context of HIV and sexual and reproductive health in the country - who is getting HIV and STIs and why? Who gets access to diagnosis and treatment and who does not? What affects the ability of different populations to access information, programmes and services.

 

  • Session 1: Regional and National data

    This session aims to familiarize participants with up-to-date Regional and National data and what that means for the priorities for improving sexual and reproductive health among key populations. Although data is often readily available, people often skim over it. Use this session to facilitate a discussion about what the data actually means and what it shows and, just as importantly, what data gaps exist.

    In planning for the workshop, try to have the national data presented by the agency responsible for collecting and analyzing it. This increases ownership and provides an opportunity for key stakeholders and people from Key Populations to discuss their data needs with the people collecting and analyzing the data. it can also provide an opportunity for a discussion about how the data is interpreted.

    Try to move the discussion away from a single focus on HIV rates, onto a discussion about STI rates and what they mean, and other data that points to service access and to other aspects of sexual and reproductive health like rates of unintended pregnancy, abortion rates, data on access to various forms of contraception, data on sexual violence and other data that can inform better priority identification and programme development.

    Manage the timing of this session so that there is ample time (and permission) for questions and discussion.

  • Session 2: The Context of HIV and SRH for Key Populations

    The session sets up discussion and interaction in the group by exploring what the terms ‘sex work’,  ‘sex worker’, ‘man who has sex with men’, ‘transgender person’, might mean to participants and what they understand about the lives led by people in these populations. It uses environmental description or mapping techniques to expand preconceived ideas about who is at risk and affected by HIV and what places people at increased risk and impact in relation to HIV.

    This involves a discussion of the nature of HIV risk and impact aimed at exploring what people understand about who is affected and at risk. It is followed by a group work mapping exercise.

    The term ‘HIV risk and impact’ is used deliberately. If we only talk about HIV risk, we are only covering HIV prevention and the need for people who do not have HIV to avoid acquiring it. The reality is that there are people with HIV within the populations that we work in and that if we talk only about prevention, these people are marginalized and hidden. Talking about risk and impact acknowledges that we are interested in the continuum of HIV prevention, treatment, care and support and that no matter where the person’s needs are along this continuum, programmes need to be ready to assist.

    Rather than have a long presentation now, this session aims to get the participants to interact with each other – firstly in a ‘whole of group discussion or brainstorming and the in small groups. This is how you will start to find out who is in the room, what they know and what they believe about Key Populations. It helps to identify areas that might need greater focus throughout the training.

    In this session small groups work together to develop a map or diagram that explains who is in the environment that people from Key Populations live and work in, who affects their ability to maximize their health and stay safe from violence, who helps them to access information and services, who depends on them and who they depend on. These are not geographical maps, but diagrams that help to set the scene. The maps will be displayed on the walls of the training room for the entire week and will be referred to on numerous occasions.  It is therefore important that groups have sufficient time during this session to thoroughly consider and develop the maps. Instructions for the mapping exercise are attached.