INERELA+ POSITIVE FAITH IN ACTION
SAVE TOOLKIT TRAINING WORKSHOP, TOTOTA, BONG COUNTY- LIBERIA 25TH -29TH JANUARY 2016
This report covers the activities of the SAVE Toolkit training that took place from the 25th to 29th of January in Totota, Bong County, Liberia. The workshop was made possible with the financial support of Church of Sweden in collaboration with the Lutheran Church of Liberia. The facilitators were Reverend JP of Church of Sweden, Pastor Albert Freeman of INERELA+ Sierra Leone and Reverend Janice Gonoe of the Lutheran Church in Liberia. The workshop drew participants from the Muslim and Christian fraternity, representatives of People Living with HIV, government officials and the gay community.
Participants posing for a group photo after the training
- Group work, group discussions and feedback from group works
- Personal stories or testimonies
- Question and answer sessions
Day 1: Highlights
The day started with devotions led by Reverend Johannes Petrus. The scripture reading was from the book of Genesis 1 about creation. The closing prayers were done by one member of the Christian sect and a Muslim respectively. There was registration of the participants and this was trailed by self- introductions (name and surname, place where you come from, designations and one thing which you want other participants to remember you for). The participants were then given a pre- workshop questionnaire before the commencement of the workshop to assess their level of vulnerability.
Expectations of the participants
Reverend JP took the participants through the expectations as follows:
- Meet with all friends
- Certificated at the end of the workshop
- Widen knowledge on advocacy
- Learn more about HIV and AIDS
- To know how to use the toolkit
During the expression of the expectations by the participants, Reverend JP made it clear that if you are HIV positive, this workshop will help you with the knowledge you need to live a full positive life, and if you are HIV negative, it helps you with the knowledge you need to avoid engaging in risky behaviors and risky behaviors that makes you vulnerable to contracting HIV. Finally if you HIV ignorant, then you are posing a danger to yourself and the community at large however, the training will change you by removing the misconceptions and ignorance about HIV and AIDS.
Formation of ground rules
Reverend JP facilitated the formation of ground rules for the workshop and they were as follows:
- Respect each other’s opinions and views
- Observe time
- Speak through the chair
- One meeting
- All cellphones should be off or on silent
Reverend Janice Gonoe of the Lutheran Church in Liberia welcomed all the participants and thanked them for attending the workshop hosted by the Lutheran Church in Liberia. She encouraged free participation in order for the workshop to be successful and wished the participants a blessed stay in Liberia
Why there has been a move from the ABC to SAVE?
Reverend JP highlighted that the ABC has been used as a traditional HIV prevention method globally before the SAVE Toolkit. Richard who was representing the INERELA+ Secretariat explained to the participants why there has been a move from the ABC to SAVE. In 2003, members of the African Network of Religious Leaders Living with or Personally Affected by HIV and AIDS (ANERELA+) 1 developed SAVE as a more inclusive approach to address many facets of the HIV epidemic. The SAVE response (Safer Practices, Access to Treatment, Voluntary Counselling and Testing, and Empowerment) originated as a reaction to build on the strengths and shortcomings of the ABC approach (Abstain, Be faithful, Use a Condom). The ABC approach has long been used as the foundation of ‘comprehensive’ HIV prevention programmes around the world. ABC’s sole focus is on sexual transmission—a focus that fails to address other modes of HIV transmission that are non-sexual yet equally important. Additionally, by only focusing on HIV prevention, the approach falls short to include testing, care and treatment for people living with HIV as well as the empowerment of children, youth, women, men, families, communities and nations to most effectively address the epidemic. Finally, SAVE aims to overcome the inaccurate connection inferred by the ABC approach between immorality and HIV, which further creates additional stigma surrounding HIV. The ABC approach implies that people who are HIV positive have failed at abstinence and being faithful. It also suggests that people should abstain and that condoms are a last resort. SAVE provides a more holistic and non-judgmental approach to HIV by incorporating the principles of ABC, whilst addressing its gaps by confronting all structural drivers of the epidemic. It comprehensively gives information related to HIV and AIDS, methods of HIV transmission and how to mitigate these. It gives users a step by step methodology of addressing sensitive issues such as sex, sexuality and gender in an open, informative and non-stigmatizing way which doesn’t avoid otherwise difficult issues. Having highlighted this, one may want to ask whether SAVE is a replacement of the ABC approach, NO!, SAVE is not a replacement of the ABC but it does incorporates ABC under Safer Practices, whilst going further by covering all underlying factors that shape the scale of the epidemic. SAVE upholds the notion that everyone has the right to access information and to appropriate HIV prevention, treatment, care and support. In particular, SAVE challenges the stigma that often prevents men, women and children to seek HIV testing or disclose their HIV status, as a major driver of the epidemic. Empowerment through education and a shift in attitudes can have a significant impact in reducing the spread of HIV. It is a framework for preventing the spread of HIV and caring for those who have the virus, irrespective of how they contracted it. SAVE encourage people to understand the limitations of the ABC approach as a stand-alone message.
History if INERELA+
Reverend JP gave a brief history of INERELA+ stating that it started in February 2002 as African Network of Religious Leaders Living with or Personally Affected by HIV and AIDS. A group of Religious Leaders who were deeply concerned about HIV got together at Mount Claire Hotel in Nyanga Hills, Zimbabwe and eight of the Religious Leaders present were living with HIV. Together they decided that a Network to support Religious Leaders living with HIV needs to be formed. Nine months later they gathered again at the Collins Hotel in Mukono, Uganda and at this time around they were 40 participants who formed ANERELA+ and jointly developed a vision of “A world where HIV related Stigma, Transmissions and Deaths are Eliminated”. In the year 2008, ANERELA+ transitioned into an International Network after realising the need to go international and in the 2012, INERELA+ celebrated its 10th anniversary.
Unpacking of the SAVE by Reverend JP
Having highlighted why there has been a move from the ABC to SAVE and history of INERELA+, Reverend JP unpacked the SAVE model to the participants. SAVE is a holistic approach that can be used in a variety of circumstances and stands for:
|Safer Practices||Access to treatment||Voluntary, Confidential, Regular Counselling and Testing||Empowerment|
· Safe blood
· Sterile medical instruments
· Oral substitution therapy
· Delay of sexual debut
· Mutual fidelity
· Partner reduction
· Male circumcision
· Clean needles and blades
· Safer traditional practices and treatment as prevention
Treatment of opportunistic infections
· Nutritional support
· All necessary pathological support/tests
· STI treatment
· Moving from AIDS friendly congregations that know their HIV status
· Teaching the need for knowing HIV status at all levels
· Gender imbalance
· Gender, sex and sexuality
· Travel restrictions
· Migrant labour and refugees Racism
· Economic imbalance
· Overcoming SSDDIM
After lunch break, the participants came back and before they were divided into their respective groups for group tasks, they sang a song led by Reverend JP to make them alert for the group work to commence. The participants were divided into groups and this was trailed by Pastor Freeman reading them a story of stigma about Gugu Dlamini and asked the participants to answer how they experience stigma in their own lives. Rev JP reiterated that in order to break the stigma associated with HIV and AIDS, the following stigma formula should be used: AIDS=SEX=SIN=DEATH. He asked participants the following questions:
- Can you get AIDS from sex?-No
- Can you get HIV from sex?-No
On both questions, the participants were able to give the correct answer and this showed their level of understanding HIV and AIDS. After the group feedback, Pastor Freeman emphasised the point that if we break one thing in the stigma wheel, then the wheel won’t be effective in working thus removing HIV and AIDS related deaths, stigma and discrimination. Pastor Freeman went on to read the story of stigma from the module of a boy who was beaten on suspicion that he is gay and this was followed by group work and feedback.
Day 2: Highlights
The day commenced with seating arrangements; the participants were instructed to change their seating positions so that they can form groups with different people from the first day. This was trailed by an opening prayer by Sheik (a Muslim). Reverend JP did the scripture reading from the book of Matthew 1 verse 1, an account of the geneology of Jesus. Reverend JP gave the closing prayer. The participants were given the opportunity to share their “WOW” moments of the previous day, i.e. .what is the new thing that they learnt or found interesting on the previous day. This was done for the purpose of reflection before proceeding into activities of the second day. During this session, it emerged that some cultural practices in North East Of India and many parts of Liberia can increase the risk of HIV transmission for instance in Liberia, it is every lactating mother’s responsibility to pick-up and breastfeed a crying baby even if the mother’s serostatus is not known thus risking HIV transmission. As a way of keeping the participants alert, Reverend JP introduced an energizer of the COCONUT game whereby the participants were instructed to shape all the letters of coconut using their left hand, right hand, left hand, right hand and finally their whole body. The participants went for lunch break and upon coming back, those who came late for the afternoon sessions were punished as a way of encouraging them to consider the importance of time for the sake of progress. They were made to sing the song; “We are too sex to keep time” as they move around other seated participants. It was interesting and it helped in a long way throughout the training as the participants were no longer deliberately coming late for the sessions.
A condom line-up led by Reverend JP trailed. Participants were given pieces of paper with instructions written on them how to use a condom and they were ordered to put them in their correct order. They took time to come out with the correct order, however, they came out with the correct order. The emphasis was on correct and consistent use of condoms. Practical demonstration of condom use followed suit, all the participants were given the opportunity to practical demonstrate how to use a male come by putting it on a curved penis. It was an exhilarating experience to witness all the participants practically demonstrate how to use a condom. As the participant puts on a condom on the curved penis, he/she will be telling others what he/she is doing. After all the participants were through, Reverend JP asked the participants what did they observed during the practical demonstration of condom use. Other participants noted that some others didn’t use inclusive language in their demonstration, for instance, they were talking of withdrawing a male condom from their wives and putting it on their husbands and not even one participant mentioned of withdrawing it from his partner after having sex. One participant observed that, some participants were putting the condom incorrectly and then remove it and change the side. If the condom is put incorrectly then it should be thrown away as this can facilitate transmission of HIV and STIs especially with the presence of the fluids on the penis.
Voluntary Counselling and Testing
Reverend Janice Gonoe of the Lutheran Church in Liberia trailed with Voluntary Counselling and Testing. She asked the participants to name the types of counselling and they mentioned three types of counselling namely; pre-test counselling, post-test counselling and ongoing (supportive counselling). The participants were tasked to write down the benefits of Voluntary Counselling and Testing and they managed to indicate that VCT is important in the sense that it makes it possible for people to make early decision regarding their health, i.e. a person can commence or make a decision to start taking ARVs. They however indicated that VCT can be very traumatic if no supportive counselling is offered especially for difficult clients.
Day 3: Highlights
At the beginning of each day, the devotion was in line with the modules to be covered. Reverend JP read the story of Lot from the book of Genesis 19, the story of Sodom and Gomorrah. His emphasis was on the fact that in the Middle East, breaking the code of hospitality was something serious and that is the case why Lot pleaded with the men of the city not to break into his homestead pledging his daughters instead. The whole story of Sodom and Gomorrah was read aloud to the clients and at the end they were asked if there was any mention of the word homosexuality in the story. Unfortunately there wasn’t any mention of the word in the whole story. Reverend JP closed the devotion with a prayer and shifted his focus on sexual and gender-based violence.
The participants were asked the following questions:
- How do you think you can do to avoid sexual and gender-based violence?
- What are the qualities of a man and what are the qualities of a woman?
The first question was difficult to the participants and they only mentioned that respecting each other as a husband and wife is the only way a person can avoid Sexual and gender-based violence, with some participants mentioning that wearing clothes that doesn’t expose a woman’s thighs can prevent sexual violence. On the question of the qualities of men and women, the participants mentioned a number of qualities for both men and women but most important qualities were attributed to men showing that a question of striking a gender balance is still far from being achieved.
Pastor Freeman did presentation on discrimination. After writing the word on the flip-chart, he asked the participants to describe the meaning of discrimination in their own words and they managed to come up with the following words:
- Less important
- Unfair treatment
The participants were asked to form groups of five and were given work to do in five minutes which was followed by presentations on the following questions:
What makes women vulnerable to HIV?
The participants mentioned some of the following factors:
- Biological make-up
- Sexual violence
- Limited opportunities
- Cultural practice
- Domestic violence
- Harmful cultural practice
What makes men vulnerable to HIV?
- Multiple partners
- Act of circumcision
- Inability to masturbate
- Wife inheritance
Voluntary Counselling and Testing
Reverend Janice Gonoe continued with VCT but before she could continue, introduced an energizer for the alertness of the participants. The emphasis on the issue of VCT was the fact that it is the only way a person can make a risk-benefit analysis based on the outcome of the test, for instance, if a person tests positive to HIV, then he/she will know that initiating ART will be the best option available to them but the person need not to engage in risky sexual behaviours under the pretext that they are spreading the virus otherwise they will get infected with a new strain of the virus. Again if a person tests negative that dosen’t necessarily follow that they are free from HIV and they should go for confirmation because of the possibility of a false positive and a false negative result. A person who tests negative to HIV should take full responsibility to avoid getting infected through risky behaviours such as unprotected sexual intercourse and injecting unsterilized needles.
Day 4: Highlights
The day commenced with devotion led by Reverend JP. The scripture reading was from the book of Genesis 38, the story of Judah and Tamar. The lessons drawn from the devotion was that of hypocrisy, don’t be fast to judge and finally that people mustn’t disobey the Lord. The devotion was centred on the issue of how the bible views masturbation. The devotion ended with a prayer by Rev JP. The participants were taken through the “WOW” session to reflect what they had learnt on the previous day.
Myths about masturbation.
Participants were able to list the following myths about masturbation:
- It causes blindness
- It causes sterility
- Only deviant people do it
- Masturbation is biblically wrong
- Women doesn’t do it
- It causes hairy palms
The participants were then given the following questions to do in their respective groups:
- What holds you back from talking about masturbation?
- What are the words in your local language about masturbation?
- Does talking about it leads to the assumption that you do it?
- What does your faith say about masturbation?
- If masturbation is about spilling the seed, is it rightful for women to masturbate?
During the group feedback, the participants began to open up on their experiences with masturbation. It was generally agreed that masturbation is meant for the satisfaction of both male and female people as it has no socio-economic speciality, race, creed or gender. Masturbation is 100% safe and realistically speaking it should be encouraged as a means of sexual release in order to make abstinence easy to maintain over time.
Reverend JP the chief facilitator introduced the module of Human Rights and read the Universal Declaration of Human Rights comprising of articles 1-30, whereupon finishing he gave participants the following questions for group work:
- What is the nature of being human?
- What in your mind is the link between human being and human rights?
- Can you think of human rights, what are some of the things you can do to protect your inherent human dignity?
The participants were able to satisfactorily answer the above highlighted questions but the whole idea behind the Human Rights module is that people should be made to understand their rights especially those they are not aware of regarding HIV and AIDS and sexual minorities. In the area of HIV and AIDS, every human being has the right to be respected whether they are HIV positive or HIV negative. This session reminded the participants that it is their God-given right to be fully respected as human beings and they have to champion the rights of other people who are denied or deprived of their human rights because of their sexual orientation or based on their HIV status.
Pastor Freeman led the session of shame by reading a story from the module which highlights the ugly features of shame in the module. The story of a girl; Rhaya who was raped and the perpetrator threatened to kill her if she disclose but when the pregnant becomes obvious the father tried to hide her by taking to another village. This didn’t helped though as it was only short-lived before the villagers realised that she is pregnant of rape. The following questions were posed to the participants:
- How does this make you feel?
- What form of shame do you see playing in the story?
- How has shame led to vulnerability to HIV?
The lesson extracted from the story is that shame does nothing except making people silent killers in the community and it can lead to denial for fear of being scapegoated of living with HIV in the community. People won’t disclose their HIV status and their stories fearing shame. To add more on the topic of shame, Pastor Freeman continued with the session by giving the participants tags written in red and blue, the participants were then told to approach the community (other participants) and disclose their identities to them. To great surprise, those in red were facing rejection from the community members whereas those with blue were wholly accepted. This was meant to highlight on the consequences of shame.
Day 5: Highlights
The devotion of love was led by Reverend JP reading the scripture from the book of Corinthians 1 verse 13. In our work related to HIV, we are often embroiled in a scenario whereby people fight for resources, who is to get this and what? The epicentre of the devotion was on respecting each other in a way that implies we are all human beings and must become catalysts in enriching the lives of other people. After the closure of the devotion, the participants were taken through the “WOW” moment to recap on the previous day’s work.
Inaction was the last session and this was meant to remind the participants of the ugly features of inaction, now that they have completed the training, they are not supposed to go and do nothing about the issues of stigma and discrimination related to HIV and AIDS. The story of inaction was read aloud to the clients whereupon the participants were given group work to do. The participants did this with great easy and the session was fruitful in that they managed to point out the inactions in societies and different organisations and they pointed out that advocacy is the most cardinal thing to deal with inaction.
Distribution of the SAVE Toolkit
The participants were given SAVE Toolkit by Annie-rose, Pastor Albert, Richard (who was representing the INERELA+ Secretariat) and Reverend JP. Reverend JP then told the participants how to use the SAVE Toolkit emphasizing that the Toolkit is experiential learning and is not supposed to be given at random.
Reverend JP, Annie-rose( Church of Sweden), Reverend Janice( Lutheran Church in Liberia), Pastor Freeman( INERELA+ Sierra Leone) and Richard( INERELA+ Secretariat) ready to distribute the SAVE Toolkits to participants.
Key follow ups
The participants were assured that their certificates will be processed by Reverend JP once he arrives in Sweden and they will be posted back to the Lutheran Church in Liberia for distribution to the trainees. Secondly, the participants were encouraged to cascade the SAVE training to their respective communities so as to bury the issues of stigma and discrimination
Key observation and Recommendations
There was a very high motivation for people from different religious backgrounds to participate in the SAVE training hence there is great need for financial support for the SAVE training to reach out the needy people. Another observation made was that of punctuality during the training. Despite the participants formulating their own ground rules without undue influence, it’s very disheartening to note that during the training the very people who formulated the ground rules were failing dismally to respect them( this is in particular regard to cellphones and speaking during the session which disrupts the facilitator’s attention leading to an unintended outcome). It was very pleasing however to note that throughout the session, the participants managed to use inclusive language and they didn’t exhibited a homophobic attitude.
Any other matter
Depending on the availability of funding, and following the lifting of the Ebola ban in Sierra Leone, there is need to carry out the SAVE training there.
Sources of Information
The main sources of information were:
- The SAVE Toolkit
- The Bible
- Personal stories and testimonies from the facilitators
Means of verification
- This report
- The SAVE Toolkits given to trainees
- Attendance register
- Air tickets
- Invitation letters
Annex 1: Data Analysis (INERELA+ administered questionnaire)
|Question||Number of respondents with YES||
|Number of respondents with NO||
|Number of respondents with Not Sure||
Question 1: Do you know the means through which HIV is transmitted? If yes, may you list them?
This section of the questionnaire sought to find out if the participants are aware of the means by HIV is transmitted. 100 %( 32) of the respondents indicated a “YES” response, an adequate response that they are fully aware of the ways by which HIV is transmitted. Part of the questionnaire also requested the respondents to list the ways by which HIV is transmitted if they responded “YES”. Only a few respondents managed to list the ways by which HIV is transmitted chief among sex.
Question 2: Do you consider yourself at risk of contracting HIV? If yes, no or not sure, please state why?
Most respondents indicated that they consider themselves at risk of HIV because since it is a Human-Immunodeficiency Virus, it can affect human beings, thus 93,75%(30) of the respondents indicated that they are at risk of contracting HIV. This is an indication that most people are aware of HIV and the many ways it can be contracted. However, 2(6, 25%) of the respondents coded a “NO” response citing the reasons that they are already living with HIV so they don’t consider themselves at risk of HIV infection. This is evidence enough to show that some people are ignorant of re-infection with a new strain of the virus if they engage in unprotected sex or if they use unsterilized when they are injecting drug users. Of this 6,25%, some indicated that they are not at risk because of infection because they are knowledgeable of the ways by which HIV is transmitted, again they are use condoms consistently and correctly but notwithstanding the fact that HIV can be transmitted in the event of an accident.
Question3: Do you know the measures used in preventing HIV infection? If yes, you may please list them.
87, 5 %( 28) of the respondents indicated that they know some of the measures used in preventing HIV infection, with only 3(9, 38%) coding a “NO” response, and 1(3, 12%) coding a Not Sure response. Respondents listed among other things; condoms (both the male and female condoms), abstaining from sex, being faithful to one uninfected partner or one infected partner to avoid the chances of reinfection with a new strain of the virus, avoiding early sexual debut and avoiding the use of unsterilized objects such as needles and razor blades. This denotes that the respondents are aware of the measures that can be used to prevent HIV.
Question 4: Have you ever had an HIV test? If yes, state when last did you test-month and year.
Out the 32 respondents, 26 which constitute 81, 25% indicated that they have tested for HIV, with 5 respondents (15, 63%) giving a “NO”, response and only one respondent, i. e (3, 12%) coded a Not Sure response. However, a considerable number of participants indicated the date they last had an HIV test, with a few not indicating the date raising the speculation that the respondents were most likely giving false answers just for the sake of completing the questionnaire.
Question 5: After receiving the results were you supported with counselling?
Out of the 32 sampled respondents, 20(62, 5%) indicated that they were supported with counselling after receiving the results. 9(28, 12%) of the respondents indicated that they did not receive supportive counselling after receiving test results with 3(9, 38%) of the respondents coding a Not Sure response. If these statistics are anything to go by, this is evidence enough that in most Voluntary Counselling and Testing centres, post-test counselling is not adequately provided and this can have serious consequences for difficult clients who goes into denial because of not being made to accept their results. Question 6, however went on to ask the support those who respondent with a “YES” were given after testing.
Question 6: What other support measures were you supported with?
This question sought the participants to list the measures which were taken to support them after they had undergone testing. Most respondents indicated that they were given medication, trial drugs, they were given nothing, nutritional support, psychosocial referrals, referrals treatment of Sexually Transmitted Infections, link to a support group, supportive counselling, skills training, prevention information, condoms, both male and female condoms and home visits. This denotes that the respondents either tested positive or negative to HIV because they were given different forms of support for both the negative and positive clients.
Question 7: If living with HIV, were you supported with treatment? If yes, how so?
This part of the questionnaire sought to find out whether those respondents who tested positive to HIV were supported with treatment or not. Out of the 32 respondents, 9(28, 12%) of the respondents indicated that they were supported with treatment in the form of medication, therapeutic treatment in the form of supportive counselling and trial drugs. However, 21(65, 62%) of the respondents indicated that they were not supported with treatment after they had tested positive to HIV, with 3(9, 38%) of the respondents giving a Not Sure response. This is crystal clear that 9 out of the 32 respondents were living with HIV hence the form of support they were rendered. They openly indicated their status in response to this question.
Question 8: Would you declare your HIV status in your congregation?
A considerable number of respondents indicated that they will openly declare their HIV status in their congregations and this amounted to 15(46, 88%) of the respondents gave a “YES” response, with 8(25%) of the respondents indicating that they cannot declare their HIV status in their congregations and 9(28, 12%) of the respondents gave a Not Sure response. This implies that despite the ongoing HIV and AIDS awareness campaigns, most people are not ready to disclose their HIV status whether in the church or anywhere, hence the need for supportive counselling to facilitate beneficial disclosure after creating a conducive environment. This again shows that stigma is rampant in the area of HIV and AIDS which makes it even difficult for people to disclose their HIV status.
Question 9: Would you declare your HIV status beyond your congregation?
The respondents gave the same responses as to question 8, thus 15 of the respondents which constitutes 46, 88% indicated that they can declare their HIV status beyond their congregations. However, 8 of the respondents which constitutes 25% indicated that they won’t declare their HIV status to their congregations and finally 9(28, 12%) of the respondents were Not Sure whether they will declare their status to their congregations or not. This simply means that readiness is the key thing for one to openly declare his/her HIV status. Again this shows that even in churches which are deemed to be consolation places, stigma and discrimination is still rampant coercing many to hide their serostatus.
Question 10: Do you preach against HIV related stigma and discrimination in your congregation?
23(71, 88%) of the respondents indicated that they can preach about HIV related stigma in their congregations and 7 of the respondents which constitute 21, 88% indicated that they cannot preach of HIV related stigma in their congregations, with 2 of the respondents giving a Not Sure response. This denotes that if churches which are thought of as places of comfort for the depressed and stressed people cannot preach about HIV related stigma and discrimination, the battle of eradicating these two things will remain a pipe dream. The Gospel of eradicating stigma and discrimination should commence in the places of worship cascading down to communities. However, it will be different scenario if the churches are finding it difficult to kick-start this.
Question 11: Are you comfortable to speak about HIV in your congregation?
Out of the 32 respondents, 26(81, 25%) indicated that they are comfortable to speak about HIV in their congregations with 6(18, 75%) indicating that they are not comfortable to speak about HIV in their congregations. A high number of respondents indicating that they are comfortable speaking about HIV in their congregations is most likely due to ongoing HIV and AIDS awareness campaigns aimed at removing stigma and discrimination hence the openness on sensitive issues.
Question 12: Have you initiated any HIV care and support services in your congregation?
13(40,62%) of the respondents indicated they have initiated HIV care and support services in their congregations and 19 of the respondents which constitute 59,38% indicated that they haven’t initiated anything yet in their congregations about HIV care and support. No respondent gave a Not Sure response.
Question 13: Do you include HIV in your sermons? If yes, how many times? E.g. one out of eight.
The question sought to find out if the respondents include HIV in their sermons and 16 (50%) of the respondents indicated that they do include HIV in their sermons, however on the part of giving the number of times, the respondents varied from one to everyday. On the other hand, those who indicated that they don’t include HIV in their sermons amounted to 16 which constitutes 50% citing the reason that they are not religious leaders.
Question 14: Are you engaged in any advocacy on HIV?
This part of the questionnaire sought to find out if the respondents are engaging in advocacy work. Advocacy encompasses the activities that an organisation and individuals can take to exert pressure for change in a specific policy or behaviour of a government, organisation or single individual. Advocacy is about successfully influencing agendas to achieve the desired outcome through policy analysis, awareness raising, lobbying and media. 24 of the respondents indicated that they are engaging in advocacy work on HIV and this constitutes 75% whereas 8 of the respondents indicated that they are not engaging in advocacy work and this constitutes 25% of the 32 sampled respondents.
Question 15: Are you comfortable to talk about safe sex practices in your congregation?
The question explores the respondents’ knowledge on safe sex practices and whether they are comfortable preaching about it in congregations. It was interesting to note that 31 of the respondents indicated that they are comfortable preaching about safe sex practice and constitutes 96, 88% of the sampled respondents whereas, 1 (3, 12%) respondent indicated that he/she is not comfortable speaking about safe sex in congregation. This denotes that most people are aware of the safe sex practices even if they act with negligence. As part of a safe sex practice some congregations went a step further by making condoms available in churches to break the yoke of silence which makes people vulnerable to HIV.
Question 16: Do you consider education and information on sex and sexuality good for children for reducing HIV transmission?
Information on sex and sexuality as well as education is good for children in reducing the transmission of HIV, hence all the respondents, i.e. 32 of the respondents gave a “YES” response which constitutes 100%. If people are well informed of the likelihood of the dangers, they can be able to avoid these dangers.
Question 17: Do you consider education and information on sex and sexuality good for teens for reducing HIV transmission?
32(100%) of the respondents indicated a “YES” response to the fact that they consider education and information on sex and sexuality good for teens for reducing the transmission of HIV. In countries where the provision of information on sex and education is considered pivotal, teenage pregnancies and HIV among the teenagers is less prevalent hence the phrase, “Catch them young”
Question 18: Do you consider education and information on sex and sexuality good for adults in reducing HIV transmission?
All the respondents, i.e. 32(100%) respondent with a “YES” response to the verdict that they consider education and information on sex and sexuality pivotal in reducing the transmission of HIV among the adult population. This shows that the respondents are aware of the fact that some adults despite the fact of being physically and mentally mature they might still be lacking information on sex and sexuality which makes them vulnerable to HIV, hence sex education should be done across all age groups because some adults didn’t get sex education during their juvenile age which makes them vulnerable too. This also strikes home the reality that all age groups are vulnerable to HIV.
Question 19: Do you know of any faith-based network of people living with HIV?
This question sought to find out if the respondents are aware of the networks of people living with HIV in their respective areas which they can seek support on how to facilitate a smooth passage in living positively with HIV. Out of the 32 respondents, 25(78, 13%) of the respondents indicated that they are aware of the faith-based organisations of people living with HIV whereas 7(21, 87%) of the respondents indicated that they are not aware of these networks.
Question 20: Do you have any views about religious leaders living with HIV? If yes, what are they?
Religious Leaders with HIV are oftenly viewed in different ways. Here, 15(46, 87%) of the respondents indicated that they have views about religious leaders living with HIV. These views are both negative and positive. On the positive side, some indicated that they view religious leaders who are living with HIV as courageous enough for the sole fact that they are openly living with the virus after disclosing their serostatus in spite of stigma at its boom. Some respondents indicated that they view religious leaders as role models and true activists who have accepted their status after doing away with denial. On the negative side, some respondents indicated that they view religious leaders living HIV as promiscuous because they need to be exemplary, they should teach people of good practices such as safe sex but they get infected themselves with the virus. This denotes that living with HIV is still viewed as a deviant and promiscuous behaviour regardless of how one gets infected. 17(53, 12%) of the respondents gave a “NO” response.
Question 21: Are HIV and AIDS punishments from God?
3 of the respondents which constitute 9, 38% agreed to the verdict that HIV and AIDS are punishments from God. This verdict is based on the misconceptions that people have about HIV and AIDS forgetting the fact that even children can be infected at birth, during breast feeding and the fact that HIV infection can also occur in the event of an accident. This verdict does nothing but makes God a capricious and vindictive person for punishing even the infants and is wrong. However, 29(90, 62%) of the respondents disagreed to the verdict that HIV and AIDS are punishments from God.
Question 22: Can AIDS be cured?
24(75%) of the respondents are aware that AIDS despite being a chronic illness can be cured, with 6(18, 75%) coding a “NO” response implying that they are of the idea that AIDS cannot be cured. However, 2(6, 25%) of the respondents gave a Not Sure response on whether or not AIDS can be cured.
Question 23: A virgin cannot get infected with HIV.
There are misconceptions that a virgin cannot get infected with HIV and this is exaggerated by the sangomas who encourage people living with HIV to have sex with a virgin person so that they can get cured. 5(15, 63%) of the respondents agreed that a virgin person cannot be infected with HIV, however, a whopping 27(84, 37%) disagreed to the verdict that a virgin person cannot get infected with HIV. This takes us back to the conditions necessary for transmission of HIV to occur: that blood or bodily fluids must find a way to enter the body in sufficient quantities and the duration of exposure should be long enough, hence HIV trans mission can take place if these conditions are present regardless of the fact that a person is a virgin or not, again HIV transmission can take place in the event of an accident. It is a common practice in South Africa that a person can be virgin but will be practicing annul sex for the sake of maintaining virginity due to high importance attached to marrying a virgin person in some cultures.
Question 24: People living with HIV should be treated and accommodated in society just like everybody else?
25(78,13%) of the respondents coded a “YES” response showing that they agree that people living with HIV should be treated and accommodated just like any other person in the society. In most societies, PLHIV are often treated as outcasts for the reason that they brought infection upon themselves forgetting the fact that there are many ways by which a person can get infected rather than through sex alone. Their views are deeply rooted in the ABC approach which consider sex as the sole method of HIV transmission. However, 6(18, 75%) of the respondents disagreed that PLHIV should be treated in the same way as others in the community and 1(3, 12%) respondent is not sure whether they should be treated as equals or not. This reflects that despite ongoing HIV and AIDS awareness campaigns some people still have a discriminatory attitude towards PLHIV, hence the campaigns should be ongoing in order to provide people with accurate information because some misconceptions are based on fear of the epidemic.
Question 25: Members of the LGBTI Community should have access to medical treatment just like everybody else.
All the respondents, i.e., 32(100%) wholly agreed that members of the LGBTI should have access to medical treatment just like everybody. This indicates that most of the respondents were not homophobic or are not homophobic and accepting people of different sexual orientations is the only way forward to achieving the “Zero Goals” because side-lining key populations does more harm than good in that if they are not treated the same way as other people when seeking medical assistance they will remain silent killers in the community.
Question 26: Religious Leaders who cannot get cured of HIV and AIDS do not have enough faith in God.
The respondents gave different views on the issue of one getting cured based on his/her faith. 2(6, 25%) of the respondents agreed that religious leaders who cannot get cured of HIV and AIDS do not have enough faith in God. In the modern days this belief is worsened by some pastors who fervently preach of having faith and that by faith people can get healed of HIV and AIDS. The majority of the respondents however disagreed and this amounted to 27 which constitute 84, 37% of the sampled respondents. On the other hand, 3(9, 38%) of the respondents coded a Not Sure response.
Question 27: Separating people living with HIV from those who are HIV negative is the best option for the safety of those who are HIV negative?
Only 1 respondent agreed that separating PLWHIV from those who are HIV negative is the way forward in curtailing the spread of HIV and this constitute 3,12% of the respondents. The majority of the respondents however refuted to the verdict, thus, 29 (90, 63%). On the other hand, 2(6, 25%) of the respondents responded with a Not Sure response.
Question 28: Having many partners is higher risk to HIV infections?
Half of the respondents agreed that having many partners is higher risk to HIV infections, 16(50%). Alternatively, 11(34, 37%) of the respondents disagreed that having many partners is higher risk to HIV infections, so this is clear that having many partners is not a higher risk to HIV infection but it does increase the chances of one getting infected with HIV especially if they do not use protective measures such as condoms and if the status of the partners is not known. 5( 15,63%) of the respondents coded a Not Sure response reflecting that having many partners might or it might not increase the chances of one getting infected. Their response is likely to be based on the fact that in many cultures where polygamy is practised, the husband and the wives doesn’t get infected as long as faithfulness is practised hence their response.
Question 29: Would you as a Religious Leader marry two people in Church when one or both are HIV positive?
Out of the 32 respondents, 25 which constitute 78,12% agreed that they can marry two people in church regardless of their HIV status, however, 4(12,5%) of the respondents disagreed to marrying a person living with HIV, with the other 3(9,38%) giving a Not Sure response. Despite the fact that most people are not aware of their serostatus, they stigmatise and discriminate those who are openly living with HIV. These are the HIV ignorant people and being HIV ignorant is more dangerous.
Question 30: All HIV positive mothers will give birth to HIV positive babies.
2(6, 25%) of the respondents agreed that all HIV positive mothers will give birth to HIV positive babies and 29(90, 63%) of the respondents disagreed with 1(3, 12%) giving a Not Sure response. This part of the questionnaire sought to find out the respondent’s level of understanding in relation to HIV in giving birth. While it is a known fact HIV transmission from the HIV positive mother to a baby can occur during birth, ARVs can reduce the chances of the mother transmitting the virus to a new born baby. The bottom line is that while HIV transmission can occur during delivery, it doesn’t necessarily follows that all HIV positive mothers give birth to HIV positive babies.
Question 31: A wife cannot accuse the husband of rape in their marital bed.
6(18, 75%) of the respondents agreed to the verdict that a wife cannot accuse the husband of rape in their marital bed, whereas 25(78, 12%) of the respondents disagreed, with only 1(3, 12%) respondent giving a Not Sure response. By definition, rape is canal knowledge of a woman and forcibly against her will, implying that rape can occur anywhere, in bed to a married somebody or in the bush raped by a stranger. In this case, in bed, rape can occur especially if a couple has a discordant result or both are HIV negative, forcing somebody against his/ her will to have sex is still described as rape. However, some are of the view that a woman cannot accuse a man of raping her in bed since the man is the one who pays the bride prize and has the right to have sex any time he feels like.
Question 32: Everyone should have responsibility over their own sexual health and therefore a person who is living with HIV should not be forced to tell the sexual partner about his/her HIV status?
While it is a well-known fact that people should have responsibility of their own sexual health, this doesn’t necessarily follows that people should hide their serostatus to their spouses because this will have dire consequences in the event that the other partner in not aware of his/her spouse’s serostatus. Only 13(40, 63%) agreed to the verdict with 17(53, 12%) disagreeing and 2(6, 25%) of the respondents gave a Not Sure response. This implies that sexual responsibility doesn’t mean hiding crucial health information to your partner.
Question 33: Homosexuality is not an African behavior and should not be a subject of discussion among us.
The question sought to find out how the respondents view homosexuality from an African perspective. 5 (15, 63%) of the respondents agreed that homosexuality is not an African behavior and therefore it should not be a subject of discussion with the majority giving a “NO” response, thus 27 which constitute 84, 37%. Clearly, this shows that people are now aware that homosexuality has been there since time immemorial hence it is absurd to say it is not an African behaviour because of the names which existed long back before written records.
Question 34: I recommend masturbation as an alternative to sex as a way people can stay safe from HIV by satisfying their sexual desires when under pressure.
Majority of the respondents agreed to recommending masturbation as an alternative way to sex which makes people safe to HIV, thus 27(84,37%). However, 5(15, 63%) of the respondents gave a “NO” response. Realistically speaking, to make abstinence easier to maintain over time masturbation should be encouraged. Those who gave a “NO” response, it’s most likely that their response was influenced by the myths surrounding masturbation that one can go blind, can cause sterility etc. Masturbation though it is biblically wrong is 100% safe.
Question 35: Considering the way you have lived the last five years, do you at any time consider that you have exposed yourself to risk of getting HIV infection?
This part of the questionnaire wanted to find out if the respondents are aware of the other means by which a person can get infected with HIV rather than sex. It seeks to move respondents from the confinements of the ABC approach which views HIV as sexually transmitted infection. Of course, we are not disparaging the fact that HIV is mainly transmitted sexually but there are other ways too. Thus 26(81,25%) of the respondents coded a “YES” response implying that they are aware that HIV is not only a sexually transmitted infection. Transmission can occur in the event of an accident, during birth, breastfeeding and of course through using unsterilized equipments such blades and needles. However, 6(18, 75%) responded that they consider themselves not at risk of HIV. This is not true in the sense that HIV is a virus which attacks human beings and the fact that someone is a human being makes him/her vulnerable to HIV.
Question 36: As a servant of God, part of my call is to attend to needs of persons living with HIV and AIDS in my congregation.
29(90,62%) of the respondents agreed that part of their call as servants of God is attend to the needs of people living with HIV in their respective congregations, however, 3(9,38%) of the respondents gave a “NO” response. This question was mainly targeting religious leaders who are obliged to preach the gospel of love and not hatred in their congregations so as to eradicate stigma and discrimination.
Question 37: Is it possible that a religious leader living with HIV can be infectious to his members of the congregation while offering his or her service?
The question sought to find out the ignorance and misconceptions people have about how HIV is transmitted which heightens the stigma and discrimination surrounding HIV and AIDS. 3(9, 38%) of the respondents gave a “YES” response to the verdict that a religious leader living with HIV can be infectious to the congregants during a church service. This is fallacy at its peak. The majority of the respondents, that is, 29(90, 62%) disagreed. Despite a portion of the respondents unaware that HIV cannot be transmitted during a church service, the majority of the respondents are fully aware of the ways by which HIV can be transmitted and the ways it cannot be transmitted.
Question 38: My children cannot play with children who are living HIV.
All the respondents disagreed to the verdict that their children cannot play with children who are living with HIV, thus 32(100%). This shows that people are fully aware that HIV cannot be transmitted during playing as long as there is no blood contact.
Question 39: I believe that a person living HIV should not have sex.
1(3, 12%) respondent agreed to the verdict that a person living HIV should not have sex, however, the rest of the respondents disagreed, thus 31(96, 88%). Clearly, this indicates that the respondents understand that even a person living with HIV is supposed to have sex for sexual release, but it should be protected sex to avoid the chances of re-infection with a new strain of the virus or willingly infected the sero-negative partners.
Question 40: I believe that government should develop laws to punish persons who transmit HIV.
12(37, 5%) of the respondents believe that the government should develop laws to punish persons who transmit HIV whereas 18(56, 25%) disagreed that persons who transmit HIV should be punished. The higher response on the “NO” verdict is most likely to have been driven by the fact that the respondents understand that some people can transmit HIV unknowingly hence punishing them under such circumstances will be very unfair but for those who wilfully transmit HIV should be punished. Finally, 2 (6, 25%) of the respondents gave a Not Sure response.
Question 41: I know that using a condom during a sexual intercourse is 100% safe to prevent HIV transmission.
Only 5(15, 62%) of the respondents believes that using a condom guarantees 100% safety with the rest, 27(84, 38%) disagreeing that using a condom during sexual intercourse is 100% in preventing HIV. While condoms have a higher efficacy rate in the prevention of HIV during sex, they do not totally prevent one from being infected with HIV as they have an efficacy rate of 99, 9%. Again there are other factors that can compromise the efficacy rate of a condom, for instance, if a condom is used after its expiry date the chances are high that it can burst during sex, if not used correctly and constantly a person can still can infected despite using it.
In a nutshell, the data obtained from the questionnaire reveals that though a lot has been done, more work still needs to be done in the area of HIV and AIDS to eliminate stigma and discrimination(based on misconceptions, fear and ignorance) that is faced by the key populations. It was interesting to note that the participants were not homophobic as evidenced by the use of inclusive language when referring to key populations and this created a safe and conducive environment for the participants to disclose their experiences.