HIV/AIDS Prevention Among Transport Workers:

Lessons Learned from a Peer Education Program in Ethiopia

Mengistu Asnake, MD, MPH and Metiku W/Giorgis, BSc, MSc

PATHFINDER INTERNATIONAL

131st Annual Meeting and Exposition of the American Public Health Association

San Francisco, CANovember 17, 2003

131st APHA Annual Meeting and Exposition

Background: Ethiopia

Total Pop. = 70 millionAdult HIV prevalence = 6.6%Urban HIV prevalence = 13.7%Rural HIV prevalence = 3.7%PLWHA = 2.2. MillionHighest prevalence = Age 15-24

Regions and Zones

In 2000, Pathfinder/Ethiopia, with funding from USAID, began a project with transport workers, through ISAPSO, a local partner.

131st APHA Annual Meeting and Exposition

Program Justification

The job requires mobility, resulting in frequent temptation for casual sexual.

Existing community-based programs may not reach transport workers.

Multiple purpose in reaching transport workers, passengers and surrounding community.

Transfer of HIV/AIDS message along transport routes.

131st APHA Annual Meeting and Exposition

Booth-Based Services (Information and referral at transport terminals)

From January 2001 to June 2003, 78,336 sessions of booth-based services reached:80,530 drivers & 80,794 assistants18,964 cashiers & 54,622 office workers468,326 passengers152,682 community members living in the booth area

131st APHA Annual Meeting and Exposition

1,252 Posters,14,093 fliers/leaflets and 19,859 brochures

2,369 booklets

700 paper caps and 659 T-shirts

735 car stickers and 1,656 radio cassettes

Educational/Promotional

materials distributed

131st APHA Annual Meeting and Exposition

Condom

Distribution

131st APHA Annual Meeting and Exposition

Program Collaborators

Road Transport Authority

Ten transport owners associations

Peer educators Management of Middle

Distance Bus Terminals Pathfinder International,

with USAID funding Integrated Service for

AIDS Prevention and Support Organization (ISAPSO) - implementing Partner

131st APHA Annual Meeting and Exposition

Success Stories

131st APHA Annual Meeting and Exposition

Success Stories (Cont’d) Establishment of national transport HIV/AIDS

activities coordinating committee at Federal Road Transport Authority (RTA).

Inclusion of STI/HIV/AIDS education in the training curriculum for drivers and mechanics.

Growth of peer educators committees to legally recognized local NGOs.

Replication of middle distance bus driver (MDB) experience to truck and train route.

Assignment of material and human resources for the program from transport owners association and RTA.

Breaking the silence as a sign for change in behavior (open discussions, increased condom use, and avoiding environments conducive for casual sex).

131st APHA Annual Meeting and Exposition

Perception of Beneficiaries

Decrease in fear/stigma to discuss HIV/AIDS openly.Increased availability and use of condoms.Many transport workers are getting married through the choice of faithful partnership.Replication of MDB experience to truck and train route.Avoidance of environments conducive to casual sex.With a decreased clientele from transport workers, most community sex workers are changing their professions to petty trading.

131st APHA Annual Meeting and Exposition

The Way Forward

Replicate similar activities on a wider scale.

Involve peer educators beyond the transport sector in psychosocial support.

Create linkages with hotel settings along transport routes.

Create more legal associations from peer educator committees.

Maintain HIV/AIDS activities within the labor union agreements.

131st APHA Annual Meeting and Exposition

Conclusion

The program has achieved its purpose by:

Reaching mobile and vulnerable groups. Promoting behavioral change in the target

populations. Mobilizing the road transport authority and

transport companies. Creating an environment conducive for

partnership in sustaining project activities. Establishing a model for accessing hard-

to-reach populations and creating a mechanism for replication.

For more information, please contact:

Pathfinder International HeadquartersNine Galen Street, Suite 217Watertown, MA 02472 USA

Phone: (617) 924-7200Fax: (617) 924-3833

Web: http://www.pathfind.org

or

Pathfinder International/EthiopiaBole Road, Near Lalibela Hotel

Phone: 251-1-61-33-30Fax: 251-1-61-42-09

Email: Masnake@pathfind.org

Thank You!!