Global Resources

Promoting the Participation of Men in Community-based HIV/AIDS Prevention and Care in Cambodia

Author: L. Chansophal, A. Maclean, P. Panhavichetr
Publication Date: Jun 2002
In some countries such as Cambodia, the main form of HIV transmission is heterosexual sex. Men have more sex partners than women, and often engage in commercial sex. There is therefore a need for greater emphasis on working with men towards greater awareness of HIV prevention and care, particularly since projects and programmes around sexual health have usually targeted women. Nine rural and peri-urban Cambodian NGOs sought to address issues of masculinity and HIV/AIDS in a country where dominant models of masculinity have been shaped by decades of conflict.

With the help of Khana , an initial needs assessment was made by each NGO. Among other things it was found that men talk about sexuality already within their peer groups, and it was therefore easier to design a project of participatory knowledge and experience sharing. Self-selecting peer groups were then set up, usually grouped by age, occupation or marital status and discussions included gender, violence, responsibility, sexuality and how to share learning with families and the community. The groups were initially facilitated by NGO staff and eventually facilitated by trained volunteers from the community. The groups placed an emphasis on creating solidarity amongst their members which helped them in the face of ridicule or pressures from men outside the groups. Many participatory tools used included: - Body Mapping - adding information to a map of the body to allow the facilitator to assess levels of knowledge, attitudes and practices within the group. - HIV Wheel - which identified what needs to change by drawing strategies for change around a circle and working on how to achieve them. - Bricks in a Wall - where paper bricks are used to represent different barriers and are removed from the 'wall' over time as solutions are suggested and implemented. - Role Play - of strategies for resisting peer pressure. - Impact Ranking - putting solutions in a grid depending on the level of impact and how easy they are to achieve. It was also seen as important to take action in the wider community in order to increase coverage and draw in educators from other fields. For example, monks in some areas made Pagodas available as venues for HIV/AIDS events, and local events such as plays and quizzes were organised. In most of the projects they also began to work in a similar way with groups of women and young people. Outcomes over a two-year period included: - increase in condom use - decrease in domestic violence in some projects - some myths of HIV transmission had begun to disappear - men became more able to resist peer pressure to drink alcohol or have commercial sex - married women became more able to negotiate about sex or condom use with men who had attended the groups - community facilitators often began to take on extra tasks such as liasing with village leaders. Some lessons learned: - importance of ensuring that the timing of the groups did not conflict with income-generating activities - community communication networks were important in targeting vulnerable groups - importance of training and mutual support for group facilitators.