Travel Reference
In-Depth Information
rural communities), the relative prevalence of polygamous relationships and partners,
and high birth rates (see box on
Click Here
).
In the southeast region of Anosy, indicators suggesting the likelihood of an HIV
epidemic are all too apparent. Almost 90% of the population lives below the poverty
line, illiteracy is as high as 80% and malaria, bilharzia, typhoid and respiratory dis-
eases are widespread. HIV prevention efforts in the regional capital of Taolagnaro
(Fort Dauphin) were initiated during the development of the Rio Tinto ilmenite mine
which briefly caused a boom in migration and working tourism.
HIV testing in the town is low, but indications are that infection levels have risen
by around 64% in the last four years. In 2010 the first child was diagnosed with the
virus. Other factors which increase the likelihood of the spread of HIV are underage
sex and marriage (from as young as 12) and low levels of sexual health knowledge.
Sexworkiscommonandconsideredculturallyacceptable amongstbothmenandwo-
men; acceptance is as high as 90% amongst impoverished groups. There are strong
fady
around the discussion of sex and access to information is typically low. Another
indicatorusedtopredictpotentialoractuallevelsofHIVistheprevalenceofsexually
transmitted diseases, which are estimated by doctors to be around 40% in the town.
TheMalagasygovernmenthasrespondedtothethreatofHIVwiththeimplementa-
tionofanationalstrategyaspartofthecountry'sdevelopmentplan.Thishasinvolved
the establishment of regional HIV/AIDS Task Forces to coordinate community-based
activities in prevention, counselling, treatment and aftercare. However, as a result of
the 2009 political crisis, withdrawal of international funding and restructuring of gov-
ernmental ministries, coordination has completely collapsed.
TheyouthrepresentativefortheAnosyHIV/AIDSTaskForce,AzafadybeganHIV
prevention efforts in 2006. A pilot study was conducted, from which a major three-
year behaviour change programme in the town was developed, followed by a special-
ised maternal HIV prevention project in 2010. During this time, Azafady has man-
agedtoincreaseHIVknowledgeamongstyoungpeoplebyanaverageof25%andhas
distributed over 65,000 condoms as well as information, education and communica-
tion materials. This has been achieved through local peer group educators and the im-
plementation of a range of community-based activities including focus groups, home
visits, the first antenatal group, school workshops, film screenings, sport and culture
events, and mass mobilisations.
The biggest community mass mobilisation isthe well-established WorldAIDSDay
street carnival, held annually on 1 December and supported by diverse community
groups. Participants wear traditional clothing and brightly coloured
lamba hoany
, and
decorate themselves with red ribbons and body paint, to perform energetic and syn-
chronised routines. It is an extremely uplifting and enjoyable celebration well worth
visiting Taolagnaro for.
