Who should be ashamed?

People in Sierra Leone saw a 31% drop in the number of folks who think those with HIV should be ashamed. Find out how.

Stigma around HIV is a powerful thing. I was 12 the first time I shared a meal with someone who was HIV positive, and remember feeling weird about it. I grew up in a state with mandatory HIV education in schools, and I knew I couldn’t get the disease that way, but it still gave me pause. Imagine how much stronger that is in places with little information, few treatment options, and much more restrictive norms.

In 2013, 65% of Sierra Leoneans said that “People who have HIV should be ashamed of themselves.” By 2017, that number was only 45% in areas CARE’s HIV programs covered. Part of that is because people know more about the disease, and partly it’s because social norms are changing. People are more confident because they’re taking more steps to protect themselves.

HIV/AIDS Prevention Program (HAPP III) ran from 2013-2018 with $651,873 from the Sierra Leonean National AIDS Secretariat as a bi-lateral agreement with the German Cooperation. It reached 8,781 people directly and 64,680 indirectly.

What did we accomplish?

  • There is less stigma around HIV: There was a 31% drop in the number of people who think that those who have HIV “should be ashamed of themselves.”
  • Condom use went up: Women were nearly 4 times more likely to use condoms (up to 18.6%), and men were 70% more likely to use condoms (up to 28%) than they were before the project.
  • Women are more likely to protect their daughters: The number of women who do not intend to circumcise their daughters more than tripled, from 15% to 48%.
  • Girls are waiting longer to get pregnant: There was a 9% drop in the number of girls who had their first child before age 19. This matters because girls are much more likely to have safe pregnancies and healthy babies if they are 18 or older when they have their first child.
  • Women are more independent: “Women are no longer economically dependent on men for sustenance. Other surrounding communities are now demanding for the extension of this project to their communities,” said a participant in Tonkolili District

How did we get there?

  • Creative Marketing: The Sierra Leonean Social Marketing and Development Agency (SLaDA) partnered on the project to do social marketing, and as a result, sold 12.2 million condoms, enough to protect 90,576 couples. They used mass media, and set up condom sales in unexpected places, like hotels, police stations, and military bases.
  • Support livelihoods: The project gave livelihoods and business training for 8,781 women and girls, and distributed seeds so people had ways to support themselves besides transactional sex.
  • Get people talking: The project used CARE’s Social Analysis and Action tool to host dialogues between generations in the community so they could discuss HIV. Since 72% of women say they get information about HIV from their families, providing safe spaces to ask questions and get information among family members is critical.
  • Change the rules: 150 communities signed new charters or created new rules about ending early marriage and gender-based violence.
  • Build a market: The project connected 2,393 condom retailers to 50 wholesalers, ensuring that there is a supply of condoms available in communities when people need them.

Want to learn more?

Check out the phase III final evaluation. And stay tuned for more updates from Phase IV!