Behaviour Development and Change
Behaviour development and change remains the key to HIV/AIDS prevention among children, adolescents and young adults. Using mass media, leaflets and posters, hotlines, peer education, outreach or primary and secondary school curricula, UNICEF supports behaviour development and change strategies that:
- Deal openly and accurately with HIV/AIDS risk behaviours and real-life situations
- Utilize a range of different channels sending consistent messages, with complementary campaigns where possible.
- Pay attention to the specific requirements of different target groups and risk behaviours
- Incorporate a Lifeskills approach
In the EAP region, special efforts are needed to reach linguistic minorities, and communities poorly covered by standard services and communication channels. UNICEF-supported rapid assessments of internal and inter-country mobile populations, particularly seafarers, have led to initiatives designed to overcome the difficulties of reaching a constantly moving population.
Lifeskills for Healthy Living
Prevention activities that incorporate a Lifeskills approach are effective in promoting healthier lifestyles and reducing risk behaviours. The Mekong Project helped all of the Mekong countries to design Lifeskills-based healthy living and HIV/AIDS/STI prevention curricula for children and young people in and out of school, and to start implementing them in a variety of settings. Through the Mekong Partnership and Beyond, UNICEF continues to support Lifeskills education. In particular, UNICEF supports updating existing curricula in response to emerging trends and in order to better target high-risk behaviours and vulnerable groups.
Lifeskills and other behaviour development and change channels are also playing an important role in generating acceptance and support for people with HIV/AIDS and their families.
Behavioural Surveillance
While sentinel surveys provide statistical information on levels and trends of HIV prevalence in certain population groups, behavioural research and surveillance reveals more about why these groups are vulnerable. Understanding how behaviours are shaping the present – and the future – of an epidemic is essential in designing well-targetted prevention and care programs. Behavioural surveillance also allows critical trend analysis of the impacts of interventions
UNICEF calls on the expertise of agencies like Family Health International, Population Services International and the Thai Red Cross AIDS Research Centre to help countries institutionalize and improve regular behavioural surveillance programs, as well as supporting other behavioural research initiatives.
Regionally, UNICEF supports rapid applied studies on mobile and cross-border populations, using survey methodologies pioneered under the Mekong Project for groups such as seafarers and migrant workers.
Reproductive Health
In many countries, reproductive health programs and services (including birth-spacing, family planning and STI) still focus more or less exclusively on adults in established, heterosexual relationships. The Mekong Partnership and Beyond strategy supports the development of services that are more inclusive and accessible to young people, who are becoming sexually active earlier and with more partners across the subregion, to men who have sex with men, and to minorities who are or feel excluded from these services for linguistic, social or cultural reasons. A key partner is UNFPA (the UN Population Fund), a fellow UNAIDS Cosponsor.
Prevention of Mother-to-Child Transmission
Vertical transmission of HIV during pregnancy, delivery and/or breastfeeding accounts for nearly all cases of HIV infection among young children. Medical interventions can minimize the risk of transmission during these stages, but UNICEF advocates strongly for responses that seek to break the chain of infections before it reaches the mother.
UNICEF supports comprehensive prevention programs that encompass:
- reproductive and sexual health services accessible to all young women,
- information and education campaigns that directly target young women, especially those in relationships,
- voluntary confidential counselling and testing,
- safe delivery practices,
- antiretroviral therapy for mothers and newborns (where appropriate),
- access to essential commodities and condoms,
- advice for mothers on the most appropriate options for feeding their baby.
Ensuring that care and support are available for affected and infected children is also an essential part of any prevention of mother-to-child transmission initiative.
UNICEF coordinates the UN Regional Taskforce on Prevention of Mother-to-Child Transmission, with participation from UN, NGO, government and international organization offices in South and Southeast Asia.
Voluntary Confidential Counselling and Testing
UNICEF considers access to voluntary confidential counselling and testing
All countries in the EAP region have some capacity for HIV testing, though sometimes the results are only used for sentinel surveillance. However, patients' rights, confidentiality and use of the data remain serious problems in some areas. The importance of counselling is often overlooked, and it is provided by inadequately trained staff.
UNICEF works closely with WHO, UNAIDS, UNFPA and Ministries of Health to improve and expand the availability of VCCT, particularly in antenatal care services.
Acceptance, Care and Support
For HIV/AIDS prevention programs to function effectively they need to be integrated with care and support. UNICEF provides strong advocacy and support to the establishment of programs to build acceptance, care and support for people with HIV/AIDS and their families. These programs respond to the diverse needs of people affected, from building enabling environments where they are treated with compassion and support, not discrimination, to treating AIDS-related illness.
People with HIV/AIDS have much to contribute to programming, from advocacy to supporting and advising their peers and raising awareness about the disease, its impacts and prevention. However, their participation is only really possible when there is already a certain degree of acceptance of people with HIV/AIDS in the community. UNICEF supports the activities of existing self-help and peer support groups of people with HIV/AIDS, and strives to create environments in which they can develop and operate.
The Regional Buddhist Leadership Initiative has seen Buddhist monks and nuns becoming important partners in providing and mobilizing community-level care and support, as well as prevention and awareness-raising.
Protecting the rights and needs of children affected by HIV/AIDS – those children whose mother, father or other primary carer has HIV/AIDS – is another important focus for UNICEF programming.
Advocacy and Capacity Building
UNICEF plays a critical role in mobilizing political will, resources and social support for HIV/AIDS. UNICEF dialogues with top government decision-makers, compiling data and supporting studies to back up calls for action and assistance in policy design. Partnership with the media, particularly the news media, helps keep HIV/AIDS issues in the public eye.
Small Grant Facilities
The best ideas often come from one person, one small community group, deciding to do something about a problem they see every day. UNICEF is committed to supporting innovation in HIV/AIDS programming, wherever it starts. Small grant facilities at regional and country level allow UNICEF the flexibility to provide timely support to smaller initiatives – helping them develop, grow and share their experiences.
By accessing small grant facility funds, UNICEF can:
- strengthen community participation,
- work with (I)NGOs and community-based organizations,
- address sensitive issues and respond quickly to immediate needs,
- increase the reach of programming,
- build capacity.
The UNICEF Regional Grant Facility for HIV/AIDS is intended for projects that have a significant cross-border component and are seen as being of regional importance/interest to National AIDS Programs and implementing agencies. The RGF is managed by the UNICEF Regional Technical Support Group.
UNICEF and the UNAIDS Program
The UN agencies that participate in the Joint United Nations Program on HIV/AIDS (UNAIDS) have complementary mandates and areas of expertise, allowing them to work with great synergy in he area of HIV/AIDS. As a UNAIDS Cosponsor, UNICEF has been a particularly active member of the UNAIDS South East Asia-Pacific Inter-country Team (SEAPICT). Many UNICEF HIV/AIDS activities take place under the umbrella of UNAIDS in order to increase opportunities for collaboration and coordinate use of funds.
The UNICEF-EAPRO HIV/AIDS team coordinates the UN Regional Taskforces on Youth and HIV Vulnerability and on Prevention of Mother to Child Transmission, and participates actively in the UNAIDS Regional Taskforce on Mobile Populations. UNICEF Country Representatives chair UN HIV/AIDS Theme Groups in several countries.
The Regional Project on Trafficking
The Project on Trafficking of Women and Children in the Mekong Subregion is a collaborative multi-agency project implemented by UN agencies, governments, NGOs, community-based organizations and others. Launched in 2000, the project aims to 1) reinforce existing and develop new national and subregional action and support systems, 2) support and develop locally initiated and innovative approaches to prevention, protection, recovery and integration, and 3) increase subregional and national capacities and cooperation in enforcing laws and policies against the perpetrators of trafficking.
UNICEF coordinates the project in Myanmar, China, Lao PDR, Viet Nam and Cambodia, while at regional level UNICEF is a member of the interagency project coordinating team. Within the project, UNICEF works to integrate HIV/AIDS/STI prevention and care in rescue and rehabilitation activities for trafficked women and children.
For more information on country-level activities, see the individual country reports.
