Sex and relationships: Talking openly about taboo

Sex and relationships: Talking openly about taboo topics

Thursday 31st May 2007- Twenty years since HIV first arrived in the Pacific and we are still seeing increasing numbers of people living with HIV in the region. Recent survey findings in Pacific countries showed high prevalence of sexually transmitted infections (STIs), limited knowledge of HIV transmission, and low condom use.

The question 'How do we deal with it?' has been floating around the Pacific Ocean for several years, with the Secretariat of the Pacific Community (SPC) navigating with Pacific countries and the regional and international community on what is the best way forward.

The quest to identify steps to reducing the vulnerability of Pacific Islanders to getting infected with HIV has encouraged those involved to go beyond the Pacific to fetch the best-possible stories and lessons learned that can be personalised and tailored to the Pacific way.

Stepping Stones is a training package developed to foster community dialogue and communication on issues relating to HIV. It was originally developed in Africa to effectively deal with communication on sexual health, including HIV and AIDS. Stepping Stones has now been adapted for the Pacific by SPC's HIV & STI Section and the Pacific Regional HIV/AIDS Project (PRHP).

Dr Dennie Iniakwala, HIV & STI Section Head at SPC, says that the Pacific version of the training package was developed in response to the growing need for community-based training and materials to address issues concerning sexual attitudes and associated risk behaviours in our Pacific communities.

'At its core, Stepping Stones assists people to analyse how their current communication regarding sexual health issues impacts upon particular risk behaviours practised in their communities,' says Dr Iniakwala. 'The training package also includes analysis of issues associated with domestic violence, substance abuse, social perceptions of gender roles, and so on.'

It is generally accepted that in most countries of the Pacific region, lack of communication regarding sexual health has contributed to the trend of increased sexual violence as well as to the spread of STIs, including HIV. The Stepping Stones approach is unique in that it encourages different groups in a community to meet and discuss sexual health issues that affect them. Participants are clustered into groups according to their age and gender: older women, older men, young men and young women.

Dr Tamara Kwarteng, Team Leader of the AusAID-funded PRHP, says, 'The Stepping Stones training package aims to provide community members with a safe environment within which they can enhance their communication skills and knowledge of sexual health issues, as well as to assist community members to identify strategies for addressing these issues relevant to their own contexts and needs.'

The programme has been piloted in selected communities in Fiji and Solomon Islands and already positive remarks are beginning to emerge.

For Kelera, who was part of the pilot programme in Fiji, the training has empowered her to talk about sensitive issues within rigid cultural boundaries. 'I could never imagine a time when I would feel free to bring up the topic of sex and HIV with my family or community. I now have a much better relationship with my family and will definitely talk with my young daughter about sex and HIV when the time is right.

'For me, more self-confidence is the most significant story. Before Stepping Stones I thought that my husband leaving me was my fault and I was ashamed and thought that everyone in my village thought I was not a good wife or mother. I didn't like living in my community and would not be involved in community activities.

'After Stepping Stones and the experience of talking openly about taboo topics such as sex and relationships, I found out that many young women have problems like mine. It has made me feel less alone and being a Stepping Stones trainer I can share my new knowledge and help other young women through their relationship problems. Women don't get much power in Fiji, and Stepping Stones gave me the confidence to tell people how they had to treat me. I will make my ex-husband pay child support as she is his daughter and he has to help raise her.'

The lessons learned from the pilot programme will inform the expansion of Stepping Stones in Fiji and into other Pacific Island countries. A number of the facilitators involved in the pilot programme participated as co-facilitators in the first regional Stepping Stones training workshop, which took place in Suva from 14 to 25 May 2007 and was coordinated by SPC and PRHP. The workshop participants were people with direct and recent experience as community health and HIV/STI/reproductive health educators and trainers.

The trained facilitators will be expected to train others in their country (with assistance from SPC and PRHP) and facilitate Stepping Stones sessions in their communities. The countries participating in the regional training are Fiji, Kiribati, Solomon Islands, Tuvalu and Vanuatu.

This initiative is supported through funds from AusAID and the Asian Development Bank (ADB), with technical assistance from PRHP and SPC.

ENDS

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