Findings from a research study to assess the outcomes of the ACER project in two urban areas in Zambia (Lusaka and Ndola) show that there has been an increase in knowledge about HIV prevention and antiretroviral treatment, greater uptake of HIV testing, reduced stigma and increased use of peer networks as an information source.
The ACER project was the first time the Alliance has put into practice a community engagement strategy to foster HIV prevention, treatment, care and support for people living with and affected by HIV.
The project links existing community organisations and support networks with existing government health services and employs people openly living with HIV to promote the uptake of treatment, provide support to help people adhere to antiretroviral treatment and to promote HIV prevention.
It is the central role played by people living with HIV that has been key to the impact of the project. Involved at every level they have planned and managed the project as the ‘public face of HIV’ in communities and clinics, as peer supporters and educators.
The visibility of people openly living with HIV led to a marked increase in the numbers of people requesting voluntary counselling and testing in the two project sites, Ndola and Lusaka, as well as the numbers receiving antiretroviral treatment.
The fact that there is a treatment support worker who acts as the interface between the community and the clinic and it is someone openly living with HIV is a key aspect in the success of the referral system.
“...when we are referred we are well received by the doctors at the hospital, we are attended to nicely and given medicine that makes our lives better, so referral projects are benefiting us.” Female client of NZP+, Nkwazi.
Whilst peer support groups for people living with HIV are an important source of information about HIV, the radio is still the main source. Overall more men than women received information through the radio while more women received their information from health workers.
The sense of fear in disclosing status diminished in all sites and the availability of treatment has played a major role in people being more willing to go for testing since they know that can do something about it if they test positive.
In order to implement ACER, the Alliance worked with several partners in Zambia. These were the Network for Zambian People Living with HIV and AIDS (NZP+); Traditional Health Practitioners Association of Zambia (THPAZ); home-based care (HBC) programmes affiliated with the Archdiocese of Lusaka and the Catholic diocese of Ndola; Africa Directions In Lusaka; the Central Board of Health and public clinics offering ART in Lusaka and Ndola.