UNICEF Maldives: Adolescent HIV Prevention

I just a training in the Maldives for health care workers on adolescent HIV prevention. Big thanks to UNICEF Maldives and the Ministry of Health for the partnership. Even greater admiration is due for their commitment to HIV prevention among young people.

Health care workers face a tension between their beliefs, prevailing religious beliefs, what is legal, what is moral, community expectation, and needs of young people. We built their communication skills about HIV and reproductive health, built human rights foundation for this work, and carefully examined their role as advocate for young people.

Talking Taboos

Picture of four fishbowls. The facilitator asked participants to contribute their vote on a taboo questions.
Fishbowl exercise

I was also advised that talking about these topics–HIV, sex, reproduction, drug use, and homosexuality, among others–was highly taboo. I thought long and hard about how to ease the participants into the subjects and build their trust in me. One of the strategies I used was to have several activities where they responded to “taboo” questions anonymously. I put several fishbowls at the front of the room with questions posted on the front of the bowl. They answered the questions taped to the front with a paper that only said “yes” or “no”.

The flipchart shows the results of the fishbowl voting.

Results from fishbowl exercise

During the break, I tallied their responses and posted the results. I did take a calculated risk that these figured would come out as I thought they would. For my purpose was to try to build empathy and compassion. I wanted each person to recognize that despite the “taboo” nature of these topics, nearly everyone was affected by them.

Nearly everywhere in the world, young people rarely seek preventative care, advice, or tools to keep healthy. As such, we also focused on building their skills in community outreach and assessment. I was able to then go and support some of the health care workers as they started their community-based work.

Taking Training into Action for HIV Prevention

This training opportunity gave the participants a chance to develop their community interventions. On day one, I split the participants into groups that would work together throughout the course of the week. They had to dive deep into one “key population” (knowing that one person can often “fit” into several “populations”) and deliver a presentation on their proposed intervention on the last day of the training. On day two, we focused on human rights and the need for adolescent-friendly health services. In their groups, they examined ways in which the health system does and does not uphold the rights of young people. On day three, they spent the day in their groups practicing community-based-participatory research methods. On day four, we practiced motivational interviewing all day and they practiced with scenarios that would be relevant to those in their key populations. Finally, on day five, they presented their work from the week along with a suggested intervention that they could implement with minimal need for support/funding or resources outside of what they currently have.

In organizing the training like this, they were able to immediately put their learnings into practice and make the lessons immediately applicable to their lives at home. Plus, they came up with great interventions on their own which will serve to build their commitment to their work.

Our Ideal World for HIV Prevention

At the very end of the training, I asked the groups to envision an ideal world, one where their work is successful, where human rights are upheld, and where young people are respected. Here is a representation of their work…

Participants drew a picture of "our ideal world" that shows a globe with people standing on the exterior of the sphere. Statements surround the globe such as "adolescent friendly" and "no stigma and discrimination".
Our ideal world
Participant drawing of their ideal world that includes items such as "I'm strong. I'm Empowered", "respect", and other terms.
Our world
Participant's drawing that shows a rainbow over words such as "acceptance", "awareness", "equality". The words represent raindrops that are watering a field of "personal growth" and seeds that say "job opportunities", "accessible health facilities" and others.
Empowered Youth
The participants drew a city block with services listed such as "youth club", "free condoms", and "syringe free".
Starling City

To say it was a great training might be an understatement. It was amazing.

You can read more about it on the UNICEF Maldives website. You can also read my earlier post about this work.

As always, I am open to new contracts and to working together. Please let me know how I can help you to build effective, exciting, and practice-based trainings.

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