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Peer-to-peer Youth Program Helps Prevent Spread of HIV/AIDS
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Elizabeth Donderewicz and Samira Shaikh
August 17, 2007

When HIV/AIDS rates began to soar in the United States during the late 1980s, the American Red Cross responded with a program called Act Smart that taught elementary, middle school, and high school students about prevention and awareness through age-appropriate materials. Today, in Kigoma, Tanzania, young people are learning how to save themselves from this deadly disease through workshops taught by their peers, not adults.

Through support from the American Red Cross and a program called Together We Can, trained youth volunteers teach their communities how to avoid contracting HIV in Tanzania, Haiti and Guyana. Students learn from each other in an environment of mutual respect.

Originally developed through a joint effort between the American Red Cross and the Jamaican Red Cross, Together We Can (TWC) is now available through Red Cross societies in more than 20 countries. The program is empowering a generation of young adults to learn life-saving skills to combat HIV/AIDS at the grassroots level.

A young HIV/AIDS peer education program participant receives a prize from a Red Cross educator as part of the Together We Can program, which utilizes activities like the 'Wheel of Knowledge' game to teach youth around the globe how to make healthy life choices and avoid risky behaviors.
A young HIV/AIDS peer education program participant receives a prize from a Red Cross educator as part of the Together We Can program, which utilizes activities like the “Wheel of Knowledge” game to teach youth around the globe how to make healthy life choices and avoid risky behaviors.
(Photo credit: American Red Cross)

Fostering Community Education

Each workshop is led by a pair of educators and provides approximately 20 young people with the knowledge and skills they need to make informed choices about their health. Each participant is then asked to share HIV prevention messages with 10 of his or her peers, thereby fostering community education.

In addition to learning about the disease and how it is spread, youth are coached to develop decision-making skills, such as postponing sex and avoiding drugs and alcohol, to help avoid the risk of HIV infection. Each activity is designed to enable participants to apply the facts to their own behaviors. The American Red Cross provides culturally appropriate videos, brochures, comic books and other materials to encourage discussion between parents and youth about HIV/AIDS prevention.

TWC youth leaders are supported by a strong network of field “coaches” who train the peer advisors. These advisors are rigorously trained to conduct dynamic peer education activities with an effective, non-judgmental approach. Through coordination with local organizations, the American Red Cross works to ensure that at-risk groups, such as out-of-school youth and girls, are included in the workshops.

TWC's simple structure and adaptive approach to education are credited with making the program a success and producing results that have far surpassed the established goals. The flexibility of the program makes it readily adaptable to regional needs. For example, the activity titled “If you loved me, you would…” offers participants the opportunity to practice assertive communication skills so they can refuse sexual advances. Building such life skills also protects youth from other risks and promotes healthy development.

As new findings on AIDS surface, they are incorporated into the program's messages, thus providing participants with the latest information on the disease. Months after the workshops are conducted, the participants attend follow-up sessions to ensures that the HIV/AIDS prevention message is being retained.

Accommodating Local Culture

Tanzania's TWC program, which is being offered in four regional districts, exemplifies how the curriculum can be adapted to accommodate local cultural expectations. When facilitators noticed a lack of female participants in the workshops, they began using a female instructor and holding sessions for girls only, which greatly improved attendance. Bright, colorful posters, based on a Haitian promotional program for TWC, were adapted for use in Tanzania to increase community awareness.

In Haiti, TWC is being taught at seven project sites, and the Haitian Red Cross and American Red Cross have started implementing follow-up programs for the 958 youth who are graduates of the first round of TWC workshops. The second group of workshops is designed to facilitate discussion and feedback about experiences in the community that occurred after the first workshops.

The TWC program is also active in three regions of Guyana, with a focus on the Amerindian population in the hinterlands. Workshops are conducted separately for males and females, as is appropriate in the community. Regional efforts continue to expand in outreach and content in accordance with local needs.

“What makes TWC replicable across countries is that its activities are designed to present the facts in a neutral and nonjudgmental way,” says Lindsay Lincoln, an American Red Cross consultant for the TWC program. “As such, local Red Cross societies can culturally and linguistically adapt it to resonate with youth locally.”

As the AIDS pandemic continues to grow, programs like TWC can help reach out to the most susceptible populations and teach them life-saving skills. Through its involvement in Haiti, Guyana and Tanzania, the American Red Cross has endowed the TWC program with technical expertise, funds and domestic support to enable its sister Red Cross organizations to provide much-needed services to local communities. The American Red Cross aims to scale up this successful program.

As part of the world's largest humanitarian network, the American Red Cross alleviates the suffering of victims of war, disaster and other international crises, and works with other Red Cross and Red Crescent societies to improve chronic, life-threatening conditions in developing nations. We reconnect families separated by emergencies and educate the American public about international humanitarian law. This assistance is made possible through the generosity of the American public.

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