Global HIVAIDS Politics, Policy, and Activism: Persistent Challenges and Emerging Issues [3 Volumes] by Smith Raymond A.;Smith Raymond A;

Author:Smith, Raymond A.;Smith, Raymond A;
Language: eng
Format: epub
Publisher: ABC-CLIO, LLC

SiRCHESI’S PRIMARY VS. SECONDARY HEALTH INTERVENTIONS

“Primary interventions” prevent communities from acquiring HIV infections by protecting them from common sources of the infection; “secondary interventions” may be health promotion programs designed to reduce and prevent the further transmission of infection, once it is already present in the community. SiRCHESI does not conduct “tertiary interventions,” which may include medical treatment programs (e.g., ARVT or HAART) once an epidemic is already established. These were brought to Siem Reap in 2003 by the international NGO Doctors Without Borders (MSF) and France’s ESTHER, supervised by the PAO, and are now implemented by the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria.

SiRCHESI's primary intervention—the Hotel Apprenticeship Program (HAP)—was launched in 2006, with follow-ups still ongoing. In two staggered cohorts, 30 women were selected (N=14, Cohort 1; N=16, Cohort 2) who were at risk for HIV/AIDS from “toxic” environments at their beer-selling workplaces (Lubek, 2005; McCourt, 2002; Schuster, 2006, Pagnutti, 2006). They left their jobs to train at SiRCHESI’s school for safer, healthier careers as hotel workers. The program guaranteed “living wages” for up to two years with frequent monitoring of their progress and changes through questionnaires and interviews. With their written consent, each individual student—26 completed the program—could be followed longitudinally with repeated measures, currently for over seven years (see, e.g., Pollock, 2008; Lee et al., 2010).

SiRCHESI's secondary interventions include health workshops with pre- and postworkshop intervention questionnaires for various risk groups and the collection of data by peer educator outreach health promotion teams. These provide yearly trends on community health awareness, HIV knowledge, and HIV-risk reduction behaviors using multiple cross-sectional community samples of some high-risk groups. Voluntary in-depth questionnaires have been made available after VCCT testing for up to 560 persons each year (Wong et al., 2003).

While international researchers, interns, and student volunteers originally brought the “research language” into the community, SiRCHESI’s staff began to offer a formal, 17-day internship program that teaches all the community health research and intervention techniques now used in Siem Reap; 3 interns participated in 2012, 8 in 2013, and up to 12 can be accepted in 2014.

Generally, SiRCHESI’s local data, when compared with international research, showed broad agreement that infection rates, risks, and prevention outcomes were related to predictor variables of gender, poverty, and illiteracy (Farmer, 1999; Lewis, 2008; Wong et al., 2003). But the “bridging pattern” of HIV transmission was in part a unique research finding, which drove SiRCHESI’s prevention strategies toward various groups, especially local men. Of prime importance to this PAR research has been the mapping of the development of the epidemic across time.

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