When PSI/Guinea Deputy Director Thierno Oumar Diallo was doing his first HIV/AIDS workshop for Islamic leaders in his country in the mid-1990s, he so enraged the president of one Islamic association with a condom demonstration that the man slapped him across the face.

Since that rocky beginning, PSI/Guinea has gradually developed close partnerships with Islamic leaders and has organized conferences throughout West Africa to tackle the issues surrounding HIV/AIDS. The man who slapped Diallo is now the secretary general of the National Islamic League, a cabinet-level rank in Guinea. The two men, allies in the fight against HIV/AIDS, now laugh about their confrontation.

Given the strong, pushing-the-envelope approach PSI often takes in dealing with thorny health problems, its programs could alienate people who should be allies. In Guinea and other places, PSI invests time and energy in building bridges to religious leaders and bringing them on board in the fight against HIV/AIDS. PSI realizes that religious leaders often have an influential role in shaping opinions, attitudes and behaviors and, therefore, seeks to engage them in the struggle to reverse the AIDS epidemic.

West Africa
In the mid-1990s, PSI/Guinea launched a series of workshops to address public health issues with Muslim religious leaders, first in Guinea, then in Cameroon, Chad, Guinea-Bissau, Mali and Niger.

PSI/Guinea Deputy Director Diallo, a practicing Moslem himself, starts these workshops with the facts about HIV/AIDS so that the leaders understand that everyone is vulnerable to HIV/AIDS. Once they understand that they, too, are vulnerable, their interest increases. Diallo, often dressed in resplendent traditional West African garb, quotes from the Koran to justify preventive health practices and gives condom demonstrations. Banners with sayings from the Koran and other Islamic sources hang in the halls.

The workshops include a broad rep-resentation of the Muslim community. Government participation reinforces the collaborative aspect of PSI programs and the importance of the workshops. The news media are often invited for at least part of the workshop and their coverage of the workshops encourages more open discussion of the issues.

The workshops are designed to address the following problems/constraints:

1. Muslim religious leaders tend to have insufficient information about HIV/AIDS and the scale of the epidemic in their country.
   
   
2. Government and non-governmental partners are faced with insufficient financial and technical resources to address HIV/AIDS. This lack of resources has resulted in a delay in reaching out to religious leaders.
   
   
3. In many countries, young people become sexually active in the early to mid teen years. However, discussion about sexuality between parents and children is often taboo. Young women generally do not propose condom use to their partners because of trust or the fear of being seen as promiscuous.

By the end of the workshop, the religious leaders have a more comprehensive understanding of HIV, how it is transmitted, how to prevent infection, facts about the pandemic and how it affects the development of their country. During the workshops, condom use is openly discussed as a critical intervention for prevention efforts. Religious leaders see that they can and should play a positive role in the fight against the spread of HIV/AIDS. Each participant prepares a plan to articulate his role and specific actions to promote HIV/AIDS prevention in his community. As a group, a declaration is signed, and a set or resolutions are adopted which express the commitment to be actively involved in the prevention of HIV/AIDS and the care of those affected.

Zambia
Former President Frederick Chiluba declared Christianity the state religion soon after he was elected in 1992 and has virtually ignored AIDS even though the country has one of the highest HIV prevalence rates on the continent. He opposed condom promotion and accused organizations that implemented such programs of “promoting promiscuity.” Three times in the last six years, Zambian health officials have canceled condom ads prepared for state-run TV.

Zambians respect their church leaders and more than half attends church. This provides church leaders with an opportunity to help in the fight against HIV/AIDS. Unfortunately, few of them have used their bully pulpit to talk openly about HIV/AIDS. In fact, some say their silence has contributed to perpetuating the stigma of HIV/AIDS.

Despite the poor political environment, PSI built its social marketing program into one of the largest non-governmental HIV/AIDS prevention programs in the country, implementing massive behavior change communication campaigns. Recent research in Zambia indicates declines in HIV prevalence among youth due partly to a decline in multiple partners, a delay in the onset of sexual activity and an increase in condom use.

PSI decided it could make further inroads against HIV if it harnessed the power of the Zambian church. In 2002, PSI, its local non-governmental partners and a faith-based organization called Turning Point Media Ministries organized two major conferences bringing together church leaders and organizations fighting HIV/AIDS in Zambia.

Dr. Kenneth Kaunda, the first president of Zambia, was the guest of honor at both conferences and emphasized the need for the church to get actively involved in the fight against HIV/AIDS. He openly challenged the church and asked church leaders why they have not done more. “Jesus is watching,” he said, “and we can no longer keep silent while AIDS is taking our people.”

He mentioned that it was important to tackle this war from many angles. “You are tackling the medical side, you are addressing the stigma aspect, you are confronting the wall of silence and you are pushing for preventive measures,” he said. Dr. Kaunda has openly advocated for condom use as a means of protection against HIV/AIDS.

The result of these conferences is that a task force has been formed to ensure that local churches implement HIV/AIDS prevention measures.

Laos
Amid the chaos and gaiety of the That Luang Festival, a serious discussion is taking place. A Lao Buddhist monk is explaining to a rapt audience of young revelers how to lead a good life according to the precepts of Sinha, a style of living that is virtuous and good. If one follows the five elements of Sinha (no alcohol, no lying, no infidelity, no stealing and no killing), then one will be living like a good person, and risky behaviors will not be tempting. The monk then talks about the frailties of the human spirit and the risks that exist. He acknowledges that some people fall short in their efforts to adhere to Sinha, particularly in their personal relationships.

The monk then announces help in the never-ending struggle to follow Sinha. To the delight and squeals of his listeners, he dramatically pulls a pack of Number One condoms from his saffron-colored robe.

PSI, which has been distributing Number One condoms in Laos since 1999, works with Buddhist monks to raise awareness about the dangers of HIV/AIDS. Using a training of trainers approach, PSI provides information about the virus to selected monks who in turn pass on this knowledge to their colleagues. With the support of PSI, these monks organize small discussion groups with Lao people who are at risk of contracting HIV/AIDS, including out-of-school youth, female factory workers and high school students. The monks underscore the urgency of practicing healthy behaviors in order to prevent HIV/AIDS from becoming an epidemic in Laos.

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Increasingly, PSI AIDS prevention programs reach out to religious figures such as this Buddhist monk in Laos, seen here with the Number One condom brand mascot of PSI/Laos.