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New Hope with "New Start" Social Marketing Motivates Behavior Change Through Voluntary HIV Counseling and Testing in Zimbabwe In Zimbabwe, where an alarming 25% of the sexually active adult population is HIV positive, an innovative and urgently-needed social marketing program—the New Start Voluntary HIV Counseling and Testing Network—is aiming to motivate healthier sexual behavior and prevent the spread of AIDS. Zimbabwe has the highest HIV prevalence of any country in the world. Estimates from 1998 show that every week in Zimbabwe, 2000 adults are infected with the AIDS virus and about 1200 people, including children, die from AIDS-related causes. In an effort to respond to this dire situation, the Zimbabwean Ministry of Health and Child Welfare’s National AIDS Coordination Program (NACP), Population Services International (PSI), and USAID/Zimbabwe are working together to manage a national, voluntary HIV counseling and testing (VCT) network. VCT is an effective, cost-efficient variation of HIV counseling and testing programs that have been conducted successfully on a limited scale in several countries. Focusing on the individual, VCT uses customized risk-reduction strategies to motivate behavior change. Research has shown that:
The New Start network, launched in spring 1999, integrates VCT services into existing health service delivery institutions, such as public clinics and hospitals, non-governmental organizations, and private health facilities. New Start VCT services are targeted to specific groups, including young couples, adolescents, commercial sex workers, transport industry workers, and other "mobile" populations, and are offered at prices target populations can afford. Three sites have already opened, and six more will be in operation by the end of 1999. By mid-2002, the network is expected to serve 72,000 clients at the nine sites around the country. While counseling sessions covering risk reduction are tailored to each individual, clients at each site receive the same high-quality, affordable services. New Start staff are trained in NACP/PSI’s standard protocols and procedures to provide on-site, state-of-the-art rapid HIV testing, confidential pre- and post-testing counseling, and referrals—when appropriate—to community support groups. By establishing the centers at institutions that already provide health-related services, the VCT network helps reduce the stigma of seeking an HIV test. Strategic marketing of VCT services is key to promoting New Start. Messages promoting VCT sites are based on consumer research that pinpoints motivations for and barriers to the use of VCT services. In addition to television, radio, and print mass media advertising, New Start spreads the word about VCT services and the benefits of knowing one’s HIV status through an organized interpersonal communications strategy that includes drama groups in each community hosting a New Start center. Communications campaigns focus on motivating sustained behavior change. Social marketing strengthens the VCT model and results in a dynamic program that works to destigmatize HIV testing and encourages people to communicate about HIV/AIDS. This VCT social marketing model has significant potential for replication in many countries.
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The
New Start project is funded through AIDS/Mark, USAID’s five-year
program—being implemented by PSI—that uses social marketing to combat
the spread of HIV/AIDS and other sexually transmitted infections in
developing countries. USAID’s mission in Zimbabwe and the NACP collaborate
closely with PSI in planning, implementing and managing New Start.
Project activities are enhanced by the efforts of AIDSMark partner Family
Health International (FHI), which assists in project evaluation and
provides technical expertise on counseling and procedures. In addition,
the Population Council’s Horizons project is conducting operations research
to determine what role community-based organizations can best play in
promoting VCT.