Introduction

This month GBCHealth features a public-private partnership implemented by our member organization RTI International that focuses on two HIV projects in the sugar and banana industries in Guatemala.

Workers in both industries, often migrants, are at risk of HIV infection. They often live away from their homes and spouses for long periods of time, leading some men to engage in sexual activity — often unprotected — with sex workers or other women. Upon returning home to their families, they can spread HIV and other sexually transmitted infections (STIs) they acquired while away.

While the overall adult HIV prevalence in Guatemala is 0.8 percent, among sugar and banana workers the prevalence is as high as 3.58 percent (Centro Nacional de Epidemiología, Ministerio de Salud Pública 2011). The majority of the country is conservative and Catholic, with most HIV information limited to lessons on abstinence and fidelity that are poorly adapted to the situations of workers in these two industries.

The partnership includes two key projects for the sugar cane industry and the banana industry. The Healthy Men, Responsible Men project aims to influence knowledge, attitudes and practices concerning sexually transmitted infections and HIV among workers of sugar cane mills in Escuintla, Guatemala. The Mano a Mano con la Prevención del VIH (Hand in Hand with HIV Prevention) project provides sexual and reproductive health information and services to banana workers in the departments (districts) of Escuintla, Izabal, San Marcos, Quetzaltenango, Suchitepéquez and Retalhuleu. Both projects are part of the Alianzas program of the United States Agency for International Development (USAID), which develops and manages public-private alliances to increase the impact of social investment in health and education in Guatemala, Nicaragua, and previously in El Salvador.

About RTI International

RTI International is one of the world’s leading research institutes, dedicated to improving the human condition by turning knowledge into practice. RTI’s staff of more than 3,700 provides research and technical services to governments and businesses in more than 75 countries in the areas of health and pharmaceuticals, education and training, surveys and statistics, advanced technology, international development, economic and social policy, energy and the environment, and laboratory testing and chemical analysis. For more information, visit www.rti.org.

USAID|Alianzas

Since 2005, RTI has implemented an innovative project with funding from USAID aimed at identifying, developing, and managing public-private alliances to increase the impact of social investment in health and education in Guatemala, Nicaragua, and previously in El Salvador. The USAID|Alianzas project in Guatemala has been very successful, and since 2005 Alianzas has leveraged $42.3 million from private sector organizations and benefited over 9 million Guatemalans, more than half the nation’s population.

About the Projects

The “Healthy Men, Responsible Men” Project

The Healthy Men, Responsible Men project is an initiative of the Sugar Foundation (FUNDAZÚCAR). FUNDAZÚCAR was established in 1990 as part of the corporate social responsibility program of the Asociación de Azucareros de Guatemala (ASAZGUA), or the Sugar Producers Association of Guatemala.

The Healthy Men, Responsible Men project began in June 2012 with funding from USAID|Alianzas, the Women’s International Network for Guatemalan Solutions (WINGS)—a reproductive health organization—and ASAZGUA. Since then, it has reached more than 8,000 men with HIV information, education and services at the Trinidad, La Unión, Santa Ana and San Diego sugar mills—which occupy a zone considered the “HIV corridor” of Guatemala.

Outcomes from the project include:

• A total of 414 HIV tests completed after an HIV testing campaign that included workshops and counseling sessions
• An increase in access to sexual and reproductive health information and services
• The development of sexual and reproductive health, family planning and HIV prevention programs at sugar cane mills

Ángel Méndez, community educator, noted that before being part of the Healthy Men, Responsible Men project, men were reluctant to talk about sexual reproductive health and family planning and considered these topics to be a woman’s concern. But according to Méndez, this is changing. “HIV prevention and family planning isn’t only a women’s issue,” he said. “We all have a role to play when it comes to family planning, as it can determine the quality of life we can offer our children.”

Critical Success Factors

Healthy Men, Responsible Men Project

The project has been helped by three critical factors:

• Interest and awareness from CEOs and top management in the sugar cane mills of the risks the workers face.
• A partnership with WINGS that brings wider experience in addressing HIV prevention and a “new masculinities” approach. The “new masculinities” approach promotes responsible parenthood, men’s participation in informed decision-making around the use of family planning methods, condom use awareness to prevent HIV and STIs and women’s empowerment. The project aims to increase knowledge about sexual reproductive health, HIV prevention and family planning by using a gender perspective. In short, it addresses men issues that historically and culturally have been related to women alone.
• The crucial benefit of building capacity within the mill workforces, which influences workers to take the lead and continue prevention among peers.

Lessons Learned

• For the sugar cane workers, initially the schedule of the activities was an issue and had to be revisited. The workers could not stop working to participate in prevention activities, so the project activities had to be held outside of working hours—at night or on weekends.
• Marketing materials needed to be revised to meet the basic literacy levels of the sugarcane workers for easy comprehension.

“Mano a Mano con la Prevencion del VIH” (Hand in Hand with HIV PreveNtion)

Mano a Mano is a relatively new project, being implemented by the Association of Independent Banana Producers (APIB in Spanish) in partnership and with support from USAID|Alianzas. As part of its corporate social responsibility practices, APIB develops health and nutrition improvement programs for the benefit of their employees.

Mano a Mano is a training and awareness-raising project focused on issues such as HIV prevention and sexual reproductive health. An institutional prevention policy is now in place, which promotes the development of a healthy work environment, enforces staff rights to confidentiality and non-discrimination with respect to HIV status and increases accessibility of health services and information for people living with HIV.

Activites include:

• Distribution of behavior change communication materials
• Workshops on sexual and reproductive health and family planning
• Voluntary HIV testing

Outcomes of the Mano a Mano project include:

• Increased awareness of issues related to HIV prevention and sexual and reproductive health
• Development of a workplace prevention policy
• Outreach to more than 25,000 workers and their families (with a total coverage of 100,000 people when including an average of four family members per household)

Learn More

• On Facebook: USAIDAlianzas
• On Twitter: @RTI_INTL_DEV
• On the Web: http://www.rti.org/idg