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HIV/AIDS Awareness Days

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The Federated States of Micronesia is comprised of four freely associated states which include: Chuuk, Kosrae, Pohnpei and Yap. From 1989 to 2003, the total cumulative HIV/AIDS cases was 38 (21 deaths and six PLWHA). Despite slow improvements toward developing an effective HIV surveillance and monitoring system, largely due to human and financial shortages and geographic barriers, FSM has initiated specific endeavors to prevent HIV/AIDS infections.1 These include regional and community collaborations and capacity building, increased testing and prevention efforts and the creation of state STD/AIDS program centers. From 2003-2005 a total of 14,156 HIV tests and health screenings were reported.

Identified as promising practices were:

  • The Chuuk Women's Council and Health Services Joint Project (Chuuk),
  • HIV/AIDS Peer Mentor Outreach Program (Kosrae)
  • High School Youth HIV/AIDS/STD Outreach (Pohnpei).
  • Attempts to include Yap in this study were unsuccessful.


Chuuk State Health Services, HIV/AIDS Program

The Chuuk State health department in partnership with the Chuuk Women's Council conducted a joint health services project in 2005 to screen and test residents living in Pattiw Island (total population 4850) and the surrounding community for HIV/AIDS. Residents were also assessed of their knowledge and risk behaviors of STI/HIV and provided access to HIV testing and STI screening. The project was funded by OMHRC and SPC. The multi-partner collaboration was successful in addressing stigma and shame and providing necessary health screening to over 1100 outer island residents who do not have regular health care access due to isolation.


Intervention Development:

  • Worked with CPG and is part of the Chuuk State 5-Year Strategic Plan.
    Strategy was developed at the end of 2006 and utilized stakeholder input.
  • CDC Guidelines used for CTR and prevention/outreach education.

Populations Served:

  • Male and female, ages 15-45 years old living in Pattiw Island

Intervention Goals and Objectives:

  • Increase knowledge and awareness of STD/HIV/AIDS among islanders living in remote/isolated communities.
  • To test for HIV and screen for STIs.
  • Assess the risk behaviors of people living in remote/isolated communities.
  • Dispel myths and misconceptions about HIV/AIDS/STI.
  • Establish support groups for positives.

Desired Outcomes:

  • 326 (15-24 years old) participated in Second Generation Behavioral Risk Factor Survey and offered HIV testing and STI screening.
  • 845 people participated in STI/HIV/AIDS prevention and education awareness.
  • Data of risk behaviors of people living in remote/isolated communities collected for policy makers and program planners.
  • Understanding of STI/HIV risk behaviors.
  • Increased knowledge and awareness of HIV/AIDS/STI.

Core Elements:

  • Partnership with Chuuk Women's Council was helpful in tackling cultural barriers, especially working toward addressing AIDS-related stigma and shame.
  • Chartered boat to access remote outer islands.
  • Team members possess communication and interviewing skills to conduct behavioral risk assessment.
  • Health assistants knowledgeable in early intervention and referral process.
  • Provide on-site testing, staffed by lab technicians and mobile laboratory.

Culturally Competent Characteristics:

  • Segregate staff and clients based on gender.
  • Work with influential group/leaders, such as island chiefs and Chuuk Women's Council, to penetrate outer island community.

Budget and Staff:

  • Total Budget: $20,440
  • Funding provided by OMHRC ($12,240) and Secretariat of the Pacific Communities ($8,200).
  • Budget Breakdown:
  • Chartered boat/ provision of fuel: $12,240
  • Materials and supplies: $300
  • Lab testing and related supplies : $3000
  • Crew Meals: $2,500
  • HIV Team Stipend: $2,400
    • HIV/AIDS Team – 10 members
    • Crew – 16 members
    • Red Cross Peer educators – 9
    • State AIDS Committee – 7

Lessons Learned:

  • Plan ahead for unanticipated costs related to increases in fuel.
  • Provide treatment for team members with motion sickness.
  • Anticipate natural barriers, such as rough seas, and how it may affect service delivery and staff safety prior to actual service delivery.
  • Despite best efforts to train staff to conduct effective interviews, challenges still exist due to differing regional cultural and linguistic barriers.
  • Results of STI specimen pending confirmation.


The Kosrae State health department HIV/AIDS Program collaborated with the National Red Cross Society of Mirconesia in training youth ages 15-30 to participate in a HIV/AIDS peer/mentor project. The project offered youth an opportunity to serve as peer educators to other youth in Kosrae at-risk for HIV/AIDS/STD at select villages over a two-week period.


Intervention Development:

  • Developed in August 2005 in partnership with the National Red Cross Society. Participating youth were trained by Red Cross staff to become peer educators in Kosrae. Youth initiated outreach with support from Kosrae HIV/AIDS Program staff.

Populations Served:

  • Youth and young adults ages 15-30.

Intervention Goals and Objectives:

  • Educate youth about basic HIV/AIDS and STD facts.
  • Teach youth about proper condom use.
  • Increase awareness about HIV testing available at the local Hospital Laboratory and the importance of knowing one's HIV status.

Desired Outcomes:

  • An increase in youth knowledge of STD/HIV/AIDS.
  • Approximately 30 youths have been trained as Peer Educators.
  • Peer Educator Training Outcome indicators: post training evaluation and direct observation.

Core Elements:

  • Recruitment and training of core group of youth and young adults to serve as peer educators; empowering youth to serve in leadership capacities and actively engaging them in project planning. Youth recruited through the College of Micronesia Peer Counseling Center at College of Micronesia.
  • Peer educator must be 18 years or older to participate.
  • Train peer educators to be knowledgeable about HIV/AIDS over 5 day period. Training topics include: HIV/AIDS/STI 101, Condom Use, Confidentiality and Voluntary Counseling and Testing (VCT).
  • Establish environment where youth are encouraged to speak freely with other youths about sensitive issues (sex, drugs, etc.).
  • Youth and young adults should possess strong communication skills to be effective peer educators and mentors.
  • Outreach should be conducted at villages at places where youth and young adults are known to gather.
  • Peer trainer provided $20 daily stipend and provided lunch and refreshments.

Culturally Competent Characteristics:

  • Youth placed in discussion groups based on gender to make it easier for same gendered persons to talk freely and openly about sex and other sensitive issues.

Budget and Staff:

  • Funding provided by the HIV/AIDS Program.
  • BUDGET (based on 30 youth participants per community):
  • Food – $100.00 x 5 communities = 500.00
  • Fuel – 35 gallons gas for 5 communities = $3.60 ea x 35 gallons gas = $126.00
  • Brochure printing = $500.00
    • HIV/AIDS Program Coordinator – 1
    • HIV/AIDS Physician – 1
    • Red Cross Peer educators – 9
    • State AIDS Committee – 7

Lessons Learned:

  • Youth learn best from each other and are successful in serving as peer educators when they are supported and encouraged to take on leadership roles.
  • Provide incentives for youth participation so that more youth maybe motivated to participate in the project.
  • Identify and address cultural barriers so that it does not deter from project goals and objectives.


The Pohnpei State HIV/AIDS/STI Program initiated a youth-centered outreach activity in 2005 through the support of local school administrators and The Global Fund. During a one week period, 219 high school students, grade levels 11th and 12th enrolled in interscholastic after-school sports programs were provided HIV/AIDS information and provided access to free HIV counseling and testing and STD screening. Six peer educator youth (trained by the local Red Cross Society) assisted health department officials conduct HIV/AIDS outreach and education.

The mission of the HIV/AIDS/STI Program is to aim to prevent transmission of HIV/AIDS and other sexually transmitted infections in Pohnpei, by providing necessary services to those at risk, awareness to those unaffected, and treatment and counseling to those detected, while continuing to provide, assist, or implement disease awareness programs in partnership with other local agencies and affiliates. The following routine services are available through the department:

  • Voluntary counseling
  • Provide free screening test for HIV/AIDS and STD
  • Education, antenatal counseling and physical exam
  • Treatment for positive STI
  • Contact Tracing of STI Cases
  • Creating and distribution of local STI/HIV/AIDS Brochures, pamphlets, etc.
  • Condom distribution
  • Assist community groups, youth, and other sectors in HIV /AIDS awareness activities
From January 2007 through May 2007, 42 people tested for Chlamydia with none positive, 164 tested for Gonorrhea with 19 positive, 1134 tested for Hepatitis B and 45 positive, 1190 tested for HIV/AIDS and 2 positive, 1220 tested for Syphilis and 69 positive and 1953 tested for Trichomoniasis and 177 positive.


Intervention Development:

  • Project was developed over 6 month period through collaboration efforts with the HIV/AIDS Program, The Global Fund and school administrators/outward bound.
    • Convene meeting of all stakeholders to determine youth most at risk.
    • Review data of at-risk youth based on teen pregnancy and STI rates.
    • Develop project timeline and project outcomes.
  • CDC, CTR guidelines

Populations Served:

  • Public and private high school youth ages 16-18 in grade levels 11th and 12th involved in after-school sports programs.

Intervention Goals and Objectives:

  • Educate youth about basic HIV/AIDS and STD facts.
  • Test and counsel youth for STD/HIV/AIDS.
  • Dispel HIV/AIDS myths and encourage discussion regarding HIV/AIDS.

Desired Outcomes:

  • 219 public and private high school students, grade levels 11th and 12th participating in after-school sports program have increased knowledge of STD/HIV/AIDS facts, transmission and means of protection.
    • Participant Breakdown
      • Total Females: 105
      • Total Males: 114
    • Participating High Schools
      • Nanpei Memorial High School: Male 15 and Female 19
      • Upward Bound: Male 16 and Female 19
      • Ohwa High School: Male 14 and Female 10
      • SDA High School: Male 8 and Female 10
      • Pohnpei Island Central School: Male 28 and Female 20
      • Baptist High School: Male 9 and Female 9
      • Pohnlangas High School: Male 24 and Female 18
  • 201 youth were tested/screened for STD/HIV/AIDS.2 Youth were notified of test results on-site at sports field, at the health department clinic and through follow-up telephone calls.

Core Elements:

  • Partnership with local education department and private school administrators.
  • Conduct interscholastic sports activities as a means to get youth interested in discussing and learning more about HIV/AIDS.
  • Convene hour-long Q&A Forum about HIV/AIDS in a classroom or gymnasium setting.
  • Six (6) peer educator youth assisted health department staff with conducting HIV/AIDS outreach education.
  • Provide sports uniform as incentive for youth participation in HIV counseling/testing.
  • Gain parental support of the project and address their concerns or fears through direct contact or flyer distribution.

Culturally Competent Characteristics:

  • Address parental concerns/fears immediately so that these fears/reservations do not prevent youth from participating in the project. Letters of encouragement were sent to parents from school administrators (principals and director of education).

Budget and Staff:

  • Public health department: $1,600 (purchase t-shirts) and trophies $5000
  • Upward Bound Director and staff FTE.
  • Umpires paid nominal fee. Total cost $2,000.
  • FSM-HIV/AIDS Program & Health Department: four staff members (lab technicians and health department staff) FTE.

Lessons Learned:

  • Extend the project into summer break
  • Apply for additional funding to support future projects
  • Include parents in such project so they understand what is happening after school
  • Conduct STD/HIV/AIDS prevention awareness with parents
  • Extend project to include other middle and high school students
  • Modify project to include high-school drop-outs.

1 UNGASS Country Report 2006, Federated States of Micronesia
2 One high school opted not to participate in voluntary STD/HIV/AIDS screening/testing.

Content Last Modified: 7/2/2008 3:12:00 PM
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