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Strategies for HIV/AIDS prevention : a study of the policy of ABC in Zambia

Abstinence, being faithful to one partner and correct and consistent condom use (known as ABC) has been a widely discussed and utilised HIV/AIDS prevention strategy. In 2003, policy analysts predicted that Zambia would follow the Ugandan trajectory of HIV/AIDS incidence decline, because both countries were implementing ABC. However Zambia presently remains one of the countries with the highest HIV/AIDS prevalence rates. Limited policy research has been carried out to investigate why countries that have utilised ABC have experienced different HIV policy outcomes. This study investigates this issue by studying the extent to which poor policy design, content or implementation was to blame. The study employs a mixed methods approach and the analysis was guided by Knoepfel et al.'s (2007) framework which examines the policy processes though the interaction of policy actors, resources and institutional rules. The study found that ambivalence towards condom promotion, gender inequity and stigma towards HIV/AIDS negatively affected the development of a comprehensive ABC public policy in the 1990s. Negative views over teaching young children comprehensive sexual education and condom use appears to have affected both policy content and implementation. The study found that the decentralised and diversified nature of sexual health education is benefiting youth of higher social economic status. The study findings indicate that aid agencies utilised resources to propel the policy process towards a more comprehensive ABC public policy approach after 2000. Stigma continues to challenge programs delivered through the workplace. Information on prevention is still required in addition to information on treatment. Finally the study indicates that communities affect sexual behaviour choices as the study found that knowing someone living with HIV/AIDS was associated with positive behaviour change. The study confirms that Knoepfel et al.'s framework is a useful tool in the study of public policy. The findings contribute to an understanding of the process of policy determination and the analysis of policy content. The findings underscore the importance of engaging with socio-cultural, economic and political factors that influence ABC in order to reduce negative societal norms if policy is to be successful. The study also highlights that dependency on foreign aid can lead to a loss of autonomy. This consequently may lead to the adoption of policies and programs that are not locally accepted. The analysis also illustrates the need to utilise the right type of universal and targeted communications and programs to target the different components of ABC.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:550584
Date January 2011
CreatorsTembo, Doreen
PublisherUniversity of Oxford
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation

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