A Community Study to Implement HIV/AIDS Education and Prevention of Mother to Child Transmission Programs Among the Miskito Peoples in Departmento Gracias a Dios, Honduras
Creators: name: McKinley, Philip H., MD
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2005

description: Honduras has the highest prevalence of HIV/AIDS in Central America and the Miskito Peoples in Gracias a Dios are some of the poorest people in Honduras. In 2004 the Board of World Missions of the Moravian Church, the largest Christian denomination in Gracias a Dios among the Miskito Peoples, recognized Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) care as a priority in Honduras and the rest of the Caribbean Basin. In concordance with this, the physicians at the Moravian clinic in Ahuas, Honduras, expressed a desire to develop a mother to child transmission prevention program. Also concurrently the Honduran government instituted their second strategic plan in the fight against HIV/AIDS 2003-2007, targeting the cycle of poverty and HIV/AIDS. The Honduran Health Department in the late 1990's had already begun sending physicians into Gracias a Dios to clinics in some of the larger villages including Ahuas. This convergence of factors offered a unique opportunity and the basic infrastructure to network church, government, and health care workers with community members to develop an HIV/AIDS education initiative and Mother to Child Transmission prevention program into Gracias a Dios. A questionnaire was developed as a first step to evaluate current community knowledge and possible impact of an HIV/AIDS education program. Thirty-two community volunteers of the Miskito Peoples living in Gracias a Dios, Honduras, who were patients or family members of patients who attended the Clinica Evangelica Morava (CEM) in Ahuas on Monday, Wednesday, or Friday, between March 25th and April 4th, 2005, were interviewed. They were asked a series of thirteen questions designed to determine community understanding of HIV/AIDS, stigma associated with the disease, origins of HIV/AIDS information, written language of preference, and their views on what could be done to stop the spread of the disease. Thirty-one percent of those interviewed stated that they did not know or understand about the disease and fifty percent cited stigmatization of community members who had HIV/AIDS. In addition, persons of influence in the area were contacted and separate interviews carried out to determine their concepts of the disease in the local communities. By understanding the community members' knowledge and concepts, both right and wrong about HIV/AIDS, themes could be developed and evaluated to create ideas to implement an effective and sustainable community education campaign. Noteworthy was the lack of understanding that mother to child transmission could be halved by medication. Fifty-three percent were unaware that anything could be done to help prevent the transmission of HIV from mother to child. To reach the small, medically underserved villages in this area, a mobile prevention of Mother to Child Transmission of HIV (pMTCT) program for a six municipality area was developed by a native born Miskito physician. From the data gathered in this pMTCT program it is hoped that the first prevalence data on HIV/AIDS can be generated for this isolated area of Honduras. The work summarized in this paper includes a pilot test of the questionnaire specifically developed for this study. The questionnaire may also be of value to establish the validity of a qualitative approach as a tool to evaluate the impact of future HIV I AIDS education initiatives.