Learning to Live Positively: a key development tool for promoting “treatment preparedness” amongst HIV/AIDS-affected rural communities in Africa

Community learning processes are crucial to increasing resilience to HIV/AIDS in Africa’s remote rural areas. This paper describes experiences of using the “How to Live Positively” discovery-learning process to empower rural communities in Benin, Malawi, Nigeria and Zimbabwe to reduce their vulnerability to HIV/AIDS, improve household nutrition and clean up their environment to reduce opportunistic infections. This process also promotes “treatment preparedness” amongst resource-poor farmers and should, therefore, be implemented alongside national and international programmes to roll out anti-retroviral drugs across Africa.

The How to Live Positively (HTLP) training is a holistic process that focuses on the specific needs of resource-poor, smallholder farmers and aims to provide scientific explanations of the links between diet, the environment and immunity to disease. It involves a series of inter-active discussions and discovery-learning exercises, which encourage participants to take responsibility for the improved health of themselves and other family members. The exercises focus on three main areas of self-help: reducing vulnerability to HIV through behaviour change, improving nutrition to strengthen the immune system and cleaning up the environment to prevent disease.

Reports back show that resource-poor farmers in all four countries, namely Benin, Malawi, Nigeria and Zimbabwe, where HTLP has been piloted, were eager to get involved and keen to take the process further. Initial impacts have been encouraging. The majority of farmers within these communities have accepted that reducing vulnerability to HIV depends on personal behaviour change. Other findings include:

• In Benin everyone that had received training said they were willing to undergo VCT and those who were found to be HIV+ have been able to access ARVs immediately

• In general, both women and men were ready to change life-time habits of giving the most nutritious food to fathers and sons in order to improve nutrition for all family members

• Communities in Zimbabwe have improved household nutrition through the development of integrated, low-external input cropping systems for the production of cereals, vegetables, fruits and small-scale livestock

• Villagers in Benin have planted fruit trees, such as papaya and citrus and gather mangoes from the wild.