Construction Workers Learn Power of HIV Prevention

Teferi Kassahun, a construction worker in Ethiopia, saw AIDS claim the lives of dozens of his coworkers before discovering a way that he could help.

Over the summer, the 37 year old took part in a new World Learning program that trained him to work as a peer counselor on his construction site in Gondar, a city in northern Ethiopia. Before the training, Kassahun struggled with persuading even his best friend to get tested for HIV when he and his wife fell ill.

"If this intervention had been done previously, we would have saved more of our friends, relatives and members of our community," he said.

Kassahun is one of 130 construction workers who are beginning to educate their peers about how to prevent the spread of HIV/AIDS. The three-year program is funded by the United States Agency for International Development and works in partnership with the Ethiopian government. It is the first such prevention program to target large-scale construction sites in the country.

Tens of thousands of construction workers are deployed throughout Ethiopia, as the government moves to provide more citizens with reliable electricity, improved roads and irrigation for farming. These projects can take workers away from home anywhere from a few months to eight years. This leads some workers to seek out the services of commercial sex workers who flock to the sites, as well as women from nearby communities who may be willing to trade sexual acts for money or favor.

"Life on the construction site usually involves drinking alcohol, chewing khat (a narcotic), and having unprotected sexual contacts with many partners," said Kassahun. "People get paid, spend it on these behaviors and never accept the danger of losing their short happiness."

Once a week, mentors such as Kassahun lead small groups of their peers in talking about how risky sexual behavior can alter the course of a person’s life, as well as affect their families. Activities include participating in role plays that dramatize the choices that workers face and in question-and-answer sessions with people living with HIV.  The sessions also link the workers with local organizations that provide condoms, medical care and voluntary counseling and testing.

Over the next two years, the program aims to train enough peer educators to reach 33,000 construction workers at 25 construction sites nationwide, as well as 3,000 commercial sex workers.

Abeba Bekele, a medical doctor specializing in reproductive health, leads the World Learning project. She said the peer education component of the program is more intense than traditional HIV/AIDS awareness campaigns, which rely simply on posters and leaflets rather than on building relationships. 

"This intensity will help change behaviors of construction workers so that they think about the future, rather than the day to day," she said.

The program will use a different approach to reach out to 200,000 people living in communities surrounding the construction sites. Influential people in these communities will be asked to incorporate HIV/AIDS education into the social activities they already lead. World Learning will also work to strengthen HIV prevention activities in schools, as well as in anti-AIDS youth groups located near construction sites. The program will especially target young women, teaching them to protect themselves against HIV/AIDS by practicing abstinence, monogamy or negotiating condom use.

One of the main challenges that Bekele faces in working with the communities is how to develop a strategy and outreach materials that are culturally appropriate for literally dozens of ethnic and linguistic groups in Ethiopia. The project team is currently working on a comic book to spark discussion within student groups. If the initial version in Amharic is successful, they will produce the books in several other local languages.

The team is also training government officials and community-based organizations to take over prevention activities once the program comes to an end.

Back at the worksite in Gondar, Kassahun said the training he received has had a profound effect on the way he views himself and his fellow co-workers. He has made a personal vow to remain faithful to his wife and provide a healthy future for his two children. Kassahun said the training also gave him the confidence to counsel his best friend.

"There has been a change in my desire to help others," he said. "You will see me changing, with other peer educators, to a better lifestyle."

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