Knut Ostby: Address at the launch of “Me, My Intimate Partner and HIV: Fijian self-assessment of transmission risks"

Dec 1, 2011

Your Excellency the President of Fiji, Ratu Epeli Nailatikau, Honorable ministers, Ladies and Gentlemen, it is my pleasure to say a few words to introduce the launch of this new report called: “Me, My Intimate Partner and HIV: Fijian self-assessment of transmission risks”.

The report being launched today on World AIDS Day, is partly the fruit of training and partly of a research project.  This has been a very collaborative effort, and on behalf of the UN family I would like first to thank very much the Ministry of Health, the members of the Health Research Ethics Committee and Civil Society Organisations such as FJN PLUS and PIAF who helped facilitate the project.

Most importantly I would like to thank all the anonymous study participants who gave so generously of their time and shared with the research team information that is by nature very intimate and confidential.

Everyone knows that it is not easy to disclose information about one’s sex life, let alone when it is in the context of a couple and when both partners in the couple are participating in the research simultaneously yet separately… And here I would really like to salute the dedication and professionalism of the research team for managing and conducting such a sensitive research by upholding very stringent standards of confidentiality and by establishing a reciprocal climate of confidence and respect which is essential for the quality of the data collected.

Thank you all!

As many of you know, UNDP has given a high priority analyzing and looking at HIV and AIDS as development issues. We feel it is not enough to look at HIV and AIDS from a health perspective – it affects society as a whole and must be addressedin that way. Within the UN family UNDP is a strong advocate of the centrality of “knowing our epidemic” from its multidimensional perspective, cultural, economic, legal and political, towards a deeper understanding of HIV risk vulnerability and impact in a given social context.

The report being launched today is taking exactly such a multidimensional perspective by presenting a sample of what Fijian couples of very different backgrounds may Think, and Believe, about their assessments of HIV risk, how they Express the risk, and also how they relate to the risk by the things that they Do.

These assessments are of course influenced by individual experiences but also by a lot of common perceptions. It is a qualitative study, which means that it has collected a sample of thoughts, behaviours, and presents common features and examples, instead of focusing on number based statistics. In that way it provides a complementary perspective to what the quantitative and epidemiological information tells us. Put together, these necessary and complementary perspectives ultimately will allow us to better understand HIV risk in Fiji and better guide the prevention efforts of the National response.
Without pre-empting too much on what the team is going to tell us, I just want to highlight two features of this project:
The first one is that it included an intensive capacity development component with a fiveweeks long training to form a local research team. Such a comprehensive preparation seldom takes place and I think this is good practice because it is about developing skills for qualitative HIV social research. These skills will stay in Fiji, and can be used for future research in many different ways. In this way, the project has created a sustainable outcome.

The second feature is that the study enrolled couples from a range of ‘walks of life’ that are not all typically identified as ‘at risk groups’, first of all because they are married or in a de facto married relationship. This gives us a broader basis for better understanding the risks and possible avenues of HIV transmission.

In the past, a lot of emphasis has been made on the individual HIV risk of certain sub-populations such as sex workers or gay men. This can lead us to fail to identify and respond to important contextual information, especially when the epidemiological data we have do not yet give us some clear pointers. As evidence for example from Papua New Guinea shows, HIV transmission in the Pacific islands could be more frequent where most people do not expect it, for example in marriage.

This carries an important message that also resonates with the theme of this World AIDS Day: “Zero Discrimination”. As we can learn from other countries, the focus on identifying specific ‘at risk groups’ gives a false sense of security to those who do not identify with these groups, and also reinforces stigma and discrimination towards these ‘identified’ groups. Besides placing unjustified blame, this ‘risk group’ focus also runs the risk of ignoring some other important channels of HIV transmission.
But enough said by me for now. It is ample time to give the floor to Rachana, Jone, Sesenieli, Bui, Verenaisi, Vilisi and Lawrence. We are all eager to learn more from their insights and the results of their research.

Thank you very much!