Innovative HIV/STD prevention program targets Guinean gold mining camps

A common, yet risky practice among gold miners in rural Guinea to engage in short "marriages" with women working briefly at the mine is the target of an innovative health communication program that educates both women and miners about how to prevent HIV and other sexually transmitted diseases.

Foudoukoudouni is the word in Malinke - a West African language - for short marriage, which often occurs between women cleaning gold and the men responsible for digging the mines. The U.S. and Guinean governments are behind this prevention program, which is implemented by Management Sciences for Health (MSH) in partnership with Johns Hopkins Bloomberg School of Public Health/ Center for Communication Programs (CCP).

"Foudoukoudouni is a very risky practice occurring in an extremely rural area of Guinea, where data on HIV and STD prevalence are scarce," said Guillaume Bakadi, CCP's Resident Advisor on the project. "But we do know from health workers in the region that STDs and HIV are a growing problem because of this age-old custom."

The basic prevention message is to abstain, be faithful, or use a condom. The project employs theater groups, street shows, community outreach activities with peer educators, and girls' soccer tournaments to get the word out. In upper Guinea where the program is concentrated, bartenders, tailors, hair stylists, and other young adults are also trained as peer educators.

According to a study of miners conducted in 2001, 52 percent said they have contracted a sexually transmitted disease and 43 percent said they are not faithful to their regular partners. Another 14 percent said they do not believe HIV exists, while 27 percent believe condoms do not work.

So far, the mining program has been launched in four prefectures - Kerouane, Kourroussa, Mandiana and Siguiri - and has been well-received at the national level as well as by community members. The National AIDS Committee head, Dr. Djelo Barry, sponsored the Mandiana launch and speaks out publicly about the risks of brief marriages.

Guinea is a mostly Muslim, male-dominated society and speaking openly about sexual matters can be controversial.

"This is the first time people spoke in public about sex, STDs, HIV, and foudoukoudouni," said Mariame Fofana, who lives in one of the mining communities. "I really think people will change their behavior following this campaign."

A miner, Amara Diakite, echoed her comments, saying, "Before PRISM arrived, I did not know anything about the consequences of foudoukoudouni. Now we will take precautions."

This HIV/STD prevention program is the work of PRISM ("Pour Renforcer les Interventions en Sante reproductive et MST/SIDA" or "Strengthening Interventions in Reproductive Health and STD/AIDS"), a project designed by the U.S. Agency for International Development (USAID) with the Government of Guinea. PRISM hopes to expand the program to diamond mines, where the practice is also prevalent.

MSH, a leading international organization working in more than 60 countries, contributes to saving lives and improving health by helping public and private organizations worldwide to manage people, money, medicines, and systems.

With representatives in more than 30 countries, Johns Hopkins' CCP is a leader in the field of strategic, evidence-based communication programs for behavior change and health promotion that have helped transform the theory and practice of public health communication.