What Works for Women and Girls

three times, 200 young people in focus group discussions and in-depth interviews withparticipants and non-participants of social action activities found that at baseline youngpeople had good knowledge about HIV/AIDS and that AIDS-related stigma was prevalentand safer sex was not regularly practiced. The final survey found widespread exposureto the project, particularly the TV series Sexto Sentido, and that greater exposure toproject activities led to a significant reduction in stigmatizing and gender-inequitableattitudes; an increase in knowledge and use of HIV-related services and a significantincrease in interpersonal communication about HIV prevention and sexual behavior.Participants with greater exposure to the intervention had a 44 percent greater probabilityof having used a condom during last sex with a casual partner and that men withgreater exposure had a 56 percent greater probability of condom use with casual partnersduring the past six months. Somos Differentes, Somos Iguales (We’re Different, We’reEqual) project (2002–2005), using a communication for social change strategy aimingto promote the empowerment of young men and women and prevent HIV infection. Theproject considered machismo (sexism) as a risk factor for HIV/AIDS. Somos Differentes,Somos Iguales used the weekly drama TV series Sexto Sentido (Sixth Sense), which wasalso broadcast in Costa Rica, Guatemala, Honduras, Mexico and the US, and the callin radio program Sexto Sentido Radio to promote the gender transformative and HIVprevention messages and worked with more than 80 local service providers to increaseaccess to SRH services for young people. The project also worked with about 200 collaboratingorganizations. Interventions included a weekly national educational program(telenovela); a daily call-in radio show; community-based activities; visits by the caseto schools; youth training camps and informational materials (Solarzano et al., 2008).(Gray III) (gender norms, youth, communication, condoms, self-perception, Nicaragua)An impact evaluation of Program H, undertaken by PROMUNDO, was conductedin Brazil to test the hypothesis that young men in slum areas of Rio de Janeiro canchange their behavior and attitudes through participation in group education activitiesthat encourage reflection on what it means to be a man. The program resulted insignificantly smaller percentages of young men supporting inequitable gender normsover time. Improvements in gender norm scale scores were associated with changes inat least one key HIV/STI risk outcome. In two of the three intervention sites, positivechanges in attitudes toward inequitable gender norms over one year were significantlyassociated with decreased reports of STI symptoms. In two of the three interventionsites young men were approximately four times and eight times less likely to reportSTI symptoms over time, respectively. No significant change was found in condom use.Those boys who reported that they had more equitable gender norms as measured bythe GEM scale also reported a decrease in STI symptoms. Program H was developed onthe premise that gender norms, which are passed on by families, peers, and institutions,among others, and are interpreted and internalized by individuals, can be changed.Furthermore, reinforcing these messages on the community level will have additional296 CHAPTER 11 STRENGTHENING THE ENABLING ENVIRONMENT