Religious workers and the Tanzania AIDS Project (TAP, an NGO) have worked together to produce, test and use a behaviour change resource package. The Fleet of Hope comprises a resource book, teacher's book and poster flipchart showing, without judgement, the three options that people can choose to practise healthy behaviour: abstinence, fidelity and condom use. The pack does not provide information about HIV/AIDS but rather aims to awaken people's emotions concerning the infection so as to give them the will and heart to protect themselves. The intention is to encourage people of different temperaments, cultures, customs, convictions and religions to choose the way that suits them best to avoid HIV infection in all circumstances.

The pack is based on three pedagogical principles:

• the use of symbols
• group discussions
• close co-operation between all groups and institutions that influence people, such as government, teachers, health workers, families, traditional leaders, religious groups and activists.

Symbols are used because they are a language that speaks to and stirs up emotions. African proverbs constantly use symbols, so the Fleet of Hope uses this tradition. A flood represents HIV infection and three types of boats represent ways of escaping it: refraining from sex, faithfulness and use of condoms.

As people's behaviour depends very much on the influence of those around them, the resource pack is meant to be read and discussed, for example, by parents and children and in educational sessions organized by various institutions.

Reasons for staying in the water (continuing risky behaviours) are also addressed. Examples are given such as: youth saying that they are young and in love so that nothing can happen to them; a man who says there is no point in protecting himself because he has been bewitched; a woman who does not dare ask her husband to practise abstinence because he is sick. It is stressed that people should be empowered to make their own choices and learn how to negotiate their choices with others, especially in the case of women and street children.

The resource book ends with advice for families, friends, community leaders, activists and religious groups. They can urge people to "get on board" a certain boat but should also advise them to always be on some boat and know how to change from one option to another. The teacher's book suggests how NGOs and government can cooperate in HIV prevention in a complementary way.

The participants were first informed about the project and asked to complete a questionnaire. Then they received copies of the book to read. At the next session, they completed a second questionnaire and took part in focus-group discussions. Due to the women's timidity in expressing themselves in the mostly male focus-groups, a separate discussion was organized for them.

The questionnaires showed that the number of respondents who had a low perception of personal risk for HIV infection actually increased after reading the book; 25% continued to believe that it is possible to identify someone living with HIV/AIDS simply by their appearance. This may be because the pack does not address risk perceptions specifically but focuses on attitudes and commitments to healthy behaviour. Those reporting continued risky behaviour did decrease.

A total of 97% of the questionnaire respondents found the book enjoyable, with 87% stating it was suitable for people of all ages. Their main criticisms were that simpler and more direct language should be used, the drawings should be improved so that they looked more realistic and the boats should be elaborated upon.

The focus-group discussions also showed that the participants thought the book was good. In addition to the message of hope that it offers, the respondents liked the self-explanatory illustrations and the portrayals of people in the community such as priests, sheikhs and others. They said that they felt "awakened" and now understood HIV prevention better.

The participants did have some difficulty in understanding the symbols of water, floods and boats because these were not straightforward. Most of them would have been more comfortable with the typical didactic approach with which they are familiar. Just having read the book did not prepare them to discuss AIDS in a symbolic sense, pointing to the need to use such resources as part of an active HIV prevention strategy rather than as a stand-alone document. On the other hand, they said that they found the vocabulary simple, understandable and suitable because it included neither offensive nor taboo words and expressions.

The respondents suggested that a few modifications would make the book more effective. For example, they proposed that more explanations be given about the meaning of the flood and the escape boats. Also, the KiSwahili translation for the condom boat ("Technology") needed to be changed and more straightforward. Colouring the pictures was thought to be a way of making the book more attractive. The focus-group participants also concluded that the book could be sold.

TAP has trained their staff to use the resource pack since mid-1994. Introductions to the symbolism and how to present it are given, using the posters or transparencies made from the posters and book. The training sessions are participatory in nature. Comments are recorded so that adjustments and additions can be made in explaining how the The Fleet can best be used.

The resource pack has been sent to all regional AIDS control coordinators and is used in training condom distributors and salespeople throughout the country. It has further been given to peer health educators working with NGOs such as AMREF. Drawings from the book have also been adapted for use in promotional calendars.

The training sessions stimulate very active, light-hearted and non-confrontational discussions. TAP finds that many people do not understand the "ABCs" (Abstain, Be Faithful, Condoms) even though they may know the terms. The Fleet helps provide more specific definitions and emphasizes that choosing one option need not be seen as permanent.
 

While TAP staff use The Fleet as part of their condom promotion activities, other institutions promote the three options equally. The churches have concentrated more on the boats of abstinence and fidelity. Over 200 church leaders throughout Africa, including Catholic bishops and cardinals, have received the pack. Their response has often been enthusiastic, with the pack receiving very positive reviews in several religious newspapers. The church leaders feel that the pack clearly shows the distinction between the roles of government and church groups, making it possible to present three prevention methods in a symbolically indirect way that relieves tensions and resistance from some groups.

Although Catholic bishops will not distribute the pack as an official prevention package, they have adopted a policy of "tolerant silence" concerning it. Individual church leaders and groups in some 20 countries have adapted it to their local situations, with youth especially reacting positively.

So far, The Fleet has represented an important area of common ground where AIDS educators from different backgrounds can work together to give people understandable and relevant information. The ultimate objective is, after all, to enable each and every individual to decide which option best suits their immediate needs.

Father Bernard Joinet, University of Dar es Salaam, Faculty of Medicine, P.O. Box 9330, Dar es Salaam, Tanzania, Tel: 255-51-21483; Fax: 255-51-44032/44934; and Wilhelm G. Nkini, Tanzania AIDS Project, c/o PSI, P.O. Box 33500, Dar es Salaam, Tanzania, Tel/Fax: 255-51-33548

Kigadye, E.N., Report on the pre-testing of The Fleet of Hope, Dar es Salaam: Muhimbili Medical Centre, 1995

Manchester, T.M., Does the "Fleet of Hope" hold water? An evaluation of a risk assessment curriculum, Presentation at the IXth International Conference on AIDS and STD in Africa, Kampala, Uganda, 1995