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GivinG Hope to a World of need

Catholic Relief Services (CRS) supports more than 280 HIV and AIDS projects reaching some eight million people directly in 62 countries. CRS has been the prime implementer of AIDSRelief, providing antiretroviral treatment for the Presidents Emergency Plan for AIDS Relief (PEPFAR) in 10 countries as well as numerous other large-scale HIV and AIDS projects funded by PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

thumbs up Young people from Rascov show the universal sign of approval of the healthy Choices for Youth program.

Raising awareness, improving communication


hiv prevalence is disproportionately high and knowledge about the virus abysmally low among young people in Moldova, making the need to engage youth in prevention programs incontestable. But a lack of consensus over how to address the challenge of protecting youth against HIV has left Moldova without a coherent, consistent, nationwide youth prevention program. The National Program on Prevention and Control of HIV/AIDS and Sexually Transmitted Infections developed life skills education for children in all gradeswith support from the Global Fund and technical input from UNICEF. However, the curriculum was never introduced in Moldovas public schools due to fierce opposition from the Orthodox Christian church. The focus, instead, has been on disseminating information rather than equipping young people with the skills they need to seek healthy behaviors and reduce their risks. This leaves young people poorly prepared, without the knowledge they need to protect themselves against HIV when they leave their rural homes in search of jobs or higher education in cities or abroad. NO TALK ABOUT SENSITIVE SUBJECTS Historically, parents, particularly in Moldovas rural villages, have been extremely uncomfortable discussing sensitive subjects such as sexuality and HIV with young people, who then rely on other sources for their information, which may be neither accurate nor reliable. Put another way, young Moldovans gener-

Fostering Healthy Choices


HC4Y is innovative because...
4It

communication between parents and children about sex. Adult participants stating that they often spoke to Drawing upon global their children about sexual relations increased from 6% expertise in HIV and AIDS to 77% as a result of the training. programming and building adult training participants towards people living with HIV and AIDS. Adults stating that they would allow their child to attend kindergarten with an HIV-positive child increased from 34% to 88% as a result of the training.

The project was noticeably successful in increasing

HOW HC4Y WORKS

The project has significantly improved the attitudes of

blends training for parents with training for youth in life skills and behavior change.

ally do not have the support from parents, religious leaders and peers they need to help them make healthy choices. The Healthy Choices for Youth: HIV Prevention in Rural Moldova program aims to encourage open and intimate communicationcritical for behavioral change in children and youthwhich has not been the norm in rural families, explains Catholic Relief Services (CRS) Head of Office Michael McKennett. CRS launched Healthy Choices for Youth after completing a comprehensive assessment in June 2008 of how it could make the most effective contribution to the national HIV awareness and prevention effort. The assessment found that there is a significant need for more information and peer support among youth. The program, known informally by the moniker, HC4Y, directly addresses the most significant gaps in prevention identified by the members of the Moldovan government and other key stakeholders.

the incidence of HIV among youth by including both Raising awareness and increasing knowledge about parental trainings and life skills education, thereby HIV in rural communities; creating an enabling environment for reducing HIV risk. Major findings of an independent midterm evaluation, July 2010
Fostering a supportive community environment that helps youth feel supported to make healthy choices; Empowering young people to make choices that promote their health and protect against HIV infection; Building the capacity of parents and other influential adults to communicate with youth about sexual health, HIV prevention and other sensitive subjects that previously were regarded as taboo topics; Promoting tolerance to eliminate stigma and discrimination associated with HIV and AIDS; Encouraging youth who receive training to become peer educators by passing on to others what they have learned about making healthy choices.

The project maximizes the likelihood of decreasing

upon the experiences of Catholic Relief Services in the country, Healthy Choices for Youth: HIV Prevention in Rural Moldova helps young people in rural areas of Moldova make wholesome decisions and protect themselves against HIV by:

tect themselves against HIV and enjoying an environment supportive of healthy choices. Of course that means that youth in the partner villages must have the capacity to make healthy choices and influence their peers positively. It also means that parents and village leaders must support youth to make healthy choices, said Michael. Once CRS wraps up the program late in 2011, the HC4Y project will transition to Caritas Moldova, which is committed to continuing the work. Villages will retain office equipment that was donated to them as part of the project as well as all of the training materials. Most important, villages now have a cadre of trained professionals who have the capacity to deliver training on healthy choices and communication for youth and adults. We hope the active participation of all stakeholders in all stages of project implementation will form the basis for the project sustainability and continuity. After all, the project unites the entire community by giving it an opportunity to participate in addressing a serious problem, says Angela Alexeiciuc, CRS senior project officer.

STRATEGIC OBJECTIVE The strategic objective for the program are clear: By the end of the project we expect to see youth in the villages that we collaborate with making healthy choices to pro-

Nurturing Healthy Behaviors in Youth

Nurturing Healthy Behaviors in Youth


Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

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HIV & MOLDOVA


steadily in Moldova since the late 1990s. While originally concentrated among injecting drug users, heterosexual sex is now the predominant means of transmission. An estimated 81.25% of new HIV cases are transmitted through heterosexual sex. Prevalence is disproportionately high among sexually active young people aged 15-24. About 80 pregnant women are diagnosed with HIV each year. Of the most frequently diagnosed HIV co-infections, tuberculosis is the most common, affecting about half of all people living with HIV in the country.

HIV prevalence has been increasing

StrateGieS for SucceSS


4Catholic Relief Services (CRS) is a member of Moldovas Country Coordinating Mechanism, which is in charge of executing the National Program on Prevention and Control of HIV/AIDS and Sexually Transmitted Infections. Membership helps ensure that all Healthy Choices for Youth activities are aligned with national guidelines and standards. 4CRS carefully targets the most glaring gaps in HIV and AIDS prevention as identified by key government authorities after confirming that its activities will not duplicate the efforts of other organizations or government agencies. 4CRS carries out activities only in communities that invite its help after consulting all local stakeholders, including religious leaders, local public authorities, school directors and parents. 4CRS engages local villages in project design, seeking advice and guidance from stakeholders, who help tailor the program to the needs and sensitivities of the community and participate in its implementation. 4CRS establishes an advisory board for the project made up of influential community members such as the mayor, a priest, a school director, parent leaders, business people and health care professionals. Members of these Village Caretaker Committees subsequently become role models for creating a safe and supportive environment for youth to make healthy choices. 4CRS awards small grants that support the knowledge that youth and adults have acquired through training and put it into practice. The grants are awarded for activities that raise awareness about HIV and AIDS; create supportive environments for youth to make healthy choices and protect themselves against HIV; and promote respect and tolerance for people living with HIV and AIDS. 4CRS weaves themes of stigma reduction and gender sensitivity throughout the program to promote tolerance and acceptance of people living with HIV and AIDS and to correct gender disparities that cause women to be more vulnerable to HIV infection.

fashion statement maxim fedoruc, 16, of Rascov wears the official HC4Y T-shirt distributed by CRS and Caritas Moldova.

HIV is considered a major public healthy priority in Moldova. As of June 2010, there were 5,999 people living with HIV (PLHIV) reported in the country, including 1,891 in Transnistria. Of the total identified number of PLHIV, 86.02% were aged 15 to 39. Just under a quarter of all PLHIV (23.77%) were aged 20 to 24 and just over a quarter (24.99%) were aged 25 to 29 years old. Reducing the incidence of HIV among populations at higher risk by increasing awareness about the disease is a key goal of the National Program on Prevention and Control of HIV/AIDS and STIs (NAP). This was an especially important objective given the low levels of awareness among youth about the virus. Only 8.3% of young Moldovans could correctly identify how HIV is spread and methods for preventing its spread in a UNICEF study conducted in 2005. Girls in rural areas were among the least informed.
Source: NAP

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6 Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

Obtaining the support and involvement of all local stakeholders, including religious leaders, is a viable means of effecting the immediate implementation of life skills education for youth in Moldova. Using this approach, CRS has succeeded in providing life skills education for youth in Moldova while other groups continue to unsuccessfully lobby the Minister of Education to provide life skills education through schools.
Independent Midterm Evaluation, July 2010

Support NETWORKS
eighteen-year-old anastasia tcaci, signed up for the Healthy Choices for Youth program after realizing how easy it is to contract HIV. I thought, I have nothing to lose. On the contrary it will be useful for me to attend these training sessions. I attended all training sessions and I undertook all measures to avoid risks of infection, says Anastasia, who adds that she felt surrounded by friends while completing the training in her hometown of Rascov. HC4Y activities were designed specifically to allow young people to integrate their own life experiences into the activities. They felt respected by the adult trainers, that others were genuinely interested in listening to what they had to say and that each opinion was valued. They appreciated the space to express their ideas and the opportunity to debate them freely. Anastasia recalls one especially lively debate that took place when it became clear that opinions were divided along gender lines. Eventually, after arguing their case, the girls succeeded in persuading all the boys to change their mind. It was very funny. First they tried to argue their opinion and later, one by one, they agreed that we were right, she says. Anastasia remains in close contact with many of the girls and boys she met during her HC4Y experience and she feels they are a tremendous support in her ongoing commitment to make healthy choices. It Abstinence, fidelity and the rest when the time is right. Elena Babalau, 16 Pelinia her in making healthy choices. The trainers became true friends with whom we can share the problems we face, seek guidance and get advice. I am still in close contact with many of the people I met there. The experience was a huge confidence boost for the teenager, who went from being afraid to talk openly to people prior to the summer camp to freely granting interviews and being captured on videotape after she returned. Her enthusiasm for the HC4Y program continued well after the camp had ended. She helped organize a theme party, distribute calendars featuring HIV awareness messages and produce a book chronicling in words and photographs her experiences at the summer camp entitled, Summer Camp: Healthy Choices for You. Elena also helped recruit young journal-

active & participative the programs participatory methods provide for cooperation rather than competition as these young people from sloboda-rascov demonstrate. they also foster listening and communication skills; address delicate issues; promote tolerance to diversity; facilitate self-knowing and positive interpersonal relations; and, stimulate creativity and innovative thinking.

is great that the people with whom I have kept in touch are informed and know how to protect themselves from HIV. Elena Babalau, 16, was one of 100 young people from five Moldovan villages who took part in a successful summer camp held at the picturesque resort town of Vadul lui Voda, which is located on the bank of the Nistru river about 18 kilometers east of Chisinau. The summer camp changed her life significantly, prompting her to rethink many of her perspectives about life. Abstinence, fidelity and the rest when the time is right, she says of her strategy to minimize her health risks. Thankfully, she has a whole network, which includes fellow campers, trainers and her immediate family, who can assist

ists from her village who contributed to a newspaper aimed at raising awareness and preventing HIV. She and the other campers created an Internet group that encourages members to post information related to healthy choices in multiple mediums such as video, photographs and text. Group membership has expanded beyond the original participants of the HC4Y summer camp to include youth from several neighboring villages. TAKING RESPONSIBILITY Healthy Choices For Youth is not designed merely to raise awareness about HIV. It is an integrated and comprehensive approach to promoting healthy lifestyles that challenges young people to take responsibility for their health and strengthen their ability to withstand a myriad of health-related challenges facing youth in Moldova today.

Nurturing Healthy Behaviors in Youth

Nurturing Healthy Behaviors in Youth


Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

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Some of the young people in Caterinovca were not very enthusiastic prior to starting the HC4Y training program, says Olga Crijanovscaia, the schools deputy director of academic and educational activity. But once they realize the HC4Y project reaches out to them in ways they can understand as teenagers, they happily attended the classes. The training helps youth understand that ultimately it is up to them to make healthy choices, says Caritas Moldova Program Manager Irina Oriol, who points out that the information gives them the power to make healthy choices at a critical formative time in their lives, as they are transitioning from adolescence to adulthood. HIV prevention is not presented to youth in isolation. Training activities focus on a vast and diverse range of physical, mental and social health issues so that participants learn how to better understand themselves, care for their bodies, develop as personalities, work with peers, make smart decisions and protect themselves from dangers, including drugs, HIV and other sexually transmitted infections. The activities help young people develop the life skills to cope with daily challenges so they adopt healthy lifestyles and live successful lives. Youth begin to make healthy choices they werent making prior to participating in the project. Young people begin to think more carefully about their friends, opting to spend time with young people who support them in making healthy choices about drinking alcohol, smoking cigarettes and sexual abstinence. They said that it was easier after the training to resist peer pressure, listen to others and avoid violence. Often during the training young people seek advice in solving personal problems, says Nina Bandiu, an HC4Y trainer and executive director of Consult Nord, a nongovernmental organization in Pelinia. We talked about many issues close to their
Nurturing Healthy Behaviors in Youth

Summer camp
Healthy Choices For Youth was delivered as a pilot project in the summer of 2009 to 100 youth. Trainers used innovative and participatory learning methods such as drama, music, dance, poetry and sport to raise awareness about HIV and help young people make healthy life choices. In the second and third year of the project, HC4Y was implemented primarily through extra-curricular activities at the village level. Two rounds of HC4Y training were offered in each village during the second and third year of the programin the spring and the autumn. Each training course was provided to a different set of youth to increase the number of beneficiaries each time a training course was held.

hearts about love, sexuality and parentchild relationships. Sometimes we talked behind closed doors, but if they agreed to discuss the problem with the group, we do so, providing an example for others about how to act if they ever face a similar challenge. We try to focus on real-life situations and ask others in the group what they would do in the same circumstance. We role-play. The girls are asked to step into boys shoes and the boys are asked to step into girls shoes, says Nina. CADRES FOR HEALTHY CHOICES Youth in Pelinia who had gone to the HC4Y summer camp in 2009 helped Nina organize HC4Y training for other youth in the community. Older youth from the high school provided peer-to-peer training to younger students from the middle school. Many friendships blossomed, which helped the younger youth when it came time for them to make what can be a difficult and awkward transitionstarting high school. The project has virtually eradicated the problem of youth smoking at the Pelinia

hands-on activities nina Bandiu, left, presents a training exercise in Pelinia. though not always structured, hc4Y training follows established objectives and specific hands-on exercises.

high school, insists the school director Ion Pripa, who let students out of their classes early so they could participate in HC4Y activities. You wont find a trace of cigarettes on school property or in the girls or boys washrooms, says the school director, who thinks the project also plants seeds of truth in the consciousness of youth that will protect them from a cruel disease. In Sloboda-Rascov, some of the older boys in the community asked the HC4Y trainer what she had done to the girls in the village to make them so assertive and outspoken in their rejection of offers of beer and cigarettes, says the projects local coordinator Oxana Oleinic.

We will face many situations and we need to know how to act. We need to know about HIV and AIDS, how to live and not get infected, says 18-year-old Rascov youth, Victoria Stomati, adding, our parents know less than we do. When they were young, they werent told about this and they cant explain this to us. Her classmate, Alexandru Gutan, 18, agrees. Not all parents can provide such a wide variety of information to their children. Here we are able to speak our minds, develop our thoughts and obtain the knowledge that will allow us to protect ourselves and avoid risk. I cant think of anywhere else where Id be able to learn so much information about healthy choices and HIV.

Nurturing Healthy Behaviors in Youth


Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

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round of applause Young people in slobodarascov, sporting red ribbonsthe international symbol for Healthy Behaviors in Youth HIV Nurturing awarenessapplaud the for Youth: HIV Prevention in Rural Moldova Program 12 Catholic Relief Services Healthy Choices Healthy Choices for Youth training program.

The projects innovative design, successfully combining parental HIV programming with parent-child communication training and youth life skills, represents a much needed, more comprehensive approach to HIV prevention that maximizes the possibility of decreasing the incidence of HIV among youth by addressing additional risk factors that Nurturing Healthy Behaviors in Youth more narrowly focused programs neglect. 13
Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

Independent Midterm Evaluation, July 2010

TRAINING THAT provokes change


prior to laUnching the program, Catholic Relief Services (CRS) met with local public authorities, school directors and church representatives in every village to discuss the project in detail, which provided a forum for the community to raise concerns and for CRS to address them, says Angela Alexeiciuc, CRS Senior Project Officer. The trainers presented the topics in such a captivating way and the atmosphere was so friendly. Everybody could express his or her opinion and they were listened to. Anastasia Tcaci, 18 Rascov of information. Participatory education is a novel experience for most participants in Moldova. CRS strategically recruits people who have established a good rapport with adults in the community to provide HC4Y training to adults while school teachers usually facilitate discussions with youth.
lively chats Drawings, developed within the framework of Moldovan tradition, are used to stimulate discussion.

CRS also established village steering committees made up of influential adults, including the mayor, a priest, a school director, parent-teacher association members, local business persons and health care professionals that serve as an advisory body to the project. To ensure the project was culturally appropriate and sensitive, the committees have the opportunity to provide input on the content of training modules and to review all training materials prior to the implementation of the project in their village. Angela remembers the school director in one community initially being quite reserved towards the project. Today she is an active partner and participates in all project activities. In another village, a priest, who vetted all of the training materials for youth and adults prior to the launch of HC4Y, is now an active participant and even submitted a small grant request. Rather than being passive recipients of information, learning during the Healthy Choices for Youth activities happens through group discussions and the sharing

ENGAGING TECHNIQUES Father Dmitrii Zelinschii, the pastor of St. Marta Catholic Church in SlobodaRascov, was impressed with the quality of the training and the trainers. He believes the success of the HC4Y training project rests on the ability of trainers to motivate participants to reflect deeply on the subject matter. No matter how valuable the information, if it is not delivered in an interesting and captivating way, it will remain raw facts and figures that have little meaning, he says. Olga Crijanovscaia, the deputy director of education at Caterinovca, was impressed with the ability of the trainers, most of whom she knew personally, to engage youth and adults. While unfamiliar even to most experienced educators, the pedagogy was widely praised by HC4Y trainers and trainees alike. We havent used such methods before, says Galina Spac, who organizes leisure activities for children at a school in Rascov. Were used to reading our lessons to students and that is it. For HC4Y, we were taught to use games, pictures and roleplaying. These techniques are very useful for us and we started using them in our regular school classes. Students remember the information easier this way. Claudia Datii, a mother of two children who completed the training in Caterinovca, admits she was uncertain about the teaching methods at first. But after several sessions we got used to it. We were very shy at the beginning, but we forgot about our shyness soon enough and began to communicate openly because everything was so interesting and the trainers drew us out. During one exercise in Sloboda-Rascov, it suddenly occurred to one mother that the participants were talking more than the trainer, who happily pointed out that was the purpose of the training, says the local coordinator Oxana Oleinic. The HC4Y training methods had a similar effect on young people. I cant tell you how delighted I was with the sessions, says Anastasia Tcaci, an 18-year-old from Rascov. The trainers presented the topics in such a captivating way and the atmosphere was so friendly. Everybody could express his or her opinion and they were listened to. In Valea Adinca, the training sparked conversations that lasted long after the sessions were over, says the head of the village administration, Nadejda Lutii. Villagers who opted not to attend were disappointed they were absent, especially after word spread in the community about how topical and fun the training was. BUILDING CONFIDENCE & SELF-ESTEEM HC4Y training activities are open-ended, there is no one correct answer and consensus is not required. The participation of each participant is considered equally
Nurturing Healthy Behaviors in Youth
Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

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important. Trainers do not direct the group in its answers or analysis. Instead, they encourage each group to discover information and reach its own conclusions. This way, participants build the confidence and self-esteem necessary to analyze complex problems, work out solutions to take action against the spread of the disease in their community and help those affected by HIV. As they complete the activities, participants discover that a great deal of knowledge already exists in the community about HIV and AIDS and the group as a collective is empowered through the sharing of knowledge. Feelings of empowerment are necessary for changes in attitudes and behavior. The group activities nurture that process and sow the seeds to move it along more quickly. The participatory methods used in the training facilitate group change as well as changes within individuals because when groups decide to change, individuals feel reinforced by the group in their personal decisions to make changes. Moreover, participants who go through the training together are more likely to change together and reinforce new behavior among each other over time. Activities are paced to allow each participant to think deeply for a few days about what they have learned. Since most people change ideas slowly, taking breaks between activities allows for personal growth. Drawings, developed within the framework of Moldovan tradition, are used to stimulate discussion. Both the style and the subject matter of the drawings are specific to Moldovan culture and to the cultural factors that contribute to the spread of HIV and AIDS in the country. The drawings and the dialogue they provoke have been found to be especially effective for people who are less informed about HIV and in cultures where women, in particular, are reticent in

Stressing abstinence & fidelity


The Healthy Choices For Youth program is grounded in abstinence and fidelity principles while also stressing the following core subjects: decision making, problem solving, creative and critical thinking, effective communication and interpersonal relationship skills, self-awareness, empathy, and coping with emotions and stress. These components are complemented with HIV-focused subjects such as negotiating abstinence, delaying the onset of sexual activity, fidelity, stigma reduction, gender equality, substance abuse prevention, domestic violence and health-seeking behaviors. Prior to its launch, a steering committee in each village reviewed the CRS-developed HC4Y education program and it was adapted, as required, with the committees help to accommodate gender, education, cultural, social, and religious norms specific to each target village. The program targets known gaps in HIV and AIDS prevention identified by high-ranking members of the Moldovan government during meetings in 2008 with Catholic Relief Services, namely: The inability to make HIV education for youth available on a national level through schools following objections from religious leaders; A general lack of information available to youth; The lack of prevention and awareness raising activities among youth, especially in rural areas, and the inability of the government at the time to make a significant contribution to these activities; The pressing need for knowledge to combat stigma and discrimination in rural areas. CRS confirmed with key government officials prior to rolling out the program that its activities would not duplicate the efforts of other organizations or government agencies. Villages also were ranked and scored on the following criteria: all leaders enthusiastically support the program; the parentteacher association is active; village is near a youth-friendly health center; no other overlapping HIV programs operate in the village; school has a designated health specialist and a psychologist; facility, outside of the school, is available; adult community is active; and, CRS has past experience working in the village.

empowering commUnity change training methods facilitate group change as well as changes within individuals.

meetings. Talk about HIV takes place in a casual and relaxed atmosphere. Participants are asked to identify community attitudes toward HIV, assess how the disease impacts their community and recognize that the possibility exists for each and every person in the community to be affected by HIV. ASSESSING RISK Participants assess their personal risk of being infected with HIV and identify behaviors that put them at risk. They improve their understanding of the various ways in which HIV is spread, then brainstorm about how to reduce the stigma and discrimination associated with the virus. Since most new HIV infections in Moldova are spread by sexual contact, the training emphasizes that abstaining from sexual intercourse is the most effective way to avoid infection. Practicing fidelity also is stressed as a critical way to reduce HIV exposure. Participants are challenged during the

training to articulate what it means to be abstinent and to be faithful, to ponder how abstinence and fidelity are regarded by their religion, culture and peers and to explore the benefits of being abstinent and faithful. To develop skills for practicing abstinence or sustaining fidelity, they are asked to consider all of the factors that may hinder or help a person in being abstinent or faithful. By the time they complete the training, participants have a solid understanding about how to stop the spread of HIV and how they may reduce their personal risk of contracting the virus through abstinence and fidelity. Participants are provided with rosters of youth-friendly health centers and voluntary counseling and testing centers, where they are encouraged to seek out more information on HIV and AIDS. External trainers transfer skills to recruited village trainers to ensure training can continue at low cost beyond the life of the program.

Nurturing Healthy Behaviors in Youth

Nurturing Healthy Behaviors in Youth


Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

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TALkING Taboos
sex edUcation shoUld start with the family, says Angela Alexeiciuc, senior project officer for Catholic Relief Services. In order to avoid confusion and to correct inaccurate perceptions, families need to take responsibility for talking to their children about sexuality, she says. Historically, however, the sort of open and intimate exchanges that are so critical for behavior change in children and youth have been missing from the typical family dynamics in Moldova, particularly in rural villages. Before the HC4Y program was rolled out in Moldova, CRS assessed communication preferences between youth and adults as well as their knowledge and attitudes about HIV prevention. When the results were analyzed, we were surprised by how reluctant adults were to communicate with their children. The topic of HIV prevention is seen as one related to sexuality and it is considered as something shameful, taboo and not to be discussed in the family, says Angela, who worked for the United Nations on developing life skills education for youth prior to joining the CRS team in Moldova. If a child cannot find answers in the home, he or she will usually seek answers elsewhere so by the time many children in Moldova reach puberty, they have informed themselves about sexuality from other sources. The information they glean is not necessarily accurate or appropriate and can cause unhealthy choices and undesirable practices among youth, notes Angela. The HC4Y project transforms age-old fam-

FEEDBACK FROM PARENTS


All the information was very interesting and useful. We can use it on a daily basis in our families. It is much easier to talk to our children. If in the past we ignored certain situations, kept silent and postponed difficult conversations, now it is definitely easier to bring up HIV and other topics as well. Nadejda, 28, Sloboda-Rascov These are our children, they need to feel our attention, care and love. In 10 years they will be living their own lives, but at this moment they need us. Anastasia Dozoret, 28, Caterinovca Before the training, children were more inhibited and they were too shy to talk about such issues. Now they feel free. The communication between parents and their children changed as well. Children began behaving and talking differently. I think children got closer and friendlier after this project. Claudia Datii, Caterinovca Not every parent was comfortable or had the knowledge to talk about HIV with their children. Some were frightened and embarrassed. But parents became more open to having sincere discussions with their children because they became better informed. They know more now and are ready to talk and their children are ready to ask questions. Angela Draganiuc, 33, Rascov Before the training, children hardly ever discussed these problems with their parents, but after they were more willing to talk and share information. The results were also surprising because the training brought 20 adults from various corners of the village together. Though they didnt necessarily know each other before the training they became very close, like a family. Galina Spac, 33, Rascov HC4Y teaches parents that if they are unsure how to go about supporting their children, help is available to them. All they have to do is ask. Oxana Oleinic, Sloboda-Rascov

transforming parent-child commUnication the program prepares parents to have intimate, frank discussions with their children.

ily norms in Moldova by improving how parents and influential adults communicate with children and young people and equipping them with the knowledge and tools to talk to teens about diverse social problem, risky behaviors and healthy choices. PREPARING PARENTS Sixteen of the 20 hours of training for adults raises their awareness about HIV and other health risks affecting youth in Moldova so they are prepared to discuss these sensitive topics with young people. Eight of the training hours nurture the

skills that parents, guardians and influential adults need to communicate effectively with youth. Talking about deeply personal issues wasnt easy for parents in Sloboda-Rascov, admits the HC4Y local coordinator. But we decided that it would be better for our children to learn about these topics from parents and other adults in the community rather than people who may have a bad influence on them, says Oxana Oleinic. Nina Bandiu, a HC4Y trainer in Pelinia, concurs. If we wont talk openly to our children, they will hear information from

Nurturing Healthy Behaviors in Youth

Nurturing Healthy Behaviors in Youth


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the street and we cant be sure that what they hear is accurate and that they understand everything they are hearing. This is why we tell parents to talk to their children more openly and in a simplified manner. Otherwise a wall will appear between the parent and the child. The more open parents are with children, the more willing they are to explain their point of view and the stronger their relationships with their children will become. Youth and children are telling me that the HC4Y project is a step in the right direction, towards a better relationship with their parents. During HC4Y training, adults identify the role they should play in raising adolescents and supporting children and youth. They explore the risks children and young people face and how those risks change depending on age and they devise strategies to help children and youth recognize and minimize their risky behaviors. They consider some of the common challenges children and young people face and what they can do to help them overcome adversity. Before, it was embarrassing and disgraceful to talk about these topics, but after the HC4Y project, people felt more comfortable talking about them in their families and in the village, says Ana, a 36-year-old mother of three, who completed the training at the same time as her 15-year-old daughter in Caterinovca. SWAPPING STORIES Mother and daughter looked forward to exchanging details about what they had learned, swapping training manuals and comparing answers to questions posed after their respective classes. Ana feels more comfortable now talking to her three daughters about the issues that affect their mental, physical and emotional wellbeing. Youth whose parents or guardians participated in the training say that, like Ana, their parents became much more open to The more open parents are with children, the more willing they are to explain their point of viewthe stronger their relationships with their children will become. Youth and children are telling me that the HC4Y project is a step in the right direction, towards a better relationship with their parents. Nina Bandiu, HC4Y trainer, Pelinia

Training for parents


Each training course is offered to a different set of parents, resulting in an increase in the number of parent beneficiaries each time a training course is held. The course is offered at approximately the same time as the youths HC4Y training course. Parents or guardians of children participating in the HC4Y training courses are encouraged to attend training offered for adults at the same time that their child is attending the HC4Y training course. Offering the training concurrently was found to magnify the benefits of the project, facilitating even greater communication about HIV and related issues between parents or guardians and children. A variety of participatory and interactive methods are used to make the experience fun and effective, including: discussion and conversation; brainstorming; role-playing; demonstrations and guided practice; behavioral observation; educational games and simulations; situational analyses and case studies; debates; interviews; revealing life stories; art, dance, music, theater; and practicing newly acquired skills. During the training, facilitators distribute lists of services that may be helpful to parents and children, such as phone numbers, websites, and support services.
starting early father dmitrii Zelinschii, the sloboda-rascov catholic priest, is interested in launching a program to help parents in the village improve communication with their pre-school children.

talking about sensitive issues that youth face, like HIV, drugs and sex, and the youth reported that their parents began to speak more frequently about these topics after participating in the training. Since such profoundly positive changes were observed in communication between parents and young people who completed their respective HC4Y training at the same time, CRS encouraged parents to attend training. But in some communities, this proved difficult because so many parents work abroad to support their families. Still, youth also shared what they had learned with parents who did not attend trainings and say they were curious to find out more and to be supportive of the HC4Y activities. HC4Y trainers in Rascov encouraged parents to reconsider how they relate to their

Parents were less apt to raise their voices and instead became more affectionate towards their children. Mothers and fathers began to ask their children their opinions on things and were more generous in their praise. For their part, Nadejda noticed children were more compliant at home, willing to help out with family chores and better behaved at school. Inspired by the HC4Y project, Oxana, along with the village Catholic priest, hope to launch additional training for parents of children who attend preschool in the community. Parents need to begin developing the skills to support youth in making healthy choices when their children are still young, says Oxana, who is mother to three children ranging in age from 3 to 21. Oxana applied the techniques she learned as a HC4Y trainer to her own life when she had difficulties communicating with her 11-year-old son. Her relationship with her son improved dramatically because, she says, his attitude toward me changed and mine towards him changed. We had a better understanding of each other.

children on a day-to-day basis because the usual attitude is to reprimand children and criticize what they do, says Galina Spac. After the training, parents say they dont yell at their children anymore. They try to speak calmly and try to relate to them. Stunning, is how the villages head of administration, Nadejda Lutii, describes the impact of HC4Y training on families in Valea Adinca. Besides opening up channels of communication, family relations became more balanced and harmonious after the training by promoting mutual respect and understanding among children and their parents, says Nadejda.

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Nurturing Healthy Behaviors home from schoolin Youth 22 Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program children in sloboda-rascov head home from classes.

Qualitative evidence suggests that the project is achieving its objectives in significant part and has had a very positive impact on the communities in which it was implemented. Its broad-based approach of involving both civil and religious village leaders has resulted in the successful implementation of its three core training programs, which are providing life skills education to youth, increasing adult knowledge about HIV, and improving parentNurturing Healthy Behaviors in Youth child communication about sensitive subjects. 23
Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

Independent Midterm Evaluation, July 2010

Young people in the 7th, 8th and 10th grades already have begun asking me when they will have the opportunity to attend such training. HC4Y trainer in Rascov, Elena Cushnir

We were able to talk on many mature topics and it brought us closer. We started communicating better (and) we started respecting each other more. Denis Serdiuc, 18

We had interesting discussions. We never had such conversations before with our peers. We became friends and we were able to open up. Anastasia Tcaci, 18

Now, in discos, when someone brags about smoking or drinking alcohol, we can argue with them and we know that what we say is accurate. Iana Conoplitcaia, 18

AMBASSADORS for living well


eighteen-year-old Denis Serdiuc didnt know what to expect prior to starting HC4Y. Initially, he wasnt thrilled that his sleep would be interrupted, but eventually he looked forward to waking early Saturday mornings to attend the training sessions in Rascov, which he says had a very positive impact on him and his peers. We were able to talk on many mature topics and it brought us closer. Especially in our class we started communicating better. We became friendlier, and the topics we discussed brought us all closer together. We started respecting each other more, says Denis, adding that rules for communication that were followed during the trainNurturing Healthy Behaviors in Youth

ing completely transformed how he was used to communicating with his peers and the Rascov group began to relate to one another on a much deeper level. There were several rules. One of them was not to interrupt, to listen to each other. This is a part of respect. You need to listen and it is very difficult to simply listen. You need to let one speak his mind and not interrupt him. During classes in school, this happens very often, but during the training it was forbidden, he points out. Eighteen-year-old Anastasia Tcaci says

she, too, had to overcome her laziness about attending the training, but she did so quickly once she discovered how stimulating and engaging the HC4Y training sessions were. We had interesting discussions. We never had such conversations before with our peers. We became friends and were able to open upsomething we have never done before this training. OLD ACQUAINTANCES & NEW FRIENDS Some of the young people in Rascov had known each other since kindergarten, but they learned more about each during the

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50 hours of HC4Y training than all of their previous 11 years attending school together, says Victoria Stomati, 18. We got to know each other from a different perspective because we were able to open up, freely express our opinions, emotions and share our knowledge in a way we never did before. We learned a lot about each other, she points out. The trainer of the Rascov group, school psychologist Elena Cushnir, remembers feeling tension between the young 11thgrade participants at the beginning of the HC4Y sessions. They felt awkward and embarrassed, says Elena. It didnt seem to occur to them that they could become friends, she adds, but thats exactly what happened as they got to know one another better. Elena, likewise, grew attached to the young people. She was sad when the training was finished, but she is determined to continue supporting them and other youth in the community in making healthy choices. At the end of the training they asked me if they could come to me from time to time to talk. Young people in the 7th, 8th and 10th grades already have begun asking me when they will have the opportunity to attend such training. Everyone is looking forward to it, says Elena. SPEAKING UP & SHARING IDEAS World Health Organization research on health education for youth has found that active and participative learning is the most efficient tool of all in providing young people with knowledge and skills to make healthy choices. Youth are attracted by activities that allow for peer communication and exchanging experiences because often they pay more attention to what their peers say and do than what they are being told by adults. The HC4Y training, therefore, is energetic, participative and customized to strengthen
Nurturing Healthy Behaviors in Youth

and change behavior by allowing young people to speak up, ask questions, share personal experiences and take over the role of teacher by steering the training topics according to their needs. The concerns, hardships and opinions expressed by youth are addressed organically as they emerge, providing participants with the chance to support each other, analyze and talk through issues, formulate conclusions and provide realtime constructive feedback and creative solutions. Armed with their new knowledge, the training gave the Moldovan youth the confidence and self-assurance to speak out to other young people and children about making choices that promote rather than harm their health. They enthusiastically share what they learned. Now, in discos, when someone brags about smoking or drinking alcohol, we can argue with them and we know that what we say is accurate, says Iana Conoplitcaia, 18. Victoria says she also became more assertive in championing healthy choices. She noticed that her words were more persuasive and she stirred up interest in the subject when she was able to provide specific examples to support her argument. When she pointed out, for instance, the harmful effects smoking has on the body to her siblings and peers, she noticed that they started listening more carefully and began to wonder whether smoking is worth doing, she says.

youth visiting the country from Belarus, Russia and the Ukraine. The Rascov students happily told the visitors all they could about HC4Y and their efforts to raise awareness about HIV and AIDS. Young people who complete the HC4Y training are wonderful ambassadors for healthy choices, adds Victoria, because the opinion of peers has a powerful influence over the behavior of young people. I believe that through peer-to-peer communication the information is delivered more effectively. Peers will listen more carefully to each other because they think of themselves more as equals, she suggests. I totally agree with Victoria, chimes in Denis, because if a person who did not attend the training talks to any one of us and doesnt understand what we are talking about, he is eager to learn more because he can find common ground with us. This way, the Healthy Choices For Youth knowledge can be shared among a larger group of people and we can improve the awareness of others. The training of peer educators guarantees that HIV awareness and prevention messages will continue to be transmitted for years to come by young people within their communities and beyond when they leave their villages for work or studies. Changing the attitudes and behavior of youth rather than merely delivering information will help them make the sort of healthy choices that have long-standing bearing that will be felt for years to come and through generations. Though she is graduating and expects to leave her school soon, Victoria is eager to continue sharing what she learned through the HC4Y program. Kids will need this information in the future and I want to share it to prevent them from making mistakes or doing things that will harm them.

Peer-to-Peer
Young people in Sloboda-Rascov who participated in HC4Y training are passing on their knowledge with younger children in the community during special classes organized at the school, says local coordinator Oxana Oleinic. We firmly believe that after graduating from our school, when going to study or work elsewhere, the youth will be well informed and they will share the information they learned with other young people. One of the girls in the Sloboda-Rascov HC4Y youth group intends to become a teacher, she adds, and the knowledge she has gained will be particularly useful for her. Recognizing that youth are more likely to engage in conversations with their peers as opposed to adults, especially concerning sensitive issues such as HIV and sexuality, the HC4Y project includes a peer prevention education component. All youth who complete the program are invited to become peer educators about healthy choices and HIV prevention. They learn techniques for peer education, design peer-to-peer initiatives, and have access to mini-grants funded by the CRS to carry out their activities. Peer education initiatives, which stress prevention, raising awareness and reducing stigma, may be carried out in their own villages or done as outreach activities in neighboring communities.

CHAMPIONING HEALTHY CHOICES They are even transmitting the HC4Y message beyond Moldovas borders. At a school function in a village in Transnistria, their HC4Y T-shirtsadorned with the iconic red ribbon, the international symbol of AIDS awareness, and the Catholic Relief Services logocaught the eye of some

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Theres still work to be done. This is an issue we cant put aside. It needs permanent attention. Dr. Adela Cojocaru

close to home
one 40-year-old schoolteacher from Pelinia had a particularly poignant reason for joining the Healthy Choices For Youth movement as a youth trainer. The death in 2010 of her husbands brother of tuberculosis, an HIV co-infection, left a gaping hole in the familys lives. The tragic loss also gave rise to a personal longing to learn more about HIV and AIDS for the sake of the loved ones left behind her sister-in-law and nine-year-old nephew, who are both living with HIV. Though they have access to life-prolonging antiretroviral treatment thanks to funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria, they have suffered so much, she says. At the time the boy was born, HIV testing of pregnant women was not standard medical practice in the country. She didnt discover she was HIV positive until almost a decade after the birth of her son when she was exploring employment opportunities in Greecea country that requires Moldovan workers be tested for HIV prior to entry. They kept secrets from us until last year because they were afraid we would shun them. I was so disappointed with them because I thought, Why didnt you say anything, maybe I could have helped you, says the schoolteacher and HC4Y trainer, who requested that her name not be used. At first, she confesses, she was apprehensive when the couples child played with my children. But now it is as usual and we accept them because it is not so dangerous and they play together and eat together. Its not fair to blame him for having the virus. Even though she and her immediate family members are completely healthy, she felt the stigma of the disease when word spread that her in-laws were infected. I was so ashamed and afraid to tell my colleagues about my brother-in-law. I didnt want to come to school because everybody had heard about it and everybody was asking me, Is it true that he has this virus and I said, I dont know; maybe its a different disease because they looked at me so strangely as if I also had this disease, like we were all the same. INCREASING AWARENESS She educated herself about the disease and then became a HC4Y trainer. She provides the training to her 9th-grade students during her regular classes. Today, she feels at ease talking about HIV and AIDS. Her students tend to be very curious about the virus and the disease. They are somewhat timid and shy at the beginning to ask questions but once they overcome their bashfulness, they become very engaged in the discussions. Tests, which are administered before and after the HC4Y training to gauge levels of awareness about HIV and AIDS, show vast improvements in understanding about the disease, she points out. Increasing awareness through programs like HC4Y is urgently required if the dis-

hiTTing

chief doctor dr. adela cojocaru, the chief doctor at the pelinia health center, poses in front of a catholic relief services sign that is prominently displayed at the entrance to the health center.

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Linking physical & spiritual well-being


HIV and AIDS didnt emerge as a concern in Panasesti until villagers began traveling abroad, says Father Iamandii, the communitys Orthodox priest. The disease hit much closer to home in mid2011 when the parents of a troubled 42-year-old buried him in the village after he succumbed to an AIDS-related illness. Linking physical wellbeing to spiritual wellbeing is one strategy for minimizing the risk of exposure to HIV, suggests Father Iamandii. Caring only for ones physical health is not enough, he says, adding that Moldovans must relate physical health to spiritual health and the traditional cultural values that keep the country strong. We are all in Gods hands and anything can happen because the world changes, but tradition is what counts, and the seed planted in a person by the family makes the difference. Wherever one goes, he or she remembers what his or her mother and father said.
SPIRITUAL SUPPORT Father Iamandii, Orthodox Christian priest in Panaseti, Nurturing Healthy Behaviors in Youth provides spiritual advice about Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program 31 HIV as part of a Healthy Choices For Youth small grants program.

improving Understanding dr. adela cojocaru says she joined the hc4y program out of concern that most people in her village did not know how to behave around people infected with hiv.

trict is to reverse an alarming upswing in new HIV infections. In 2010, the district registered 12 new HIV infections and there were 13 new cases in the first five months of 2011 alone, says Dr. Adela Cojocaru, who is the chief doctor at the Pelinia health center. Dr. Cojocaru has been involved in the HC4Y program since it was first launched, providing training to HC4Y youth and adult trainers, serving as a resource person at training sessions for youth and adults and participating in HC4Y community activities. She says many villagers do not know how to behave around people who are HIV-positive, which is what sparked her involvement in the HC4Y program. In particular, she found that most relatives do not know how to share a home with a person infected with HIV. The HC4Y project has managed to raise awareness and change attitudes so that villagers are now more accepting of people living with HIV and AIDS. But community leaders must practice vigilance in creating an environment supportive of healthy choices among youth given their insouciant attitude about the disease, suggests Dr. Cojocaru. Theres still work to be done. This is an issue we cant put aside. It needs permanent attention, she adds.

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small grants catholic relief services and caritas moldova awarded small grants to support the healthy choices for youth program in each of the target village. sloboda-rascov used the funds to hold a community event filled with fun activities aimed at improving communication among parents and children.

nurturing environments
small grants, provided by Catholic Relief Services (CRS) through the Healthy Choices for Youth, help create an environment supportive of healthy choices while raising awareness about HIV and AIDS. The small grant activities allowed community leaders such as priests, mayors and teachers to participate in the project. In implementing the small grant projects, we tried to focus on improving communication between youth and adults, deepening understanding of healthy choices and topics that, until recently, were considered taboo in rural villages, says Angela Alexeiciuc, CRS senior project officer. In Pelinia, the mayor had a community bulletin board erected to spread the HIV

In implementing the small grant projects, we tried to focus on improving communication between youth and adults, deepening understanding of healthy choices and topics that, until recently, were considered taboo in rural villages. Angela Alexeiciuc, CRS senior project officer

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Exceeding expectations
At least 78 community leaders across the five target villages have participated in training or small grant activities as of the midterm evaluation of the program, vastly exceeding the projects target of involving 15 community leaders.

IMPACT ON YOUTH
HC4Y SMAll gRANTS
Year
2009 2010 2011

Number Small grants


6 25 16

Number Beneficiaries
165 1,780 3,552

Our communication with our parents improved a lot. Before it was very difficult for us to find common ground with our parents and discuss openly these sensitive subjects related to intimate issues. After this training I started paying more attention to my parents opinions and I started telling them more about myself.

Anastasia Tcaci, 18, Rascov

TOTAl
awareness message and a large banner was erected at the towns health center to publicize the project. Nina Bandiu, local coordinator of the HC4Y project in Pelinia, says a team of enthusiastic young volunteers who completed HC4Y training assisted her in creating and distributing information, communication and educational materials. The group made calendars, brochures, writing pads, featuring photographs of project participants, and bookmarks, adorned in bold letters with the phrase Stop AIDS and presented to village children as a Christmas gift. Nina and other trainers organized a tour of several local monasteries following by a round-table discussion with a Pelinia priest about saints and martyrs, the role of religion in the lives of the younger generation and the churchs efforts to solve the HIV crisis. Small grant funds also helped the Pelinia Parent-Teacher Association launch a newspaper, entitled Access, which was distributed for free to villagers and dedicated to HIV prevention. It was the first-ever newspaper to be produced and circulated by a school in the district. The first edition covered the purpose of the HC4Y project and also chronicled the summer camp training experiences of Pelinia youth. Another issue focused on the role of family

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in educating young people about healthy choices and included interviews carried out by young people in the village. Students from the middle school and high school submitted poetry that appeared in an issue of the newspaper along with coverage of a roundtable conference on child-parent relationships held at the middle school for parents and students. One edition of the newspaper was dedicated to Valentines Day and explored themes of love and sexuality and featured poems and drawings about love produced by students. A newspaper released at Easter included articles and interviews with local priests. In Sloboda-Rascov, the Catholic priest merged HC4Y topics into the themes he discussed at Bible study classes for youth and children. The priest from Panasesti set aside a room, adjacent to the local church, where young people could discuss healthy choices and HIV prevention. In other communities, HC4Y small grant funds were used to organize public screenings of films related to HIV and AIDS, as well as concerts, plays, poetry and essay contests, art exhibits, flash mobs and peerto-peer education events.

Before the training, we didnt talk much about HIV in the family because people do not talk about it here. After the classes, we were coming home and telling our families that this is a huge problem and they even found out new things from us. We were able to talk more openly with our parents on various subjects, and we were finding out new things and were telling our parents all about them. It was easier for them as well to talk with us.

Victoria Stomati, 18, Rascov

Even if our parents knew about certain things, there were subjects they were embarrassed to talk to us about. Here, we found out about things our parents failed to tell us.

Iana Conoplitcaia, 18, Rascov

I found out a lot and when I went home I shared this information with my parents. They supported my decision to talk about this problem that concerns all people. After the project my relationship with my parents changed due to the fact that before the training I was taking all of our conflicts too seriously, but afterwards I understood that a relationship with your parents is very important and every conflict can be resolved easily.

Maxim Fedoruc, 16, Rascov

Elena Babalau, 16, Pelinia

My parents are happy that I have participated in this project and that I know how to protect myself from risk.

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Anastasia Tcaci, 18, Rascov

REduciNg STigMA
galina spac first encountered a person living with HIV when she was 18 years old, working at a mental institution. She remembers feeling frightened after being warned not to go near the young boy, who was confined to a cell. Her fear turned to confusion about why the boy was living in isolation when he exhibited no signs of mental health problems. She took pity on him and provided him with food from the canteen. Galina, now 33 and a Healthy Choices for Youth (HC4Y) trainer, wonders how life would have been different for the boy if projects like HC4Y had existed back then. Maybe he would have been able to live among people and would not have been locked away, she says. HC4Y activities raise awareness while debunking myths abut HIV and AIDS, encouraging participants to internalize and personalize the epidemic so that they begin to empathize with those affected. The program shatters the silence while reducing the stigma and discrimination associated with the disease. Prior to becoming a HC4Y trainer Nina Bandiu had some trepidation about meeting people infected with HIV. But as she became better informed about the virus, her fears vanished to the point that she is comfortable now inviting people living with HIV and AIDS over for dinner in her home. Ninas hope is that the HC4Y training has left a mark in the hearts of the participants and they will be more tolerant and empathetic about people living with HIV and AIDS. For many, it has done just that. People with AIDS are not a danger to society, says Iulia Prosianaia, 16, from Sloboda-Rascov. We have to support and help them. If they adopt a healthy lifestyle they can live a long life, says Cristina, 16, also from Sloboda-Rascov. It isnt as if HIV is transmitted through the air. We shouldnt be afraid. People with HIV are just like us, says Denis Serdiuc, a Rascov youth. Elena Babalau, a 16-year-old from Pelinia, says people infected with HIV/AIDS should not be isolated and they need to be included in society. They are a part of our society and should not be ignored. Before participating in the HC4Y project, Polina, a 36-year-old mother from SlobodaRascov, thought HIV and AIDS was a problem that only existed far away from her village. Now we know that it can happen to anyone and we do not need to fear them or avoid them. We need to support them. The training helped 28-year-old Nadejda, also from Sloboda-Rascov, appreciate the extent of the discrimination facing people infected with HIV and it touched my soul. Our opinions were wrong, admit Ana and Claudia, two mothers from Caterinovca. We used to think that our child should not go to the same kindergarten as an HIVpositive child or that an HIV-positive teacher should stop teaching in school. Now we are well informed and we know that HIV does not pose a danger to everybody. The HC4Y training challenged adults and youth to reflect on their personal attitudes toward HIV-positive people. They thought about how it would feel to be in that persons place and how others would treat them if they were infected. This deeply affected them, says Olga Crijanovscaia, deputy director of academic activity in Caterinovca.
all in the family iulia Prosianaia, 16, chatsYouth Nurturing Healthy Behaviors in about her hC4y experience while Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program 37 babysitting brother, Vadim in Sloboda-Rascov.

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healthy choices karaoke Girls Nurturing Healthy Behaviors in Youth in sloboda-rascov use equipment Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program 38 Catholic purchased through a hc4y small grant to entertain classmates.

Youth training participants are influencing their peers to make healthy choices by engaging in peer-to-peer and other small grant activities, as well as through informal conversations with friends about what they have learned in Nurturing Healthy Behaviors in Youth the trainings. 39
Catholic Relief Services Healthy Choices for Youth: HIV Prevention in Rural Moldova Program

Independent Midterm Evaluation, July 2010

Michael McKennett Head of Office Email: mmckennett@eme.crs.org Ludmila Ungureanu Program Manager Email: lungureanu@eme.crs.org

Writing and Graphic Design Alanna Jorde Cover Design Angela Robak

Catholic Relief Services staff members in Moldova include standing (left to right) Igor Fetiniuc, Svetlana Cires, Daniela Cuzicov, Adrian Catan, Violeta Cernei and Michael Mckennett and seated (left to right) Angela Alexeiciuc, Ludmila Ungureanu and Mariana Romanciuc.

CRS Moldova Headquarters 106 Columna Street, 2nd Floor Chisinau, MD-2012 Republic of Moldova Tel. +373-22-226065 Fax +373-22-229542 Website: www.crs.org/moldova

CRS programs improve the lives of over 130 million people in more than 100 countries. In emergency response, agriculture, education, food security, health, HIV and AIDS, microfinance, peacebuilding, water/sanitation and policy change the scope of our work is global, with large-scale results.