ROCíO RUBí RONCAL ROJAS

Peru,

Rocío Roncal is drawing on a large network of public and private institutions from around Peru to establish localized, one-stop service centers providing AIDS education, treatment, and prevention assistance to one of the country's most high-risk groups: young people.

This profile below was prepared when Rocío Rubí Roncal Rojas was elected to the Ashoka Fellowship in 2003.

INTRODUCTION

Rocío Roncal is drawing on a large network of public and private institutions from around Peru to establish localized, one-stop service centers providing AIDS education, treatment, and prevention assistance to one of the country's most high-risk groups: young people.




THE NEW IDEA

Rocío is harnessing expertise from HIV- and AIDS-focused institutions to target the needs of Peru's at-risk youth. Rocio's new model for service delivery brings together individual resources borrowed from other organizations, some of which have fallen dormant over time, and offers them as a complete package to young people through a series of multifunctional service centers. These complexes form a localized "city" of HIV and AIDS service providers–unparalleled in Peru and most of the Andean region–providing complete access to testing, condoms, counseling, emergency telephone hotlines, support groups, prevention information, medical care, and legal assistance. In addition to addressing the most pressing issues surrounding the growing AIDS epidemic in Peru, Rocío's program is leading a new movement toward greater responsibility among youth, including understanding lifestyle risks and exercising sexual and reproductive rights, thereby tackling the behaviors that make adolescents a particularly high-risk group.




THE PROBLEM

AIDS is on the rise in Peru. According to UNAIDS and the Peruvian Ministries of Health and Women and Children, there were 76,000 reported cases of HIV in Peru as of 2000, although the real figure, including unreported and undiagnosed cases of infection, is likely five or six times higher. Young people have been particularly hard hit by the epidemic: of the cases on file 35 percent were contracted by people between the ages of 10 and 19. As the fastest-growing segment of the population in the country, adolescents engage in sexual behavior that puts them at high risk for contracting HIV. On average, Peruvians first become sexually active between the ages of 13 and 17, and evidence like high rates of teen pregnancy suggest that condom use is not common.

Yet despite their status as a high-risk group, there has not been a coordinated effort to provide the services, information, and resources they need to overcome the growing threat. Adolescents are among the least informed populations affected by the AIDS crisis; parents tend not to educate their children about safer sex because they fear encouraging their children to engage in sexual behavior. For those who already have HIV/AIDS, prejudicial treatment is not unusual. Although Peru's AIDS Law guarantees confidential testing, many Peruvian schools expel students who test positive. Furthermore, few doctors will treat teenage HIV/AIDS patients, with even fewer able to offer treatment specific to a young person's needs.




THE STRATEGY

The core of Rocío's strategy is the creation of centers that pull together a variety of resources from unique institutions to offer them to young people in a single, accessible space. Rocío's Ciudad Vida SIDA ("City for Life with AIDS") incorporates much of the now-defunct Peruvian AIDS Network with other government agencies, organizations, and businesses offering services to youth, HIV-positive people, and other at-risk groups. With these numerous partners, the centers can provide comprehensive services to address the most pressing issues surrounding AIDS like prevention information, condoms, testing, counseling and support groups, medical care, and legal assistance. Because Discosida–an initiative Rocío previously launched to inform teenagers about safer sex and reproductive rights through a nightclub setting–is a core member of this collaboration, the centers have a strong focus on creating greater responsibility among youth, addressing the roots of their high-risk behavior.

Attracting and ensuring collaboration between varied groups is key to providing these comprehensive services; to that end Rocío initiated Ciudad Vida SIDA on a small scale to demonstrate its viability to potential partners. After performing an exhaustive search of the key representatives from public health, education, city councils, local media, and citizen organizations that included visiting each site to evaluate potential contribution to her project and receptiveness to the concept, Rocío opened the first center within Villa El Salvador (located in Lima's marginal Southern Cone region) in 2002. Eighty percent of the participating institutions attended the pilot center's opening and immediately began planning for follow-up group activities, including World AIDS Day events. This successful engagement has shown that these very different groups–including teachers, medical doctors, transsexuals, and parents of HIV-positive young people–can sustain the kind of involvement necessary for the centers to operate on a long-term basis.

The first center's success sparked an impetus for two more pilot centers, which Rocío anticipates will take three years to get up and running in Lima's Southern Cone. From there, she plans to extend the model to Lima's other areas, and she intends to advocate for the state government to incorporate her Ciudad Vida SIDA model into its public policy and eventually spread it nationally and abroad. Accordingly, she has already begun collaborating with the National Ministries of Education, Health, and Women and Children. Rocío also sees the Peruvian AIDS Network as a valuable partner in advocating for the expansion of her model. Although it is currently inactive, it still has the credibility to persuade the state and national governments to adopt her model.




THE PERSON

Since childhood, Rocío has been oriented toward social issues. She dreamed of becoming a doctor, and while in school, did a great deal of volunteer tutoring and teaching. Her father, an accountant, and her mother, a teacher, encouraged her to embody the values of both a doctor and an educator as best she could, while still developing her own entrepreneurial spirit.

After her early education in a Catholic School, where sex was treated with absolute silence, Rocío went on to study obstetrics in college. While traveling to rural health posts, she began seeing the gaps in training and adequate information. These observations sparked her interest in health-related education and led to her work with traditional midwives and building awareness about breast and cervical cancer in these communities. After graduating in 1991, she worked at a health center in one of the poorest districts of Lima's Southern Cone, at which time she had her first contact with AIDS.

In 1994 Rocío moved away from medical practice to further pursue her interest in health education and began working for an organization that allowed her the freedom to design and promote her Discosida project, an AIDS education program organized around the youth nightclub culture. Discosida's success inspired Rocío to create something larger with an impact that would go beyond prevention to change both the behavior of young people and the institutions that provide them with services. She has been developing the concept for Ciudad Vida SIDA since November 2001.




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