An Innovative Approach Addresses Multiple Concurrent Partnerships
C-Change is providing technical assistance to Lesotho National AIDS Commission (NAC) and local partners to support a “community dialogue program” to address the issue of multiple concurrent partnerships (MCP).
MCP is the main behavior fueling the spread of HIV in Lesotho. C-Change has developed a program, Relationships: Intimacy Without Risk, that includes a facilitator's guide and training manual and materials that local Sesotho facilitators use to carry out discussion sessions that aim to stimulate deeper dialogue around relationship issues and HIV prevention. Additional tools that C-Change is introducing to this program include videos for group discussion and movie nights and games for couples.
The Community Dialogue program is the first of its kind in Lesotho. During the series of conversations with groups of adults, participants reflect on how they can improve their relationships and sexual lives without taking on extra lovers. The sessions are spread over 11 weeks. It is important to include the 11 weeks of time to allow people to think about what they are learning and to go through a process of change in their values, attitudes, and behavior. The conversations help to mobilize and engage communities in conversations that encourage and empower them to address their own concerns with the practice of MCP.
C-Change has been working in Lesotho to strengthen prevention communication skills and programs and develop national prevention communication strategies that address key drivers of the epidemic.
Lesotho Multiple Concurrent Partner Program
The UNAIDS Modes of Transmission Study (2008) showed explicitly that the key mode of sexual transmission of HIV in Lesotho relates to the widespread practice of multiple concurrent partnerships (MCP). The report noted that sexual relationships by both married and unmarried adults will contribute to 65 percent of all new infections in Lesotho in the next 12 months.
To address this issue, C-Change developed a program that includes behavioral research, media awareness, and community mobilization. In February 2009, C-Change launched the Lesotho Multiple Concurrent Partner Program. It is designed to address the risks involved with MCP and other issues related to intergenerational relationships, transactional sex, and gender norms. The program is a partnership with CARE-Lesotho, Phela Communication and Health Institute, and national and local NGOs.
The program uses a combination of behavioral and social change communication interventions. An umbrella media effort organized under the regional OneLove campaign is working to increase awareness of the risks related to MCP among adults ages 18–50. It is also being used to spark public discussions around the risk of HIV infection related to MCP and the need for partner reduction. A community program features tools for groups to carry out community-level discussions. Training materials provide stories and exercises for groups to explore various issues related to relationships.
Research informs programming around MCP and HIV
C-Change partner Social Surveys designed and carried out qualitative research in 2008 that provided a clear picture of the 'silent' language of sexuality and MCP. The findings of the research report enhanced the understanding of the cultural context within which sexuality and MCP occur in Lesotho and helped inform the interventions that C-Change is currently carrying out.
C-Change also conducted research on the complex behavior patterns of MCP, beginning with a baseline study among Basotho men to measure the levels of concurrency and attitudes leading to concurrency. Information detailed in this research report provided critical guidance as the country expands efforts to address MCP and prevent HIV.