Lesotho

Innovative Approach Uses Community Dialogue to Reduce MCP

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 Relationship and Risk training manual to stimulate deeper dialogue and discussion. Additional tools that C-Change is introducing to this program include videos for group discussion and movie nights and games for couples.

Called “Relationships: Intimacy Without Risk,” and the first of its kind in Lesotho, this program provides for a series of conversations among groups of adults. During the conversations, 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 weekes 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 to develop national prevention communication strategies to 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% of all new infections in Lesotho in the next 12 months.

To address this issue, C-Change has developed a program that includes behavioral research, media awareness and community mobilization. In February 2009, C-Change launched the Lesotho Multiple Concurrent Partner Program. The program 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 18-50 and to spark public discussions around the risk of HIV infection related to multiple relationships 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. 

In addition, C-Change partner Social Surveys designed and carried out qualitative research that provided a clear picture of the 'silent' language of sexuality and MCP. The research report  on the findings 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 in Lesotho.

C-Change also conducted research in Lesotho 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 from the study and detailed in the research report provided critical guidance as the country expands efforts to address the MCP ssue.