Prevention of HIV
Behaviour Change Communication

Behaviour change communication remains an important and strategic input into the process of reducing the number of new HIV infections globally. The focus of BCC interventions has been the development of the necessary strategies and capacities to enable fully fledged programme implementation in subsequent years to address major gaps in this area in the country. The strategies developed are presented below.

Multimedia campaign on reduction of multiple concurrent sexual partnerships

One of the key drivers of the HIV epidemic in the country is having multiple concurrent sexual partnerships (MCP) by both men and women. A communication strategy to guide BCC interventions for the reduction of multiple concurrent partnerships was developed under the technical leadership of PSI and ACHAP with MOH and NACA as active members of the technical working group that developed the strategy. The national MCP campaign, branded “O icheke”-(meaning watch yourself) was launched in March 2009 and IEC materials to support this campaign were developed.

Two priority target populations were identified as the focus of generalized media and community mobilization activities, based on the prevalence of MCP in these population segments and their susceptibility to behaviour change interventions. The first priority target population is young women aged 18-24 years who engage in MCP with wealthier, usually older, men to satisfy a range of material needs and wants, or advancement in education and employment.

The second priority target group is men aged 25-34 years having affairs with women other than their primary partners for sexual variety. There is widespread, often tacit, acceptance that men need more than one woman to satisfy them sexually, with myths such as ‘mistresses/concubines strengthen relationships’ and ‘man cannot live on bread alone’ supporting this norm. These relationships often have a compensatory function, providing benefits that are lacking in a main partnership or relief from stress or boredom.

A third key focus of the campaign, particularly in media commentary and community debate will be the phenomenon of older men having sex with young girls, particularly in rural areas. The two populations engaged in this type of cross-generational sex are distinct from 18-24 year old women engaged in MCP for personal or material gain and men 25-34 engaged in MCP for sexual variety in two key respects: firstly, there are much larger differences in age and wealth between the girls and men; and secondly the girls are too young and/or poor to enter into these partnerships of their own volition and feel pressured to do so by the older men involved.

Development of a communication strategy on male circumcision

In 2008, ACHAP supported the Ministry of Health to develop a short term communication strategy on safe male circumcision to provide information to the general public on this new HIV prevention strategy. This was done to allow the Ministry of Health and its partners to communicate well structured messages and create general awareness on this intervention while preparations were being made for a KAP (knowledge, attitudes and practices) study that would provide the necessary inputs to the development of a broader and longer term communication strategy for behaviour change. With financial support from ACHAP, the Ministry of Health working together with PSI/B used the strategy to produce 85,000 English and 50,000 Setswana client brochures on male circumcision. As part of the overall support for the scale up of safe male circumcision in the country, ACHAP, on request from the Ministry of Health has recruited a public health specialist to support the ministry in the coordination of this new intervention.