HIV Prevention Knowledge Base
Behavioral Interventions: Partner Reduction
Reassessing HIV Prevention
This paper provides an overview of current prevention interventions, their effectiveness, and recommendations on how interventions should be redirected to increase their impact in the sub-Saharan African hyper-epidemic countries. Programs that demonstrated weaker evidence for effectiveness at the population level included condom use, HIV testing, sexually transmitted infection treatment, vaccines and microbicides, and abstinence. Programs that have achieved promising results are male circumcision and reducing multiple sexual partnerships. The authors argue that funding priorities should be reassessed, in light of what is known about their potential for impact.
Transforming Male Gender Roles to Combat Cross-Generational Sex, ‘Be a Man’ Campaign
The ‘Be a Man’ campaign is one component of the Young Empowered and Healthy (Y.E.A.H) initiative that is being implemented in Uganda to address cross-generational sex. The campaign was initiated in 2006 to challenge traditional male norms, attitudes, and behaviors. Objectives of the campaign included improving gender equtable beliefs and attitudes, and redefining what a “respectable” African male is in modern day society.
The campaign used a combination of television, radio, small media, and community channels. A qualitative evaluation was conducted in 2007. It found that the target group favored responsible men who did not have multiple partners, drink or use violence against women. However, respondents also identified certain circumstances when a man was justified in not performing these behaviors.
Couple-to-Couple Influence in HIV Prevention: The UPHOLD-TUKO Network Experience in Uganda
This presentation describes the experiences and lessons learned of the UPHOLD-TUKO Network in Uganda. The Tuko Club is a civil society organization of married couples that promotes mutual faithfulness among couples. The 2004 Uganda National HIV/AIDS Sero-Behavioral Survey found that the overwhelming majority of high-risk behavior occurs with spouses and that almost half of new infections arise from sex with one’s spouse. Married couples are trained as trainers. The definition of “marriage” is broad-based (e.g., religiously married, cohabiting, traditional) to ensure inclusivity of all couples. Standardized messages are supported through the use of training materials with consistent content that are translated into the local languages.
Listen to the Bell: HIV/AIDS Prevention Through Zero Grazing
The Sikia Kengele (“Listen to the Bell”) campaign uses community opinion leaders known as “Bell Ringers” to initiate talks on the risks of multiple partners and the benefits of knowing one’s HIV status. The campaign is conducted in high-risk areas of Tanzania such as major transportation corridors, mining communities, and plantations. The Bell Ringers initiate discussions in bars, stadiums, churches, mosques, farms, and bus stations, and they prepare “Giant Bell” road shows in which a high profile team of influential individuals and educators (and large bell) travel to communities, using music, dance, dramas, and cinema to encourage people to reduce the number of sexual partners.
Evaluation of the African Youth Alliance Program in Ghana, Tanzania, and Uganda: Impact on Sexual and Reproductive Health Behavior among Young People (Summary Report)
The African Youth Alliance (AYA) Program, implemented in Ghana, Tanzania, and Uganda, uses peer educators to encourage counseling and testing for HIV and sexually transmitted infections. A 2005 evaluation of the program found that it had a significant impact on condom use, partner reduction, and several knowledge measures. The impact of the AYA program was greater for females than males. For example, partner reduction was demonstrated in both males and females in all three countries but it was statistically significant only in females in Ghana and Tanzania.
Proven HIV Prevention Strategies
This fact sheet reviews effective strategies to prevent all three routes of HIV transmission: sexual, blood-borne, and mother-to-child. The interventions are listed by route of transmission. Although effective interventions have been identified over the past two decades, access to these interventions is low. Researchers with UNAIDS and the World Health Organization estimate that increased program access could avert half of the 62 million new HIV infections that are expected to occur between 2005 and 2015.
Trusted Partner Campaign
PSI’s “Trusted Partner” mass media project was launched after a research team found that youth often use ineffective criteria to evaluate their personal risk of HIV within trusted relationships. Trusted Partner uses a variety of media messages to counter myths about HIV and to promote fidelity, awareness of the risks of mixing alcohol and sex, and HIV testing. One poster produced by the project provides a visual reminder that even healthy-looking people can have HIV. Trained field officers encourage community leadership and peer education in drinking establishments, while creating forums to address partner reduction and risky drinking. The program has been reproduced at low cost in 11 countries in east and southern Africa.
Men as Partners (MAP) Project
Men as Partners (MAP) focuses on gender equity which includes gender based violence and behaviors that make both men and women vulnerable to HIV infection. The program is implemented through workshops with men, and through local and national public education campaigns that use a variety of channels to reach men. MAP challenges stereotypes that equate manliness with risky behaviors, such as violence, alcohol use, pursuit of multiple sexual partners, and domination over women. The program takes a positive approach toward male involvement and the sessions are respectful, open-minded, and address the needs of the men in the community. The project is active in over 15 countries.
Current Thinking About Behavior Change and Prevention of Sexual Transmission of HIV
This PowerPoint presentation outlines how HIV epidemics are more heterogeneous than initially thought. Concurrent sexual relationships in southern Africa are cited as an important factor with half of all transmissions occurring during the first five months of infection. The “lethal cocktail” of concurrent sexual relationships and low circumcision rates are said to increase transmission up to 30-fold, and may be a factor explaining the hyper-epidemic in southern Africa. The effects of protective strategies are reviewed for concentrated and generalized epidemics, and male responsibility for reducing transmission is emphasized.