Andar Fora | Multiple and Concurrent Partnerships
MCP messages were integrated into the larger interpersonal communication strategy, using community debates, participatory theater, and mass media campaigns (radio, TV spots, print, billboards) to create dialogue on the impact and consequences of multiple and concurrent partners at the community level.
Community Debates: Community agents (CA) are trained to facilitate community debates on. CAs are community members who are identified by community leaders as being capable, credible, and appropriate to conduct these activities. Debates are carried out in groups of 15-20 adults asked to identify the sexual networks in their communities. The community agent uses a "typical couple” to elicit discussion on how many other partners this couple might have, which partners those other partners would have, and encourages open discussion. The community agent asks people to depict the sexual network by adding partners until everyone can see how just having more than one partner(s) can put everyone at risk of HIV infection through the resulting sexual network. CAs conduct 20 community debates per month.
Theatre: In Maputo, Gaza and Manica theatre groups conducted 40 plays per month in each province. Two community plays were developed to broach the topic of cross-generational sex and MCP between married couples. For the life of the project, theatre groups reached around 915,000 individuals.
Mass Media: Mass media activities are part of a national campaign led by CNCS. In 2009, PSI conducted qualitative research among men and women in Gaza Province to gain a better perspective of MCP and understand the context and drivers of concurrent sexual relationships. The findings from this research informs the campaign’s messages that aims to increase risk perception among men and to address social norms that support MCP.
- Demonstrate that having more than one partner exposes one to a large sexual network (increasing individual risk perception).
- Identify the social consequences and conflicts that result from MCP in the community.
- Generate discussions about gender norms that promote or mitigate MCP in the community.
- All activities are done in coordination with local leadership.
- CAs facilitate community debates but discussions happen between community members and solutions are borne out of their ideas and participation.
- Activities are evidence-based (pre-tested and based on qualitative and quantitative research conducted by PSI) conducted in Chibuto and Manjacaze Districts of Gaza Province, Mozambique, to better understand the factors which motivate men and women to engage or not engage in multiple and concurrent partnerships (MCP) and to identify the barriers that might prevent people from changing their behaviour and reducing the number of partners.
- Guidelines for activities are created centrally and later adapted to local contexts.
- Post-campaign intercept surveys in Maputo, Matola and Marracuene show high exposure to the TV spots (69-87%) and high recall of campaign slogan among those exposed (>90%)
- The network of more than 100 CAs reached close to 925,000 individuals in community debates since debut of MCP module.
- PSI used results of pre-testing to modify training before rolling out to all community agents of the other provinces of Mozambique. Pretest findings indicate that for many people involved in MCP, exiting secondary relationships is not an option (or is very difficult), at least in the short term. Although the primary goal of MCP communications is partner reduction, for some audiences promoting consistent condom use will be a more viable short-term risk-reduction strategy. A dual approach is needed for community-level behaviour change communications interventions
- MCP sessions using these new techniques are now being carried out in all provinces of the country
- Andar Forais working with USAID, PEPFAR, Johns Hopkins University and Mozambique partners FDC and N’weti (the local affiliate of Soul City) to develop a mass media TV, radio and print campaign that will extend similar behavior change messages around risk perceptions of MCP and HIV to more communities in Mozambique
- Mozambique’s epidemic is highly regionalized. The variance in HIV risk factors by region indicated a need for regionalized HIV prevention strategies.
- Research disaggregated the concepts of multiple partnerships (MP) and concurrent partnerships (CP), and found that levels of social acceptability varied significantly between MP and CP – particularly between men and women.
- Men and women have very different reasons for engaging in MCP, and those reasons need to be simultaneously addressed. To this effect, a new module was created to follow-on to the original community debates to address social norms that drive MCP including gender roles, general acceptance and encouragement of MCP and cross-generational sex by men
- Target community leaders (traditional, administrative, religious, political) to create dialogue about their role in condoning or mitigating MCP. As respected member of their community they can have a role in HIV prevention.
- Content of sessions needs to be tailored to the group’s level of education and context (rural vs. urban)
- Different target groups will identify different solutions appropriate to their context(condom use among miners, police, military and migrant groups for example). This needs to be respected by programmers.
- Some concepts do not translate to local language, and attempting to may lead to more confusion.
- Small, single-sex group discussions facilitate openness
- Adolescents (ages 13-17)