Using Male Peers to do Community Outreach and Deliver One-on-One Counseling Sessions for Risk Reduction

Category 1

Pathfinder's Expansion of Psychosocial and Peer Counseling Services Program has worked in Botswana to promote well being among HIV-positive antenatal women, new mothers, and people living with HIV/AIDS. It was initiated to address the many challenges associated with the Prevention of Mother-to-Child Transmission of HIV/AIDS (PMTCT), including cultural beliefs that hinder safe infant feeding, inadequate male involvement and participation, baby testing, and the disclosure of one's HIV status.

In September of 2006, Pathfinder added on a male peer counseling component to the existing PMTCT program. The add-on project was entitled "Male Involvement Activity" and trained male peers to reach other men in communities and popular places such as mines, clubs, schools and drinking places. Pathfinder trained the NGOs involved in the project, improving capacity in monitoring and evaluation, strategic planning, and financial management.

Goal of the Practice
  • Increase interventions targeted at men, including work to reduce the risk of sexually transmitted infections among Botswana men and their partners.
  • Increase Men's positive and gender equitable attitudes and behaviors towards HIV prevention at family and community levels.
  • Improve capacity for implementing partners.
Core Components
  • Male Involvement project -- this activity works with male peers who reach their male counterparts at individual and group level within clinics, at their homes, workplaces and other places where they congregate.
Noteworthy Results
  • Multiple Concurrent Partnerships - while 80.6% of men had partners during pre intervention only 77.5 of them reported the same post intervention, while 33.8% of them reported to have other partners pre intervention only 23.4% of them reported same post intervention and while pre intervention 39.3% had casual sex , 27.7% reported the same post intervention.
  • Transactional Sex -- 17.6% of men reported to be engaged in transactional sex pre intervention and only 8.9% reported the same post intervention.
  • Alcohol and Substance Abuse -- Alcohol abuse came done from 68% to 64.5% post intervention.
  • Gender-Related Issues -- While 79.8% reported to negotiate sex in marriage pre intervention 87.9 % reported the same post intervention.
  • Sexual Violence -- 70.4% view sexual harassment as unacceptable pre intervention and 83.8% reported same post intervention.
Lessons Learned
  • Involvement of key stakeholders and community leaders facilitates program implementation and improves outcomes.
  • New concepts (e.g., gender awareness, multiple partnerships) take a long time to introduce and gain acceptance.
  • Peer mother and male components should be linked to promote prevention and gender equity i.e. should not be implemented parallel to each other.
  • Male peers were more effective in locations where their services were well-linked to clinics and the peers had support of health care workers at the clinic.
Focus Areas
Implemented By
Pathfinder International
Participating Organization
  • Botswana Council of Churches
  • True Men
  • Humana People to People
Target Population
  • Adults (over 18)
  • Males
5000 - 10000
Implementation Years
09/2006 - 09/2009