Community dialogues as a method to discuss and reduce multiple concurrent partnerships in Lesotho: executive summary

Abstract

HIV prevalence among adults ages 15-9 in Lesotho was estimated at 23.2 percent in 2008, the third highest in the world. That year, an estimated 270,000 people were living with HIV in the country, and 60 died each day from AIDS complications. The practice of concurrent sexual partnerships or 'concurrency' (UNAIDS 2009) is considered to be linked to between 32 percent and 59 percent of all new HIV infections in the country (Khobotlo, Tshehlo, Nkonyana et al. 2009). Findings from a 2009 survey of 1,600 men in Lesotho by the Communication for Change (C-Change) project suggested that high levels of HIV and AIDS awareness do not necessarily affect concurrency and other sexual behaviors (Tan et al. 2009). Among the men surveyed, 45 percent reported having more than one sexual partner at a time and only 13 percent reported using condoms with their regular partners. C-Change supported the collaboration of the National AIDS Commission and the Ministry of Health and Social Welfare to reduce the prevalence of concurrency through a series of social and behavior change communication (SBCC) initiatives. OneLove, a regional campaign of the Soul City Institute for Health & Development Communication that addressed concurrency, was implemented in Lesotho from 2009 to 2011, in partnership with Phela Health and Development Communications. C-Change supplemented the OneLove campaign's booklets, flyers, radio PSAs, radio drama, short films, and posters with a radio talk show, billboards, and additional pamphlets and radio PSAs. C-Change launched a community-based, outreach program in Lesotho in January 2009. It focused on promoting open dialogue about HIV and concurrency, while educating and mobilizing communities to effectively implement further interventions to lower concurrency prevalence. The community dialogue program, Relationship: Intimacy Without Risk (C-Change 2010), was adapted, facilitated, and managed by Phela, and the dialogues were co-branded by C-Change and OneLove. Between mid-2009 and September 2010, dialogues were conducted in five districts: Maseru, Leribe, Butha-Buthe, Mafeteng, and Mokhotlong.