Implementing Multiple Gender Strategies to Improve HIV and ... - ICRW

STEPPING STONES—ADAPTED FOR SOUTH AFRICAN YOUTH
LEAD ORGANIZATIONS:
COUNTRY:
HIV PROGRAM AREA:
Medical Research Council (MRC), South Africa
South Africa
Prevention
OVERVIEW:
Stepping Stones is an HIV prevention training package that was first implemented in Uganda and
recently replicated and tested in South Africa by the MRC. The training uses participatory learning
activities to cultivate healthier intimate relationships and behavior change that ultimately will help
improve sexual health and reduce HIV incidence. The 13-session curriculum covers topics such as
relationship skills, communication, contraception, motivations for sexual behavior, risk-taking, dealing
with grief and loss, and preparing for the future. Impact assessment evaluations of the South Africa
program show that it did not reduce the incidence of HIV, though it is associated with a reduction in
herpes simplex virus-2 (HSV-2) incidence. Results also show that the South Africa program
significantly reduced male-reported intimate partner violence, transactional sex, and problem drinking.
Lessons learned include the importance of matching the facilitator to participants by age and sex to
encourage open and honest communication, and the need to allow sufficient time to train and support
local staff and fieldworkers.
BACKGROUND
HIV & AIDS
Program Goals
Stepping Stones seeks to decrease gender-based violence, improve sexual
health and decrease the incidence of HIV infection by establishing and
strengthening gender-equitable relationships.
Gender Strategies
Addressed
Reducing violence and coercion
Addressing male norms and behaviors
Increasing women’s legal protection
Increasing women’s access to income and productive resources
Other: gender equity
Description of
Intervention
Stepping Stones (Welbourn, 1995) is an HIV prevention program that aims
to improve sexual health by building stronger, more gender-equitable
relationships that foster better communication between partners. It uses an
HIV prevention training package that employs participatory learning
activities to increase knowledge about sexual health and risk-taking,
improve communication skills, and facilitate self-reflection on sexual
behavior. It was originally developed in 1995 for use in Uganda and was
adapted by MRC for South African youth in 1998.
In the South Africa adaptation of the program, the training addresses how
to discuss HIV, sex and other issues in the local language and in the local
context. Participants, recruited from schools, are divided into single-sex
groups and attend 13 three-hour sessions over the course of a few weeks.
Facilitators are the same sex as the participants and are only slightly older.
The curriculum covers a wide range of topics:
1. Listening and communication
2. How we act and what shapes it
3. Sex and love
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